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Rosenthal SR, Gately KA, Archibald N, Baker AB, Dawes MP, Swanberg JE. Substance Misuse among Sexual and Gender Minorities: The Role of Everyday Discrimination and Identity. Subst Use Misuse 2023; 58:1874-1882. [PMID: 37707795 DOI: 10.1080/10826084.2023.2257309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
BACKGROUND Sexual and gender minorities (SGMs) often deal with discrimination which can result in maladaptive coping like substance misuse, yet few studies have examined the association between everyday discrimination and various types of substance misuse among SGMs or whether there is heterogeneity in substance misuse or this relationship by SGM identity. METHODS Data from 1316 adult SGMs in the United States were recruited from Reddit between February and March 2022. SGM identities (sexual minorities assigned male at birth (AMAB), sexual minorities assigned female at birth (AFAB), gender minorities AMAB, gender minorities AFAB), everyday discrimination, depressive symptoms, marijuana and alcohol misuse, over-the-counter drug misuse, prescription drug misuse, and heroin use were measured, along with demographics. Multivariable logistic regressions examined relationships between everyday discrimination and each substance misuse outcome, adjusting for SGM identity, race/ethnicity, age, income, and depressive symptoms. Interaction terms between everyday discrimination and SGM identities were added to each model to test for moderation. RESULTS In fully adjusted models, with each additional unit of everyday discrimination score, there were significantly increased odds of substance misuse for all outcomes. SGM by everyday discrimination interactions was significant for alcohol misuse, over-the-counter drug misuse, and heroin use, with the association between everyday discrimination and substance misuse stronger among gender minorities. CONCLUSIONS Substance misuse varied by SGM identity. Everyday discrimination was associated with substance misuse, but there was heterogeneity in this relationship between SGM identity and substance. Substance use disorder treatment and prevention among SGMs should consider heterogeneity by SGM identity and substance.
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Affiliation(s)
- Samantha R Rosenthal
- Department of Health Science, College of Health & Wellness, Johnson & Wales UniversityProvidence, USA
- Department of Epidemiology, Brown School of Public Health, Brown University, Providence, USA
| | - Kelsey A Gately
- Department of Occupational Therapy, College of Health and Wellness, Johnson & Wales University, Providence,USA
| | - Natalya Archibald
- Department of Health Science, College of Health & Wellness, Johnson & Wales UniversityProvidence, USA
| | - Allyson B Baker
- Department of Occupational Therapy, College of Health and Wellness, Johnson & Wales University, Providence,USA
| | - Monique P Dawes
- Department of Occupational Therapy, College of Health and Wellness, Johnson & Wales University, Providence,USA
| | - Jennifer E Swanberg
- Department of Health Science, College of Health & Wellness, Johnson & Wales UniversityProvidence, USA
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Mouton C, Hughes JS, Olson JN. Using Drugs or Non-Drugs Alternatives to Alter Mental States in the Online, Virtual Era. Subst Use Misuse 2023; 58:1324-1332. [PMID: 37287394 DOI: 10.1080/10826084.2023.2201938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background: In the 1970s a body of literature was generated advocating the alternatives approach for drug misuse prevention and rehabilitation which encouraged healthy nonchemical behaviors leading to reinforcing moods. Although this behaviorally oriented approach was overshadowed with the popularity of cognitive therapy in the 1980s, many of the recommended alternative behaviors remain embedded in cognitive approaches for drug misuse prevention and rehabilitation. One objective of the present study was to replicate, in part, two studies conducted in the 1970s which examined usage patterns of non-drug alternatives. A second objective was to explore of the use of newer technologies like the internet and the smartphone to alter emotional states. A third objective was to examine perceived stress and discrimination experiences on preferences for drug and non-drug alternatives. Methods: Three questionnaires were administered: use of drugs and non-drug alternatives in response to everyday emotions; the Everyday Discrimination Scale; and the Perceived Stress Scale. A total of 483 adults participated; their mean age was 39 years. Results: The results revealed that non-drug alternatives were preferred to drugs in treating experiences of anxiety, depression, and hostility, and to induce pleasure. Drugs were used most often to deal with pain. Experiences of discrimination increased perceptions of stress, and stress, in turn, affected the use of drugs to cope with a range of emotions. Social media and virtual activities were not preferred methods for altering negative moods. Conclusions: Social media may actually be a contributor or cause of distress, rather than a means for reducing it.
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Affiliation(s)
- Candace Mouton
- Department of Psychology, The University of Texas Permian Basin, Odessa, Texas, USA
| | - Jamie S Hughes
- Department of Psychology, The University of Texas Permian Basin, Odessa, Texas, USA
| | - James N Olson
- Department of Psychology, The University of Texas Permian Basin, Odessa, Texas, USA
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Jones DM, Masyn KE, Spears CA. Discrimination, psychological functioning, and substance use among U.S. young adults aged 18-28, 2017. Exp Clin Psychopharmacol 2022; 30:884-896. [PMID: 34398638 PMCID: PMC9134875 DOI: 10.1037/pha0000502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study aimed to test whether (a) discrimination is associated with past 30-day/current alcohol, cigarette, e-cigarette, alcohol, marijuana, and other illicit drug use among Black and White U.S. adults aged 18-28, (b) psychological distress (PD) and positive well-being (PW) are mediators of the discrimination-substance use relationships, and (c) the associations are moderated by race and sex. Using data from a 2017 U.S. nationally representative survey we conducted multiple-group moderated mediation analyses among 2,192 young adults aged 18-28 (508 Black males, 594 Black females, 533 White males, 557 White females). Black males had higher discrimination, Whites had higher PW, and females had higher PD scores. Discrimination was positively associated with PD and negatively associated with PW. Among all groups, discrimination was positively associated with other illicit drug (direct and indirect), and marijuana use through PD. Indirect effects were stronger among White males for other illicit drugs and Black males for marijuana. The indirect effect of discrimination and alcohol use through PW was positive for Black females and negative for all other groups examined. Among Black males only, discrimination was positively associated with cigarette and alcohol use through PD (positive) and cigarette smoking through PW (negative). This study highlights the negative influence of perceived discrimination on current licit and illicit substance use among Black and White young adults. Our results suggest that this relationship may be partially mediated by PD and PW, especially among Black male young adults. Future discrimination and substance use studies should consider potential mediation effects of poor mental health and differences by race and sex. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Dina M. Jones
- Center for the Study of Tobacco, Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences
| | - Katherine E. Masyn
- Department of Population Health Sciences, School of Public Health, Georgia State University
| | - Claire Adams Spears
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University
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Nicholson HL, Wheeler PB, Smith NC, Alawode OA. Examining the Relationship between Discrimination and Prescription Drug Misuse: Findings from a National Survey of Black Americans. Subst Use Misuse 2022; 57:1014-1021. [PMID: 35395923 DOI: 10.1080/10826084.2022.2052096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background: Research shows that substance use may be a way individuals cope with psychosocial stressors. Less is known about whether discrimination contributes to prescription drug misuse. Methods: Using a national sample of Black Americans, we examined whether two psychosocial stressors (i.e., everyday and lifetime major discrimination) were associated with lifetime prescription drug misuse (i.e., opioids, tranquilizers, sedatives, or stimulants). Results: Our logistic regression models separately examining the influence of everyday and major discrimination controlling for relevant demographic, health, and other drug use variables showed that only everyday discrimination was associated with higher odds of prescription drug misuse. In the model simultaneously considering both types of discrimination, only unit increases in everyday discrimination were associated with higher odds of prescription drug misuse. Conclusions: Encounters with everyday discrimination may be an important psychosocial stressor linked to prescription drug misuse in Black adults and possibly other racial-ethnic minorities. Intervention strategies aiming to reduce prescription drug misuse should consider developing ways to curb the negative health-related consequences of discriminatory experiences. Strategies to combat discrimination-related prescription drug misuse and limitations of this study are discussed.
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Affiliation(s)
- Harvey L Nicholson
- Department of Sociology and Criminology & Law, University of Florida, Gainesville, Florida, USA
| | - Paris B Wheeler
- Department of Educational, School, and Counseling Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Nicholas C Smith
- Department of Sociology, Indiana University, Bloomington, Indiana, USA
| | - Oluwatobi A Alawode
- Department of Sociology and Criminology & Law, University of Florida, Gainesville, Florida, USA
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Sartor CE, Woerner J, Haeny AM. The contributions of everyday and major experiences of racial discrimination to current alcohol use and regular smoking in Black adults: Considering variation by demographic characteristics and family history. Addict Behav 2021; 114:106711. [PMID: 33153774 DOI: 10.1016/j.addbeh.2020.106711] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/25/2020] [Accepted: 10/11/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Racial discrimination has consistently been linked to elevated alcohol use and smoking in Black adults, but the independent contributions of everyday and major experiences of discrimination have rarely been investigated. The present study aimed to identify variation in magnitude of the links between each type of racial discrimination with current frequency of alcohol use and regular smoking by demographic characteristics and family history of problem drinking/regular smoking in Black adults in the U.S. METHODS Data were drawn from 4462 adults (29.40% Afro Caribbean, 70.60% African American; 63.20% female) in a nationally representative sample of Black Americans. Logistic regression analyses were conducted to predict current frequency of alcohol use and regular smoking using the Everyday Discrimination Scale (EDS) and Major Experiences of Discrimination Scale (MEDS), testing for interactions with demographic characteristics and family history. RESULTS In the alcohol model, an EDS by education level interaction was observed: OR = 1.04 (CI:1.02-1.07) for < high school; OR = 0.95 (CI:0.92-0.98) for ≥ high school. MEDS was independently associated with alcohol use (OR = 1.11, CI:1.04-1.18). In the smoking model, EDS was associated with elevated risk (OR = 1.03, CI:1.01-1.04) and a MEDS by age cohort interaction was observed: OR = 1.24 (CI:1.11-1.38) for <age 45; OR = 1.07 (CI:0.97-1.19) for ages 45-65. CONCLUSIONS Everyday and major experiences of racial discrimination contribute independently to both alcohol use and regular smoking in Black adults, with some variation by education level and age. Differentiating everyday from major experiences of discrimination in studies of mechanisms linking racial discrimination to substance use will enhance their informativeness for intervention development.
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Affiliation(s)
- Carolyn E Sartor
- Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue, New Haven, CT 06511, USA.
| | - Jacqueline Woerner
- Departments of Psychology and Sociology, University of Central Florida, 4297 Andromeda Loop N., Orlando, FL 32816, USA.
| | - Angela M Haeny
- Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue, New Haven, CT 06511, USA.
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Kim H, Epstein NB. Racism, stress and health in Asian Americans: A structural equation analysis of mediation and social support group differences. Stress Health 2021; 37:103-115. [PMID: 32790912 DOI: 10.1002/smi.2979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 07/28/2020] [Accepted: 08/11/2020] [Indexed: 11/12/2022]
Abstract
The buffering effect of social support on the negative effects of racism exposure on health outcomes has been mixed in prior studies regarding Asian Americans. Based on the stress-coping framework and using structural equation modelling (SEM) methods, we tested a theoretical model portraying simultaneous mediational paths from racism exposure to general physical and mental health through racism-related stress. Bootstrap analysis was used to test the indirect effects present in the model. Additionally, multi-group SEM analysis was conducted to investigate the moderation effect of social support from family and friends on the paths in the model. The sample consisted of 310 Asian American adults who completed an online survey. The results from the two-step SEM analysis and bootstrap analysis supported the theoretical model-racism exposure can simultaneously have a negative indirect effect on Asian Americans' physical and mental health via racism-related stress. Multi-group SEM analysis showed that there were no differences in model path coefficients based on having varying levels of social support from friends or family.
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Affiliation(s)
- HaeDong Kim
- Department of Family Studies and Community Development, College of Liberal Arts, Towson University, Towson, Maryland, USA
| | - Norman B Epstein
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
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Carliner H, Delker E, Fink DS, Keyes KM, Hasin DS. Racial discrimination, socioeconomic position, and illicit drug use among US Blacks. Soc Psychiatry Psychiatr Epidemiol 2016; 51:551-60. [PMID: 26810670 PMCID: PMC4824661 DOI: 10.1007/s00127-016-1174-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 01/10/2016] [Indexed: 01/20/2023]
Abstract
PURPOSE We assessed the relationship of self-reported racial discrimination with illicit drug use among US Blacks, and whether this differed by socioeconomic position (SEP). METHODS Among 6587 Black participants in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (2004-2005), we used multiple logistic regression models to test the association between racial discrimination (measured on the 6-item Experiences of Discrimination scale) and past-year illicit drug use, and whether this differed by SEP. RESULTS Racial discrimination was associated with past-year drug use [adjusted odds ratio (aOR) 2.32; 95 % confidence interval (CI) 1.70, 3.16] and with frequent drug use (aOR 1.91; 95 % CI 1.22, 2.99). For frequent illicit drug use, this relationship was stronger among higher SEP participants (aOR 3.55; 95 % CI 2.09, 6.02; p interaction < 0.01). CONCLUSIONS The stronger association between racial discrimination and frequent illicit drug use among higher SEP Blacks suggests a complex interplay between disadvantaged and privileged statuses that merits further investigation. The finding of a significant difference by SEP highlights the importance of considering differences within heterogeneous race/ethnic groups when investigating health disparities.
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Affiliation(s)
- Hannah Carliner
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Erin Delker
- New York State Psychiatric Institute, 1051 Riverside Drive #123, New York, NY 10032, USA
| | - David S. Fink
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Deborah S. Hasin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA,New York State Psychiatric Institute, 1051 Riverside Drive #123, New York, NY 10032, USA,Department of Psychiatry, Columbia University, New York, NY 10032, USA
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Rowe C, Santos GM, McFarland W, Wilson EC. Prevalence and correlates of substance use among trans female youth ages 16-24 years in the San Francisco Bay Area. Drug Alcohol Depend 2015; 147:160-6. [PMID: 25548025 PMCID: PMC4297727 DOI: 10.1016/j.drugalcdep.2014.11.023] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 11/20/2014] [Accepted: 11/21/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Substance use is highly prevalent among transgender (trans*) females and has been associated with negative health outcomes, including HIV infection. Little is known about psychosocial risk factors that may influence the onset of substance use among trans*female youth, which can contribute to health disparities during adulthood. METHODS We conducted a secondary data analysis of a study on HIV risk and resilience among trans*female youth (N=292). Prevalence of substance use was assessed and multivariable logistic regression models were used to examine the relationship between posttraumatic stress disorder (PTSD), psychological distress, gender-related discrimination, parental drug or alcohol problems (PDAP) and multiple substance use outcomes. RESULTS Most (69%) of the trans*female youth reported recent drug use. In multivariable analyses, those with PTSD had increased odds of drug use [AOR=1.94 (95% CI=1.09-3.44)]. Those who experienced gender-related discrimination had increased odds of drug use [AOR=2.28 (95% CI=1.17-4.44)], drug use concurrent with sex [AOR=2.35 (95% CI=1.11-4.98)] and use of multiple drugs [AOR=3.24 (95% CI=1.52-6.88)]. Those with psychological distress had increased odds of using multiple heavy drugs [AOR=2.27 (95% CI=1.01-5.12)]. Those with PDAP had increased odds of drugs use [AOR=2.62 (95% CI=1.43-4.82)], drug use concurrent with sex [AOR=2.01 (95% CI, 1.15-3.51)] and use of multiple drugs [AOR=2.10 (95% CI=1.22-3.62)]. CONCLUSIONS Substance use is highly prevalent among trans*female youth and was significantly associated with psychosocial risk factors. In order to effectively address substance use among trans*female youth, efforts must address coping related to gender-based discrimination and trauma. Furthermore, structural level interventions aiming to reduce stigma and gender-identity discrimination might also be effective.
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Affiliation(s)
- Chris Rowe
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA 94102, United States
| | - Glenn-Milo Santos
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA 94102, United States
| | - Willi McFarland
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA 94102, United States
| | - Erin C Wilson
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA 94102, United States.
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