Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL 60611, United States; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, United States.
Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL 60611, United States; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, United States.
Addict Behav. 2018 Feb;77:143-151. doi: 10.1016/j.addbeh.2017.09.021. Epub 2017 Sep 28.
Sexual minority adolescents (SMA) may be at disproportionate risk for misusing prescription psychotropic medications compared to their heterosexual peers. However, generalizable studies specific to this age group are lacking. The current study aimed to describe the prevalence of sexual orientation disparities in prescription drug misuse among a nationally representative sample of adolescents as well as to examine key correlates of misuse.
Using data from the National Youth Risk Behavior Survey, we conducted stepwise multivariable weighted logistic regressions, sequentially controlling for demographics, experiences of victimization, mental health, and other illicit substance use.
Adjusting for grade and race/ethnicity, female SMA and gay and unsure males had significantly elevated odds of ever misusing a prescription drug compared to heterosexual adolescents (ORs from 1.7-2.5). Most sexual orientation disparities among females remained significant with the addition of victimization and mental health covariates but attenuated completely after controlling for other illicit drug use. The effect for unsure males attenuated when victimization variables were included, but the effect for gay males remained significant through the final model. Controlling for other illicit drug use, mental health variables remained significant correlates for females whereas only forced sex was significant for males.
These results suggest experiences of victimization and mental health partially account for the disparities in prescription drug misuse between SMA and heterosexual adolescents, and their effects may differ by sex. A combination of structural, individual coping, and universal drug prevention approaches should be used to make the largest impact on reducing these disparities.
与异性恋同龄人相比，性少数青少年（SMA）可能面临不成比例的滥用处方精神药物的风险。然而，针对该年龄组的可推广研究却很少。本研究旨在描述在全国代表性青少年样本中，性取向差异与处方药物滥用的相关性，并探讨滥用药物的主要相关因素。
本研究使用国家青少年风险行为调查的数据，我们进行了逐步多变量加权逻辑回归，依次控制人口统计学、受害经历、心理健康和其他非法药物使用等因素。
在调整年级和种族/族裔后，与异性恋青少年相比，女性 SMA 和同性恋及不确定性别男性滥用处方药物的可能性显著增加（比值比从 1.7 到 2.5）。在加入受害和心理健康协变量后，大多数女性的性取向差异仍然显著，但在控制其他非法药物使用后完全减弱。在纳入受害变量后，不确定男性的影响减弱，但同性恋男性的影响在最终模型中仍然显著。在控制其他非法药物使用后，心理健康变量仍然是女性的显著相关因素，而只有被迫性行为对男性有显著影响。
这些结果表明，受害经历和心理健康部分解释了 SMA 和异性恋青少年之间处方药物滥用的差异，其影响可能因性别而异。应采用结构、个体应对和普遍药物预防方法的组合，以最大程度地减少这些差异。
