Intersectionality in substance use disorders: Examining gender, race/ethnicity, and sexual orientation in the 2021–2022 National Survey on Drug Use and Health

Q1 Psychology

Addictive Behaviors Reports Pub Date : 2025-01-26 DOI:10.1016/j.abrep.2025.100587

Marvin A. Schilt-Solberg , Lisa M. Blair , Julie A.M.J. Kurzer

{"title":"Intersectionality in substance use disorders: Examining gender, race/ethnicity, and sexual orientation in the 2021–2022 National Survey on Drug Use and Health","authors":"Marvin A. Schilt-Solberg , Lisa M. Blair , Julie A.M.J. Kurzer","doi":"10.1016/j.abrep.2025.100587","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>This study examines the impact of the intersection of gender, racial/ethnic identity, and sexual orientation among adults on substance use disorders (SUDs) from 2021 to 2022.</div></div><div><h3>Method</h3><div>We conducted an analysis of persons (ages 18 and older) who responded to the 2021 and 2022 National Survey on Drug Use and Health (NSDUH). Logistic regression models were constructed to examine odds of past-year SUDs at the intersection of gender, sexuality, and race/ethnicity. All analyses were design-corrected to enhance population representativeness and generalizability.</div></div><div><h3>Results</h3><div>Prevalence varied by race/ethnicity and sexual orientation across both sexes (total <em>n</em> = 83,722). Non-Hispanic multiracial lesbian/gay individuals had the highest prevalence of any SUD in both sexes (46.6 % in women, 52.3 % in men). Bisexual women showed consistently elevated odds of SUD across most racial/ethnic groups (aORs 1.48–2.99) compared to White heterosexual women. Men had higher prevalence of SUD than women (21.1 % compared to 15.0 %, <em>p < 0</em>.0001). Only White gay and bisexual men had significantly increased odds for any SUD compared to heterosexual White men (aOR 1.73 and 1.57, respectively). White bisexual men had higher odds of reporting cannabis use disorder (CUD; aOR 1.87). Hispanic men demonstrated lower odds of any SUD or CUD (aORs 0.85 and 0.71, respectively).</div></div><div><h3>Conclusion</h3><div>Women demonstrated more pronounced SUD disparities between intersectional identity. While men had higher SUD prevalence overall, few disparities were observed between intersectional identities. To effectively address these disparities and their consequences (e.g., differential minority stress and mental/physical health outcomes), prevention and intervention efforts should prioritize an intersectionality approach.</div></div>","PeriodicalId":38040,"journal":{"name":"Addictive Behaviors Reports","volume":"21 ","pages":"Article 100587"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Addictive Behaviors Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352853225000057","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Psychology","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

This study examines the impact of the intersection of gender, racial/ethnic identity, and sexual orientation among adults on substance use disorders (SUDs) from 2021 to 2022.

Method

We conducted an analysis of persons (ages 18 and older) who responded to the 2021 and 2022 National Survey on Drug Use and Health (NSDUH). Logistic regression models were constructed to examine odds of past-year SUDs at the intersection of gender, sexuality, and race/ethnicity. All analyses were design-corrected to enhance population representativeness and generalizability.

Results

Prevalence varied by race/ethnicity and sexual orientation across both sexes (total n = 83,722). Non-Hispanic multiracial lesbian/gay individuals had the highest prevalence of any SUD in both sexes (46.6 % in women, 52.3 % in men). Bisexual women showed consistently elevated odds of SUD across most racial/ethnic groups (aORs 1.48–2.99) compared to White heterosexual women. Men had higher prevalence of SUD than women (21.1 % compared to 15.0 %, p < 0.0001). Only White gay and bisexual men had significantly increased odds for any SUD compared to heterosexual White men (aOR 1.73 and 1.57, respectively). White bisexual men had higher odds of reporting cannabis use disorder (CUD; aOR 1.87). Hispanic men demonstrated lower odds of any SUD or CUD (aORs 0.85 and 0.71, respectively).

Conclusion

Women demonstrated more pronounced SUD disparities between intersectional identity. While men had higher SUD prevalence overall, few disparities were observed between intersectional identities. To effectively address these disparities and their consequences (e.g., differential minority stress and mental/physical health outcomes), prevention and intervention efforts should prioritize an intersectionality approach.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Addictive Behaviors Reports Medicine-Psychiatry and Mental Health

CiteScore

6.80

自引率

0.00%

发文量

审稿时长

71 days

期刊介绍： Addictive Behaviors Reports is an open-access and peer reviewed online-only journal offering an interdisciplinary forum for the publication of research in addictive behaviors. The journal accepts submissions that are scientifically sound on all forms of addictive behavior (alcohol, drugs, gambling, Internet, nicotine and technology) with a primary focus on behavioral and psychosocial research. The emphasis of the journal is primarily empirical. That is, sound experimental design combined with valid, reliable assessment and evaluation procedures are a requisite for acceptance. We are particularly interested in ''non-traditional'', innovative and empirically oriented research such as negative/null data papers, replication studies, case reports on novel treatments, and cross-cultural research. Studies that might encourage new lines of inquiry as well as scholarly commentaries on topical issues, systematic reviews, and mini reviews are also very much encouraged. We also welcome multimedia submissions that incorporate video or audio components to better display methodology or findings.