Su Yingying, Meng Xiangfei, D'Arcy Carl
School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada.
Department of Psychiatry, McGill, University and the Douglas Research Centre, Montreal, QC, Canada.
Front Psychiatry. 2022 Mar 2;13:799655. doi: 10.3389/fpsyt.2022.799655. eCollection 2022.
Though it has been shown that men have a higher lifetime prevalence of substance use disorder and a lower prevalence of chronic pain than women, there is little research to date focusing on gender differences in the relationship between chronic pain and substance use disorder. This study examined whether gender moderates the relationship of chronic pain and substance use disorder. We also sought to examine the gender differences in the associations between specific pain types-arthritis, migraine, and back pain, and substance use disorder.
The data were drawn from the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH 2012) with individuals aged 20 years and older living in the 10 Canadian provinces ( = 23,089). A two-level logistic mixed effects model was used to account for provincial differences.
Our findings indicated gender moderated the association between arthritis as well as migraine, and substance use disorder. However, no moderation effect of gender on the relationship between back pain and substance use disorder was found. Specifically, the strength of the association between arthritis and substance use disorder was stronger among men (OR = 0.62, 95% CI: 0.53 to 0.73), whereas the strength of the association between migraine and substance use disorder was stronger among women (OR = 1.45, 95% CI: 1.18 to 1.79). In addition, geographical location was found to explain a small proportion (2.3%-2.4%) of the overall variance in SUD.
The results suggest that gender moderated the relations between arthritis as well as migraine, and substance use disorder, respectively. Treatment programs for pain and substance misuse might benefit from an approach tailored to gender differences.
尽管已有研究表明，男性一生中物质使用障碍的患病率高于女性，而慢性疼痛的患病率低于女性，但迄今为止，很少有研究关注慢性疼痛与物质使用障碍之间关系的性别差异。本研究探讨了性别是否调节慢性疼痛与物质使用障碍之间的关系。我们还试图研究特定疼痛类型（关节炎、偏头痛和背痛）与物质使用障碍之间关联的性别差异。
数据取自2012年加拿大社区健康调查-心理健康（CCHS-MH 2012），研究对象为居住在加拿大10个省份、年龄在20岁及以上的个体（n = 23,089）。采用两级逻辑混合效应模型来考虑省份差异。
我们的研究结果表明，性别调节了关节炎以及偏头痛与物质使用障碍之间的关联。然而，未发现性别对背痛与物质使用障碍之间关系有调节作用。具体而言，关节炎与物质使用障碍之间的关联强度在男性中更强（OR = 0.62，95%CI：0.53至0.73），而偏头痛与物质使用障碍之间的关联强度在女性中更强（OR = 1.45，95%CI：1.18至1.79）。此外，地理位置被发现可解释物质使用障碍总体方差的一小部分（2.3%-2.4%）。
结果表明，性别分别调节了关节炎以及偏头痛与物质使用障碍之间的关系。针对疼痛和物质滥用的治疗方案可能会从根据性别差异量身定制的方法中受益。
