Background: Substance use continues to increase in the United States. Substance use has been linked to new onset cardiovascular and cerebrovascular disorders which lead to hospitalizations. We aimed to assess the association of epidemiology and racial disparities of substance use disorders (SUDs) using the National Inpatient Sample (NIS) Database.

Methods: A retrospective study of the NIS database (2016-2017) using the ICD-10-CM codes was performed. Hospitalizations with secondary diagnosis of SUDs – alcohol related disorder, amphetamine dependence, cannabis related disorders, cocaine related disorders, hallucinogen related disorders, inhalant related disorders, opioid related disorders, nicotine dependence were identified. Weighted univariate analysis was performed using chi-square test to evaluate SUDs epidemiology amongst the US population.

Results: We found 58,259,589 hospitalizations, out of which 21.42% had substance use disorders (SUDs). Alcohol related disorder (42.61%), amphetamine dependence (76.17%), cannabis related disorder (75.17%), cocaine related disorders (57.87%), hallucinogen related disorder (82.91%), inhalant related disorders (67.25%), opioid related disorders (52.86%), nicotine dependence (35.72%) was higher in age group 18-50 years comparison in no SUD (31.83%) (p< 0.0001). Amphetamine (70.81%) and opioid (77.09%) abuse prevalence were higher amongst Caucasian in comparison to no SUD (74.30%) (p< 0.0001). Cannabis (32.24%), cocaine (48.64%), and hallucinogen (43.50%) abuse prevalence was higher in African American comparison in no SUD (17.27%) (p< 0.0001). Amphetamine (14.96%) and hallucinogen (16.49%) were more prevalent in Hispanics compared with no SUD (12.11%) (p< 0.0001). Alcohol (34.77%), amphetamine (39.52%), cannabis (42.33%), cocaine (52.87%), hallucinogen (46.09%),, inhalant (40.68%), opioid (35.33%), nicotine (38.80%) abuse was more prevalent amongst median household income (0-25th percentile) in comparison to no SUD (29.12%) (p< 0.0001).

Conclusions: In the nationwide representation, we identified racial burden of amphetamine and cannabis being the most commonly abused substance. Early identification and risk mitigation are essential to reduce the burden of SUDs.