Olamazadeh Sogol, Hassan Ahmed N, Le Foll Bernard
Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Department of Psychiatry, University of Toronto, Toronto, Canada.
Int J Soc Psychiatry. 2025 Feb;71(1):159-167. doi: 10.1177/00207640241287088. Epub 2024 Oct 25.
Substance use disorder (SUD) represents a significant public health challenge, especially among individuals who have faced early life adversities. Foster care aims to provide a supportive environment for children; however, the relationship between a history of foster care and SUD development remains unclear.
This study aims to examine the likelihood of developing SUD among individuals with a history of foster care, who have used substances during their lifetime, compared to those raised by biological parents.
Using data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), we analyzed the prevalence of social demographics and clinical variables among individuals who have used alcohol, nicotine, or cannabis. We calculated the probabilities of developing SUD for each factor, including exposure to foster care. Various covariates that could impact SUD occurrence were also assessed. The duration from initial substance use to SUD onset was calculated for both groups. Survival analysis curves were generated for each substance to depict the probability of SUD development over time.
Our analysis revealed that foster care may act as a protective factor against Cannabis Use Disorder (CUD), with a hazard ratio of 0.25 (95% CI [0.07, 0.88]). No significant associations were found with Alcohol Use Disorder (AUD) or Nicotine Use Disorder (NUD). Both foster and non-foster care groups exhibited higher probabilities of developing NUD compared to the general population. For cannabis users, the probability of developing CUD stabilizes after approximately 10 years. Family history of SUD and clinical predictors such as mood disorders consistently showed significant associations across all substance groups, highlighting their importance in SUD development.
Our findings suggest that foster care may offer some protective benefits, particularly against CUD, emphasizing the need for further research into its protective factors and the development of targeted interventions to reduce SUD prevalence in this population.
物质使用障碍（SUD）是一项重大的公共卫生挑战，在早年经历过逆境的个体中尤为如此。寄养旨在为儿童提供一个支持性环境；然而，寄养史与物质使用障碍发展之间的关系仍不明确。
本研究旨在探讨有寄养史且一生中使用过物质的个体与由亲生父母抚养长大的个体相比，发生物质使用障碍的可能性。
利用来自全国酒精及相关疾病流行病学调查三期（NESARC-III）的数据，我们分析了使用酒精、尼古丁或大麻的个体的社会人口统计学和临床变量的患病率。我们计算了每个因素（包括寄养经历）发生物质使用障碍的概率。还评估了可能影响物质使用障碍发生的各种协变量。计算了两组从初次使用物质到物质使用障碍发作的持续时间。针对每种物质生成生存分析曲线，以描述随时间发生物质使用障碍的概率。
我们的分析表明，寄养可能是预防大麻使用障碍（CUD）的保护因素，风险比为0.25（95%置信区间[0.07, 0.88]）。未发现与酒精使用障碍（AUD）或尼古丁使用障碍（NUD）有显著关联。与一般人群相比，寄养组和非寄养组发生尼古丁使用障碍的概率都更高。对于大麻使用者，发生大麻使用障碍的概率在大约10年后趋于稳定。物质使用障碍的家族史和临床预测因素（如情绪障碍）在所有物质组中均持续显示出显著关联，突出了它们在物质使用障碍发展中的重要性。
我们的研究结果表明，寄养可能提供一些保护益处，特别是预防大麻使用障碍，强调需要进一步研究其保护因素，并制定有针对性的干预措施以降低该人群中物质使用障碍的患病率。
