Opioid abuse remains high among homosexuals, bisexuals

The prevalence of opioid misuse is declining overall, but this does not seem to be the case among nonheterosexuals, who have greater levels of abuse compared with heterosexuals, results of a study presented at the Anesthesiology Annual Meeting 2022 have shown.

“[T]hus, we should consider more targeted efforts to reduce these numbers,” said study authors Mario Moric and Asokumar Buvanendran from Rush University Medical Center in Chicago, Illinois, US.

Educational programs may be applied, and clinicians should be further educated to adequately manage this patient population, according to Moric and Buvanendran, adding that the stress of COVID-19 restriction might have had a significant influence on these changes, such as higher levels of depression or stress resulting in worsening drug abuse tendencies.

In this study, the researchers obtained data on opioid use from the National Survey on Drug Use and Health (NSDUH) public data for 2019 to 2020. An annual cross-sectional survey backed by the Substance Abuse and Mental Health Services Administration, the NSDUH provides estimates of the prevalence of alcohol and drug use in the US.

Moric and Buvanendran extracted questions on past year use of opioids, sexual identity, and demographic variables. They analysed data using SAS version 9.4, which were presented as percentages of all respondents from a representative sample of the US population. Then, the researchers conducted statistical analyses while considering the multistage survey sampling methodology of the survey.

Online survey

In-person interviews were suspended for nearly half the year of 2020 due to the COVID-19 pandemic (quarters 2 and 3). An online version was implemented to address the lower number of in-person interviews. These estimates, however, must be taken as indicative rather than absolute, according to Moric and Buvanendran.

Overall, the regression model showed that opioid abuse decreased (p=0.0139) and that sexual identity was highly significant (p<0.0001). Opioid abuse showed a downward trend for all groups across time, but the overall rate was higher for the nonheterosexual groups. [Anesthesiology 2022, abstract A4174]

In particular, individuals who identified themselves as homosexual (p=0.0031) and bisexual (p<0.0001) reported significantly higher opioid abuse than heterosexuals.

Abuse of heroin, pain reliever

Moric and Buvanendran also examined heroin and pain reliever abuse in these individuals. Use of heroin did not significantly change, but that of pain reliever showed a decrease similar to that of opioid abuse overall.

Of note, heterosexuals showed the same incidence of major depressive episode (MDE) of 7.0 percent from 2019 to 2020. On the other hand, homosexuals and bisexuals demonstrated increased incidences of MDE during the same period, from 15.6 to 18.3 percent and from 26.7 percent to 32.4 percent, respectively.

In addition, binge drinking had a slight but nonsignificant decrease over the past month for all groups, according to the researchers, noting that further research is warranted.

“Vulnerable populations may show an increased opioid abuse potential,” Moric and Buvanendran said. “Although we have seen a downward terms in opioid abuse, the opioid epidemic is still having deleterious effects on some populations.”