Hawks Laura C, Walker Rebekah J, Egede Leonard E
Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Health Equity. 2022 Sep 7;6(1):684-690. doi: 10.1089/heq.2021.0051. eCollection 2022.
Criminal justice involvement (CJI) is a social risk in adults with both diabetes and substance use, however, the relationship between CJI, diabetes, and substance use disorders is not well studied.
Data from a nationally representative sample of U.S. adults with diabetes from the National Survey of Drug Use and Health (2015-2018) were used to establish the prevalence of the following substance use disorders: alcohol, opioid, cannabis, cocaine, and methamphetamine, or a composite variable for any substance use disorder. Multiple logistic regression was used to test the association between CJI and each substance use disorder in adults with diabetes controlling for relevant covariates.
Of 11,594 respondents representing 25,834,422 U.S. adults with diabetes, 17.1% reported prior CJI. Prevalence of substance use disorders was significantly higher in individuals with CJI compared to those without CJI (alcohol: 8.3 vs. 2.2; opioid: 2.1 vs. 0.4; cannabis: 1.4 vs. 0.2; cocaine: 1.2 vs. 0.1; methamphetamine: 1.2 vs. 0.1; any substance: 11.86 vs. 2.78; <0.001 for all). In fully adjusted models, odds of substance use disorders were significantly higher in individuals with CJI (alcohol: odds ratio [OR] 2.76, 95% confidence interval [CI]: 2.01-3.82; opioid: OR 5.08, 95% CI: 2.25-11.47; cannabis: OR 5.05, 95% CI: 2.60-9.81; cocaine: OR 23.62, 95% CI: 5.59-99.82; methamphetamine: OR 40.66, 95% CI: 13.23-124.95; any substance: OR 7.19, 95% CI: 4.47-11.56).
In adults with diabetes, prevalence of substance use disorder is high among those with CJI. Interventions that target substance use disorders are needed in this population.
刑事司法介入（CJI）是患有糖尿病和物质使用障碍的成年人面临的一种社会风险，然而，CJI、糖尿病和物质使用障碍之间的关系尚未得到充分研究。
利用来自全国药物使用和健康调查（2015 - 2018年）的具有全国代表性的美国糖尿病成年样本数据，确定以下物质使用障碍的患病率：酒精、阿片类药物、大麻、可卡因和甲基苯丙胺，或任何物质使用障碍的综合变量。采用多因素逻辑回归分析，在控制相关协变量的情况下，检验CJI与糖尿病成年人中每种物质使用障碍之间的关联。
在代表25,834,422名美国糖尿病成年人的11,594名受访者中，17.1%报告有过刑事司法介入。与没有刑事司法介入的人相比，有刑事司法介入的人物质使用障碍的患病率显著更高（酒精：8.3%对2.2%；阿片类药物：2.1%对0.4%；大麻：1.4%对0.2%；可卡因：1.2%对0.1%；甲基苯丙胺：1.2%对0.1%；任何物质：11.86%对2.78%；所有P<0.001）。在完全调整模型中，有刑事司法介入的人物质使用障碍的几率显著更高（酒精：比值比[OR]2.76，95%置信区间[CI]：2.01 - 3.82；阿片类药物：OR 5.08，95% CI：2.25 - 11.47；大麻：OR 5.05，95% CI：2.60 - 9.81；可卡因：OR 23.62，95% CI：5.59 - 99.82；甲基苯丙胺：OR 40.66，95% CI：13.23 - 124.95；任何物质：OR 7.19，95% CI：4.47 - 11.56）。
在患有糖尿病的成年人中，有刑事司法介入的人物质使用障碍的患病率很高。这一人群需要针对物质使用障碍的干预措施。
