宗教参与和阿片类药物使用障碍在 2004-2005 年和 2012-2013 年之间的种族差异：来自国家酒精和相关条件流行病学调查的结果。
Religious involvement and racial disparities in opioid use disorder between 2004-2005 and 2012-2013: Results from the National Epidemiologic Survey on Alcohol and Related Conditions.
机构信息
Yale School of Public Health, Department of Social and Behavioral Sciences, Studies of Religion Ethnicity Technology and Contextual Influences on Health (STRETCH)-Lab, 60 College Street, New Haven, CT 06510.
Yale School of Medicine, Department of Psychiatry, Division of Prevention and Community Research, and The Consultation Center 389 Whitney Avenue, New Haven, CT 06511.
出版信息
Drug Alcohol Depend. 2019 Dec 1;205:107615. doi: 10.1016/j.drugalcdep.2019.107615. Epub 2019 Oct 17.
BACKGROUND
Psychosocial factors have rarely been studied to understand racial differences in opioid use disorders (OUD). We investigate religious involvement and Black-White differences in OUD risk between 2004-05 and 2012-13.
METHODS
We use Non-Hispanic Black and White adults from the National Epidemiologic Survey on Alcohol and Related Conditions (wave 2, N = 26,661 and NESARC-III, N = 26,960) (NESARC). We conducted survey-weighted logistic regression to examine whether race moderates the association between religious involvement and lifetime DSM-IV and -5 OUD and whether those differences change (i.e., are modified) by time, adjusted for covariates such as age, education, and urbanicity. Religious involvement measures were service attendance, social interaction, and subjective religiosity/spirituality.
RESULTS
The prevalence of lifetime DSM-IV (3.82 vs 1.66) and DSM-5 (2.49 vs 1.32) OUD in NESARC-III was higher among White compared to Black respondents. Never attending services declined for both races over time. Race moderated the association between service attendance (F(4,65) = 14.9, p = 0.000), social interaction (F(4,65) = 34.4, p = 0.000) and subjective religiosity/spirituality (F(2,65) = 7.03, p = 0.000) on DSM-IV OUD in wave 2 and using DSM-5 OUD in NESARC-III (F(1,113) = 2.79, p = 0.066). Race differences in religion and DSM-IV OUD risk was modified by time (i.e., survey year) (all p < 0.000). For instance, higher service attendance was associated with lower DSM-IV risk for Black respondents in wave 2 but higher risk in NESARC-III. There were no changes in regression slopes among White respondents.
CONCLUSIONS
Religious involvement may be important for prevention and treatment practices that respond to racial differences in risk of OUD. Replicate studies should examine other religious factors and specific types of opioids.
背景
心理社会因素很少被研究，以了解阿片类药物使用障碍（OUD）的种族差异。我们调查了宗教参与情况以及 2004-05 年至 2012-13 年间黑人和白人在 OUD 风险方面的差异。
方法
我们使用来自国家酒精和相关条件流行病学调查（第 2 波，N=26661 和 NESARC-III，N=26960）（NESARC）的非西班牙裔黑人和白人成年人。我们进行了调查加权逻辑回归，以检验种族是否调节宗教参与与终身 DSM-IV 和 -5 OUD 之间的关联，以及这些差异是否（即，是否被修饰）随时间变化，同时调整了年龄、教育和城市化等协变量。宗教参与措施包括参加礼拜、社交互动和主观宗教/灵性。
结果
在 NESARC-III 中，终身 DSM-IV（3.82%比 1.66%）和 DSM-5（2.49%比 1.32%）OUD 的患病率在白人受访者中高于黑人受访者。两个种族的从不参加礼拜的人数随着时间的推移而下降。种族调节了服务参与（F（4,65）=14.9，p=0.000）、社交互动（F（4,65）=34.4，p=0.000）和主观宗教/灵性（F（2,65）=7.03，p=0.000）与 2 波中的 DSM-IV OUD 以及 NESARC-III 中的 DSM-5 OUD 的关联（F（1,113）=2.79，p=0.066）。宗教与 DSM-IV OUD 风险之间的种族差异受到时间（即调查年份）的修饰（均 p<0.000）。例如，在第 2 波中，较高的服务参与与黑人受访者的 DSM-IV 风险降低相关，但在 NESARC-III 中则与风险增加相关。白人受访者的回归斜率没有变化。
结论
宗教参与对于针对 OUD 风险的种族差异的预防和治疗实践可能很重要。应进行复制研究以检验其他宗教因素和特定类型的阿片类药物。
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