Infectious Disease Institute, College of Nursing, The Ohio State University, Columbus, Ohio, USA.
Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA.
LGBT Health. 2020 Nov/Dec;7(8):431-438. doi: 10.1089/lgbt.2020.0220. Epub 2020 Oct 28.
Heightened rates of prescription opioid misuse have been observed among sexual minority (SM) compared with heterosexual populations. In addition, depression and suicidal ideation are risk factors for misuse, and they are also elevated among SM populations. The purpose of this analysis was to examine whether depression and suicidal ideation attenuate disparities in prescription opioid misuse among SM adults. Data came from a publicly available, nationally representative data set, the National Survey on Drug Use and Health, 2015-2018. Among adults, survey-weighted logistic regression was used to assess the relationship between sexual orientation and past-year opioid misuse adjusting for demographics and either past-year major depressive episode or suicidal ideation. Probabilities of prescription opioid misuse were also assessed under counterfactual rates of depression and suicidal ideation. Analyses were stratified by sex. Among participants in the analytic sample ( = 169,759; SM = 11,268), 9254 (5.5%) reported past-year prescription opioid misuse. The overall rate of opioid misuse decreased from 6.2% in 2015 to 4.6% in 2018. The association between sexual orientation and opioid misuse was attenuated downward for gay men, lesbian women, and bisexual individuals (men and women) after adjusting for either major depressive episode or suicidal ideation, but opioid misuse remained higher among most SM groups. In addition, rates of opioid misuse were found to be lower in counterfactual analyses with a nearly 2.5- and 4-fold decrease in depression and suicidal ideation among gay men and bisexual women, respectively. Efforts to reduce disparities in depression and suicidal ideation affecting SM individuals may reduce disparities in prescription opioid misuse affecting this population.
性少数群体（SM）的处方类阿片类药物滥用率高于异性恋群体。此外，抑郁和自杀意念是药物滥用的风险因素，而且在 SM 群体中也更为常见。本分析的目的是检验抑郁和自杀意念是否会减轻 SM 成年人中处方类阿片类药物滥用的差异。数据来自一个公开的、具有全国代表性的数据组，即 2015-2018 年全国药物使用与健康调查。在成年人中，使用调查加权逻辑回归来评估性取向与过去一年阿片类药物滥用之间的关系，同时调整人口统计学因素、过去一年的重度抑郁发作或自杀意念。还根据抑郁和自杀意念的假设发生率评估了处方类阿片类药物滥用的可能性。分析按性别分层。在分析样本中的参与者（ = 169759；SM = 11268）中，有 9254 人（5.5%）报告过去一年有处方类阿片类药物滥用。整体阿片类药物滥用率从 2015 年的 6.2%下降到 2018 年的 4.6%。在调整重度抑郁发作或自杀意念后，男同性恋者、女同性恋者和双性恋者（男性和女性）的性取向与阿片类药物滥用之间的关联减弱，但大多数 SM 群体中的阿片类药物滥用率仍然较高。此外，在假设分析中，抑郁和自杀意念的发生率分别下降了近 2.5 倍和 4 倍，这导致男同性恋者和双性恋女性的阿片类药物滥用率降低。减少影响 SM 人群的抑郁和自杀意念的差异的努力可能会减少影响该人群的处方类阿片类药物滥用的差异。
