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Functional and structural social support, substance use and sexual orientation from a nationally representative sample of US adults.
Addiction. 2020 03; 115(3):546-558.A

Abstract

BACKGROUND AND AIMS

Sexual minority (SM) populations experience higher rates of substance use disorder (SUD) associated with increased sexual orientation-related stress. Social support may moderate the impact of stress on SUD among SM adults. This study assessed associations between social support and DSM-5 SUD by sex and sexual minority identity.

DESIGN

Cross-sectional study using data from the 2012-13 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III).

SETTING AND PARTICIPANTS

A nationally representative cross-sectional sample of adults (n = 36 309) in the United States.

MEASUREMENTS

SUD were defined based on the DSM-5 criteria for alcohol use (AUD), tobacco use (TUD) and drug use (DUD) disorders. Structural social support was measured as the type and frequency of kin and non-kin contact, and functional social support was measured by the Social Provision Scale.

FINDINGS

SM adults had higher odds of all SUD compared to heterosexual adults [AUD = 1.535, 95% confidence interval (CI) = 1.782-1.844; TUD = 1.512, 95% CI = 1.234-1.854; DUD = 1.520, 95% CI = 1.139-2.028]; SM women experienced the highest proportion of all SUD (AUD = 27.1%, TUD = 29.1%, DUD = 10.9%). Type of social support was differentially associated with SUD by sex and sexual identity status. Higher social provision was associated with lower rates of AUD [adjusted odds ratio (aOR) = 0.771, 95% CI = 0.705-0.844], TUD (aOR = 0.747, 95% CI = 0.694-0.804] and DUD (aOR = 0.558, 95% CI = 0.490-0.636). Marriage was associated with lower SUD among heterosexual men (AUD, aOR = 0.500, 95% CI = 0.432-0.579; TUD, aOR = 0.603, 95% CI = 0.521-0.699; DUD, aOR = 0.504, 95% CI = 0.369-0.689) and women (AUD, aOR = 0.637, 95% CI = 0.529-0.767; TUD = 0.0.584, 95% CI = 0.507-0.671; DUD, aOR = 0.515, 95% CI = 0.372-0.712). Compared to heterosexual adults, SM women with at least one child under the age of 18 years had higher odds of TUD (aOR = 1.990, 95% CI = 1.325-2.988). SM-related discrimination was not associated with SUD among some SM subgroups, but discrimination among male heterosexually identifying individuals reporting same-sex attraction or behavior was associated AUD (aOR = 4.608, 95% CI = 1.615-13.14).

CONCLUSIONS

In the United States there are significant associations between functional support (quality or provision of support) and structural support (type and frequency of social networks) and substance use disorder (SUD) which differ by sex and sexual identity status.

Authors+Show Affiliations

Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, USA.Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI.Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, USA. Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI. Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, USA. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI. Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, USA. Addiction Center, Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

31599027

Citation

Kahle, Erin M., et al. "Functional and Structural Social Support, Substance Use and Sexual Orientation From a Nationally Representative Sample of US Adults." Addiction (Abingdon, England), vol. 115, no. 3, 2020, pp. 546-558.
Kahle EM, Veliz P, McCabe SE, et al. Functional and structural social support, substance use and sexual orientation from a nationally representative sample of US adults. Addiction. 2020;115(3):546-558.
Kahle, E. M., Veliz, P., McCabe, S. E., & Boyd, C. J. (2020). Functional and structural social support, substance use and sexual orientation from a nationally representative sample of US adults. Addiction (Abingdon, England), 115(3), 546-558. https://doi.org/10.1111/add.14819
Kahle EM, et al. Functional and Structural Social Support, Substance Use and Sexual Orientation From a Nationally Representative Sample of US Adults. Addiction. 2020;115(3):546-558. PubMed PMID: 31599027.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Functional and structural social support, substance use and sexual orientation from a nationally representative sample of US adults. AU - Kahle,Erin M, AU - Veliz,Phil, AU - McCabe,Sean Esteban, AU - Boyd,Carol J, Y1 - 2019/12/26/ PY - 2019/02/12/received PY - 2019/05/31/revised PY - 2019/09/06/accepted PY - 2019/10/11/pubmed PY - 2021/2/20/medline PY - 2019/10/11/entrez KW - Substance use disorder KW - alcohol use disorder KW - discrimination KW - drug use disorder KW - sexual orientation KW - social support KW - tobacco use disorder SP - 546 EP - 558 JF - Addiction (Abingdon, England) JO - Addiction VL - 115 IS - 3 N2 - BACKGROUND AND AIMS: Sexual minority (SM) populations experience higher rates of substance use disorder (SUD) associated with increased sexual orientation-related stress. Social support may moderate the impact of stress on SUD among SM adults. This study assessed associations between social support and DSM-5 SUD by sex and sexual minority identity. DESIGN: Cross-sectional study using data from the 2012-13 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III). SETTING AND PARTICIPANTS: A nationally representative cross-sectional sample of adults (n = 36 309) in the United States. MEASUREMENTS: SUD were defined based on the DSM-5 criteria for alcohol use (AUD), tobacco use (TUD) and drug use (DUD) disorders. Structural social support was measured as the type and frequency of kin and non-kin contact, and functional social support was measured by the Social Provision Scale. FINDINGS: SM adults had higher odds of all SUD compared to heterosexual adults [AUD = 1.535, 95% confidence interval (CI) = 1.782-1.844; TUD = 1.512, 95% CI = 1.234-1.854; DUD = 1.520, 95% CI = 1.139-2.028]; SM women experienced the highest proportion of all SUD (AUD = 27.1%, TUD = 29.1%, DUD = 10.9%). Type of social support was differentially associated with SUD by sex and sexual identity status. Higher social provision was associated with lower rates of AUD [adjusted odds ratio (aOR) = 0.771, 95% CI = 0.705-0.844], TUD (aOR = 0.747, 95% CI = 0.694-0.804] and DUD (aOR = 0.558, 95% CI = 0.490-0.636). Marriage was associated with lower SUD among heterosexual men (AUD, aOR = 0.500, 95% CI = 0.432-0.579; TUD, aOR = 0.603, 95% CI = 0.521-0.699; DUD, aOR = 0.504, 95% CI = 0.369-0.689) and women (AUD, aOR = 0.637, 95% CI = 0.529-0.767; TUD = 0.0.584, 95% CI = 0.507-0.671; DUD, aOR = 0.515, 95% CI = 0.372-0.712). Compared to heterosexual adults, SM women with at least one child under the age of 18 years had higher odds of TUD (aOR = 1.990, 95% CI = 1.325-2.988). SM-related discrimination was not associated with SUD among some SM subgroups, but discrimination among male heterosexually identifying individuals reporting same-sex attraction or behavior was associated AUD (aOR = 4.608, 95% CI = 1.615-13.14). CONCLUSIONS: In the United States there are significant associations between functional support (quality or provision of support) and structural support (type and frequency of social networks) and substance use disorder (SUD) which differ by sex and sexual identity status. SN - 1360-0443 UR - https://www.unboundmedicine.com/medline/citation/31599027/Functional_and_structural_social_support_substance_use_and_sexual_orientation_from_a_nationally_representative_sample_of_US_adults_ L2 - https://doi.org/10.1111/add.14819 DB - PRIME DP - Unbound Medicine ER -