Substance use patterns in a community sample of adult women in the United States: Alcohol, Cannabis, and other drug use.

Greenfield S.; Bailey A.; Seidman L.; Sugarman D.; Javaras K.; Payne L.; Votaw V.; Barbaro N.; McHugh R. · Addictive behaviors reports · 2026

**Background & Methods** This cross-sectional survey study examined substance use patterns among adult women (ages 18-70) in the United States who reported use in the prior 30 days. Researchers conducted an online survey from July to September 2024 with 2,296 community-dwelling women, using latent class analysis to identify patterns of alcohol, cannabis, other drugs, and prescription medication misuse across different age cohorts. **Key Findings** • Heavy substance use was common in this population, with approximately 18% reporting heavy alcohol use (≥16 days/month) and 22% reporting heavy cannabis use (≥16 days/month). Heavy alcohol and prescription medication misuse increased with older age cohorts, while heavy cannabis use decreased with advancing age. • Latent class analysis identified four distinct substance use patterns: (1) alcohol use with some cannabis (57% of sample), (2) heavy cannabis with some alcohol (27%), (3) polysubstance use (10%), and (4) prescription medication misuse with some alcohol (6%). • More than half of adult women reporting recent substance use engaged in polysubstance use, with patterns varying significantly by age cohort and life stage, suggesting the need for age-tailored intervention approaches. **Dosage & Administration** Not reported. **Safety & Adverse Effects** Not reported. **Evidence Quality** This study provides descriptive epidemiological data on substance use patterns but has notable limitations. As a cross-sectional survey of self-reported substance use from a single three-month period, it cannot establish causality or temporal relationships. The online survey methodology may introduce selection bias, potentially overrepresenting women with internet access or those more willing to disclose substance use. The study is limited to community women reporting recent use, excluding those with no recent use or untreated substance use disorders, which may not represent the full spectrum of women's substance use. While latent class analysis provides useful pattern identification, the findings are descriptive rather than explanatory. The evidence represents moderate-quality epidemiological research appropriate for hypothesis generation and informing public health planning but requires validation through prospective studies and diverse sampling methods.

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