Evans Elizabeth A, Grella Christine E, Washington Donna L, Upchurch Dawn M
Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA; Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, USA; Department of Veterans Affairs (VA) Health Service Research and Development (HSR and D) Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, USA; Department of Health Policy and Promotion, School of Public Health and Health Sciences, University of Massachusetts Amherst, USA.
Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA.
Drug Alcohol Depend. 2017 May 1;174:128-136. doi: 10.1016/j.drugalcdep.2017.01.021. Epub 2017 Mar 7.
To examine gender and racial/ethnic differences in the effect of substance use disorder (SUD) type on SUD persistence.
Data were provided by 1025 women and 1835 men from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to examine whether gender and race/ethnicity (Non-Hispanic White, Black, Hispanic) moderate the effects of DSM-IV defined past-12 month SUD type (alcohol, drug, poly-substance) on SUD persistence at 3-year follow-up, controlling for covariates. Using gender-stratified weighted binary logistic regression, we examined predictors of SUD persistence, tested an SUD type by race/ethnicity interaction term, and calculated and conducted Bonferroni corrected pairwise comparisons of predicted probabilities.
SUD persistence rates at 3-year follow-up differed for SUD type by gender by race/ethnicity sub-group, and ranged from 31% to 81%. SUD persistence rates were consistently higher among poly-substance users; patterns were mixed in relation to gender and race/ethnicity. Among women, alcohol disordered Hispanics were less likely to persist than Whites. Among men, drug disordered Hispanics were less likely to persist than Whites. Also, Black men with an alcohol or drug use disorder were less likely to persist than Whites, but Black men with a poly-substance use disorder were more likely to persist than Hispanics.
The effect of SUD type on SUD persistence varies by race/ethnicity, and the nature of these relationships is different by gender. Such knowledge could inform tailoring of SUD screening and treatment programs, potentially increasing their impact.
研究物质使用障碍（SUD）类型对SUD持续时间的影响在性别和种族/族裔方面的差异。
来自全国酒精及相关疾病流行病学调查（NESARC）的1025名女性和1835名男性提供了数据，以检验性别和种族/族裔（非西班牙裔白人、黑人、西班牙裔）是否会调节DSM-IV定义的过去12个月SUD类型（酒精、药物、多物质）对3年随访时SUD持续时间的影响，并对协变量进行控制。使用按性别分层的加权二元逻辑回归，我们研究了SUD持续的预测因素，测试了SUD类型与种族/族裔交互项，并计算并进行了Bonferroni校正的预测概率成对比较。
在3年随访时，SUD持续率因SUD类型、性别和种族/族裔亚组而异，范围从31%到81%。多物质使用者的SUD持续率一直较高；在性别和种族/族裔方面的模式各不相同。在女性中，患有酒精障碍的西班牙裔比白人更不容易持续。在男性中，患有药物障碍的西班牙裔比白人更不容易持续。此外，患有酒精或药物使用障碍的黑人男性比白人更不容易持续，但患有多物质使用障碍的黑人男性比西班牙裔更有可能持续。
SUD类型对SUD持续时间的影响因种族/族裔而异，并且这些关系的性质因性别而异。这些知识可为SUD筛查和治疗方案的定制提供参考，可能会增加其影响力。
