Gender discrimination, educational attainment, and illicit drug use among U.S. women

  • Hannah Carliner
  • Aaron L. Sarvet
  • Allegra R. Gordon
  • Deborah S. Hasin
Original Paper



While gender inequality has been a topic of concern for decades, little is known about the relationship between gender discrimination and illicit drug use. Further, whether this association varies by education level is unknown.


Among 19,209 women participants in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (2004–2005), we used logistic regression to test the association between gender discrimination (measured with four items from the Experiences of Discrimination instrument) and three outcomes: past-year illicit drug use, frequent drug use, and drug use disorders. We then tested whether associations differed by education level.


Gender discrimination was reported by 9% of women and was associated with past-year drug use [adjusted odds ratio (aOR) = 2.67; 95% confidence interval (CI) 2.17–3.29], frequent drug use (aOR = 2.82; CI 1.99–4.00), and past-year drug use disorders (aOR = 3.15; CI 2.16–4.61). All specific domains of gender discrimination (on the job, in public, with institutions, being called a sexist name) were associated with all drug use outcomes. The association between gender discrimination and past-year drug use was stronger among women with less than a high school education (aOR = 6.33; CI 3.38–11.85) compared to those with more education (aOR = 2.45; CI 1.97–3.04; p interaction < 0.01).


Gender discrimination is consistently and strongly associated with illicit drug use and drug use disorders among U.S. women, with significantly higher odds for drug use among women with less than a high school education. Future research should examine whether explicitly addressing distress from discrimination could benefit women in drug treatment, especially among clients with lower educational attainment.


Sex discrimination Gender Drug use disorders Psychological stress Educational status 



The National Epidemiologic Survey on Alcohol and Related Conditions was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) with supplemental support from the National Institute on Drug Abuse (NIDA). This study was supported in part by NIDA Grant #T32DA031099 (HC; PI: DSH), New York State Psychiatric Institute, and the Columbia University Mailman School of Public Health Department of Epidemiology (DSH).

Compliance with ethical standards

Ethical standards

Informed consent was obtained for participation and study procedures were approved by the U.S. Office of Management and Budget. Human subjects research approval for the NESARC study was granted by the U.S. Census Bureau and the U.S. Office of Management and Budget.

Conflict of interest

The authors declare that they have no conflict of interest.


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© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  1. 1.Department of EpidemiologyColumbia UniversityNew YorkUSA
  2. 2.New York State Psychiatric InstituteNew YorkUSA
  3. 3.Division of Adolescent and Young Adult MedicineBoston Children’s HospitalBostonUSA
  4. 4.Department of PsychiatryCollege of Physicians and Surgeons, Columbia UniversityNew YorkUSA

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