VA New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System, West Haven, CT (TGR, MKRP, MS, RAR); Department of Psychiatry, School of Medicine, Yale University, New Haven, CT (TGR, MKRP, MS, RAR); Department of Public Health Sciences, School of Medicine, University of Connecticut Health Care, Farmington, CT (TGR); Psychology Service, VA Connecticut Healthcare System, West Haven, CT (MKRP).
J Addict Med. 2020 Dec;14(6):502-509. doi: 10.1097/ADM.0000000000000662.
Studies suggest that men and women have different vulnerabilities to a number of substance use disorders (SUDs). We examined whether differences between women and men with opioid use disorder (OUD) are significantly different from those without OUD for selected sociodemographic and health outcomes.
We used a cross-sectional survey design using data from 2012 to 2013 National Epidemiological Survey on Alcohol and Related Conditions Wave III, which surveyed nationally representative samples of non-institutionalized adults (n = 36,309 unweighted). Past-year OUD and other behavioral co-morbidities were defined using DSM-5 criteria. In bivariate analyses, we investigated sex differences in socio-demographic factors, behavioral co-morbidities, pain, and health-related quality of life (HRQOL) between women and men with past-year OUD, and then those without past-year OUD. We further used logistic regression analyses to evaluate interactions between effect of sex and past-year OUD status on behavioral co-morbidities, pain, and HRQOL.
When extrapolated, about 2.1 million US adults met diagnostic criteria for past-year OUD. Women with OUD had a higher likelihood of having several past-year psychiatric disorders, and a lower likelihood of having any past-year SUDs compared to male counterparts. However, similar relationships were observed among those without OUD and significant interaction effects were not found on behavioral co-morbidities, pain, and HRQOL, indicating that general sex differences are not specific to OUD.
Although sex differences are not specific to OUD, concurrent disorders are not uncommon among women, as well as men, with OUD. There is a need to treat concurrent behavioral health conditions from a multimorbidity perspective in the treatment of OUD in both sexes.
研究表明，男性和女性在多种物质使用障碍（SUD）方面存在不同的脆弱性。我们研究了患有阿片类药物使用障碍（OUD）的女性和男性与没有 OUD 的女性和男性在选定的社会人口统计学和健康结果方面的差异是否存在显著差异。
我们使用了 2012 年至 2013 年全国酒精和相关条件流行病学调查 III 期的横断面调查设计，该调查对非机构化成年人进行了全国代表性样本调查（未加权样本量为 36309 人）。过去一年的 OUD 和其他行为共病使用 DSM-5 标准定义。在双变量分析中，我们调查了过去一年患有 OUD 的女性和男性与没有过去一年 OUD 的女性和男性在社会人口统计学因素、行为共病、疼痛和健康相关生活质量（HRQOL）方面的性别差异。然后，我们进一步使用逻辑回归分析来评估性别与过去一年 OUD 状态对行为共病、疼痛和 HRQOL 的影响之间的交互作用。
推断约有 210 万美国成年人符合过去一年 OUD 的诊断标准。患有 OUD 的女性比男性更有可能患有多种过去一年的精神障碍，而过去一年患有任何 SUD 的可能性较低。然而，在没有 OUD 的人群中也观察到了类似的关系，并且在行为共病、疼痛和 HRQOL 方面没有发现显著的交互作用效应，这表明一般的性别差异不是 OUD 所特有的。
尽管性别差异不是 OUD 所特有的，但患有 OUD 的女性和男性同时存在并发疾病并不罕见。需要从多疾病的角度来治疗 OUD 患者的并发行为健康状况，无论性别如何。
