Sexual minority disparities in opioid and benzodiazepine misuse among adults with opioid use disorder

Abstract

Background and Objectives Sexual minority individuals demonstrate disparate rates of substance use. Research suggests that bisexual women are vulnerable to substance use disorders when compared to other sexual minority groups. This study explored differences in prevalence of past‐year alcohol use disorder (AUD) with and without concurrent past‐year opioid and/or benzodiazepine misuse. Methods The present study utilized responses from the National Survey on Drug Use and Health (NSDUH) public dataset between the years 2015–2019 (N = 16,002) to examine the association between sexual orientation and concurrent misuse of opioids and/or benzodiazepines among individuals with past‐year AUD, stratified by sex. Results Bisexual females demonstrated higher rates of concurrent opioid and benzodiazepine use compared to all other groups. Although there was no association between sexual orientation and concurrent substance use patterns among males, female respondents with past‐year AUD endorsing past‐year misuse of opioids and benzodiazepines, both alone and in combination, were more likely to be bisexual compared to heterosexual. Lesbians were less likely to endorse concurrent misuse of opioids and benzodiazepines compared to bisexual females. Discussion and Conclusions In a national sample, bisexual females demonstrated higher odds of risky concurrent substance use patterns. Identifying sexual minority individuals who exhibit elevated risk of co‐occurring alcohol, opioid, and/or benzodiazepine misuse is an important step to targeted prevention efforts and allocation of resources to combat rising overdose deaths. Scientific Significance For the first time, this study explored risky concurrent alcohol, opioid, and benzodiazepine misuse patterns among individuals of different sexual orientations.

Opioid and benzodiazepine misuse in the United States: The impact of socio‐demographic characteristics

“…This finding is consistent with previous findings of bisexual individuals reporting higher odds of opioid misuse 34 and Lesbian/Gay/Bisexual groups experiencing higher pain reliever misuse relative to heterosexual individuals 35 . It is also reported that bisexual females are more likely to co‐use opioids and benzodiazepines among adults with opioid use disorder 36 . However, the findings of Bisexual individuals misusing benzodiazepines and both drugs are novel.…”

“…35 It is also reported that bisexual females are more likely to co-use opioids and benzodiazepines among adults with opioid use disorder. 36 However, the findings of Bisexual individuals misusing benzodiazepines and both drugs are novel. The individuals who are Bisexual are more likely to experience anxiety, depression, and higher rates of trauma compared with their heterosexual counterparts which are risk factors for misuse of prescription drugs as well as for selfmedication.…”

Differential risks of syringe service program participants in Central Ohio: a latent class analysis

“…Conceptualizations of the risk environment and structural vulnerability guided the selection of indicator variables used to define the latent classes [ 33 – 37 , 42 , 43 ]. Sociodemographic characteristics (sex, race/ethnicity, age, sexual orientation, and housing status) were selected, recognizing (a) how race, gender identity, sexual orientation, age, and housing status shape the risk environment [ 33 – 37 , 44 – 46 ], (b) disproportionate overdose mortality rates among racial and ethnic minorities and homeless adults [ 47 , 48 ], and (c) disparities in treatment access for substance use and infectious diseases [ 49 , 50 ]. Preferences related to injection equipment were also included because (a) larger syringes are often used by individuals with longer histories of substance use because of scar tissue and overall vein health [ 51 ] and (b) shorter needles can be used for skin popping and injecting into the hands, feet, and superficial veins, all of which can increase the risk of abscesses and skin and soft tissue infections [ 51 , 52 ].…”