Trends in substance abuse preceding stroke among young adults: A population-based study

Felipe De Los Ríos, Dawn O. Kleindorfer, Jane Khoury, Joseph P. Broderick, Charles J. Moomaw, Opeolu Adeoye, Matthew L. Flaherty, Pooja Khatri, Daniel Woo, Kathleen Alwell, Jane Eilerman, Simona Ferioli, Brett M. Kissela

Research output: Contribution to journalReview articlepeer-review

88 Scopus citations


Background and Purpose: Approximately 5% of strokes occur in adults aged 18 to 44 years. Substance abuse is a prevalent risk factor for stroke in young adults. We sought to identify trends in substance abuse detection among stroke patients. Methods: Using a population-based design, we sought to identify all patients aged 18 to 54 years experiencing a stroke (ischemic or hemorrhagic) in the Greater Cincinnati and Northern Kentucky Study region during 1993 to 1994, 1999, and 2005. Demographic and clinical characteristics and substance use data were obtained retrospectively from chart review and adjudicated by physicians. Results: The number of young patients identified with a stroke increased from 1993 to 1994 (297) to 2005 (501). Blacks (61% vs 51%; P<0.02) and men (61% vs 47%; P<0.002) reported substance abuse (current smoking, alcohol, or illegal drug use) more frequently than did whites and women. Overall use of substances increased across study periods, 45% in 1993 versus 62% in 2005 (P=0.003). The trend was significant for illegal drug use (3.8% in 1993 vs 19.8% in 2005) and ever smoking (49% in 1993 vs 66% in 2005). Documentation of both cocaine and marijuana use increased over time. In 2005, half of young adults with a stroke were current smokers, and 1 in 5 abused illegal drugs. Conclusions: Substance abuse is common in young adults experiencing a stroke. The observed increase in substance abuse is contributing to the increased incidence of stroke in young adults. Patients aged younger than 55 years who experience a stroke should be routinely screened and counseled regarding substance abuse.

Original languageEnglish
Pages (from-to)3179-3183
Number of pages5
Issue number12
StatePublished - Dec 2012


  • Acute stroke
  • Alcohol
  • Cocaine
  • Epidemiology
  • Marijuana
  • Smoking
  • Stroke
  • Substance abuse
  • Young adults


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