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Associations between sexual orientation discrimination and substance use disorders: differences by age in US adults.
Soc Psychiatry Psychiatr Epidemiol. 2020 Jan; 55(1):101-110.SP

Abstract

PURPOSE

Sexual minorities are at heightened risk for substance use disorders (SUDs). Discrimination based on sexual orientation may be an important factor in this increased risk, but differences across age have not been systematically examined. We examined age-varying associations of sexual orientation discrimination with alcohol use disorder (AUD), tobacco use disorder (TUD), and drug use disorder (DUD).

METHODS

We used data from US participants aged 18-50 years who reported non-heterosexual identity, attraction, or behavior (N = 2375) in a nationally representative survey. We examined the prevalence of sexual orientation discrimination across age and its salience as a risk factor for AUD, TUD, and DUD for gay/lesbian, bisexual, and heterosexual identifying individuals using time-varying effect modeling.

RESULTS

Sexual orientation discrimination was most prevalent in early young adulthood but was positively associated with greater odds of AUD, TUD, and DUD only at later ages. We found statistically significant associations at ages 24.5-40.0 for AUD, ages 32.5-42.9 for DUD, and ages 39.3-43.2 for TUD. For example, discrimination at age 30 was associated with 2.1 times greater odds of AUD (95% CI 1.3, 3.3) compared to those who reported no discrimination at that age. Discrimination at age 35 was associated with 2.8 times greater odds of DUD (95% CI 1.2, 6.6) relative to no discrimination.

CONCLUSIONS

Sexual orientation discrimination is significantly associated with SUDs and risk varies across age. Thus, age should be considered in the development of prevention and treatment of AUD, TUD, and DUD, particularly for sexual minorities.

Authors+Show Affiliations

Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI, 48109, USA. bjevans@umich.edu.Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI, 48109, USA.Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI, 48109, USA. Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, USA.Department of Psychiatry, School of Nursing, Columbia University, New York, NY, USA.Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 N. Ingalls St., Ann Arbor, MI, 48109, USA. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30903234

Citation

Evans-Polce, Rebecca J., et al. "Associations Between Sexual Orientation Discrimination and Substance Use Disorders: Differences By Age in US Adults." Social Psychiatry and Psychiatric Epidemiology, vol. 55, no. 1, 2020, pp. 101-110.
Evans-Polce RJ, Veliz PT, Boyd CJ, et al. Associations between sexual orientation discrimination and substance use disorders: differences by age in US adults. Soc Psychiatry Psychiatr Epidemiol. 2020;55(1):101-110.
Evans-Polce, R. J., Veliz, P. T., Boyd, C. J., Hughes, T. L., & McCabe, S. E. (2020). Associations between sexual orientation discrimination and substance use disorders: differences by age in US adults. Social Psychiatry and Psychiatric Epidemiology, 55(1), 101-110. https://doi.org/10.1007/s00127-019-01694-x
Evans-Polce RJ, et al. Associations Between Sexual Orientation Discrimination and Substance Use Disorders: Differences By Age in US Adults. Soc Psychiatry Psychiatr Epidemiol. 2020;55(1):101-110. PubMed PMID: 30903234.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations between sexual orientation discrimination and substance use disorders: differences by age in US adults. AU - Evans-Polce,Rebecca J, AU - Veliz,Phillip T, AU - Boyd,Carol J, AU - Hughes,Tonda L, AU - McCabe,Sean Esteban, Y1 - 2019/03/22/ PY - 2018/12/05/received PY - 2019/03/09/accepted PY - 2019/3/25/pubmed PY - 2020/4/9/medline PY - 2019/3/24/entrez KW - Discrimination KW - Sexual minorities KW - Substance use disorders KW - Time-varying effect models SP - 101 EP - 110 JF - Social psychiatry and psychiatric epidemiology JO - Soc Psychiatry Psychiatr Epidemiol VL - 55 IS - 1 N2 - PURPOSE: Sexual minorities are at heightened risk for substance use disorders (SUDs). Discrimination based on sexual orientation may be an important factor in this increased risk, but differences across age have not been systematically examined. We examined age-varying associations of sexual orientation discrimination with alcohol use disorder (AUD), tobacco use disorder (TUD), and drug use disorder (DUD). METHODS: We used data from US participants aged 18-50 years who reported non-heterosexual identity, attraction, or behavior (N = 2375) in a nationally representative survey. We examined the prevalence of sexual orientation discrimination across age and its salience as a risk factor for AUD, TUD, and DUD for gay/lesbian, bisexual, and heterosexual identifying individuals using time-varying effect modeling. RESULTS: Sexual orientation discrimination was most prevalent in early young adulthood but was positively associated with greater odds of AUD, TUD, and DUD only at later ages. We found statistically significant associations at ages 24.5-40.0 for AUD, ages 32.5-42.9 for DUD, and ages 39.3-43.2 for TUD. For example, discrimination at age 30 was associated with 2.1 times greater odds of AUD (95% CI 1.3, 3.3) compared to those who reported no discrimination at that age. Discrimination at age 35 was associated with 2.8 times greater odds of DUD (95% CI 1.2, 6.6) relative to no discrimination. CONCLUSIONS: Sexual orientation discrimination is significantly associated with SUDs and risk varies across age. Thus, age should be considered in the development of prevention and treatment of AUD, TUD, and DUD, particularly for sexual minorities. SN - 1433-9285 UR - https://www.unboundmedicine.com/medline/citation/30903234/Associations_between_sexual_orientation_discrimination_and_substance_use_disorders:_differences_by_age_in_US_adults_ L2 - https://dx.doi.org/10.1007/s00127-019-01694-x DB - PRIME DP - Unbound Medicine ER -