Opioid pain medication misuse, concomitant substance misuse, and the unmet behavioral health treatment needs of transgender and gender diverse adults. (1st May 2021)

• Record Type: Journal Article
• Authors: Hughto, Jaclyn M.W.; Restar, Arjee J.; Wolfe, Hill L.; Gordon, Lily K.; Reisner, Sari L.; Biello, Katie B.; Cahill, Sean R.; Mimiaga, Matthew J.
• Is Part Of: Drug and alcohol dependence. Volume 222(2021)
• Publication Date: 2021-05-01
• Subjects: Opioid -- Pain medication -- Substance use -- Substance misuse -- Behavioral health -- Transgender; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2021.108674
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: TGD people reported misusing opioid pain medications and other substances. Healthcare stigma and social support were related to opioid pain medication misuse. Opioid pain medication misuse was associated with having unmet BHtx needs. Abstract: Background: Limited research has explored risk factors for opioid pain medication misuse, concomitant substance misuse, and the unmet behavioral health treatment (BHTx) needs of transgender and gender diverse (TGD) adults. Methods: In 2019, TGD adults (N = 562) in Massachusetts and Rhode Island were purposively recruited and completed a psychosocial and behavioral health survey (95 % online; 5% in-person). Multivariable logistic regression was used to examine factors associated with past 12-month opioid pain medication misuse and unmet BHTx needs. Results: Overall, 24.4 % of participants were trans women; 32.0 % trans men; and 43.6 % were non-binary. Past-year substance misuse included: marijuana (56.8 %), hazardous drinking (37.5 %), hallucinogens (9.8 %), benzodiazepines (8.2 %), and opioid pain medication (8.0 %). Among participants with past-year substance misuse and BHtx need (n = 326), 81.3 % received BHtx and 18.7 % had unmet BHtx needs. Being a trans woman, having HIV, stigma in healthcare, and number of substances misused were associated with increased odds of past-year opioid pain medication misuse; high social connectedness was associated with decreased odds of opioid pain medication misuse ( p -values<0.05). Younger age, stigma in healthcare, and misusing opioid pain medications were associated with increased odds of unmet BHTx needs; post-traumatic stress disorder and family support were associated with decreased odds of unmet BHtx needs ( p -values<0.05). Conclusions: Addressing disparities in opioid pain medication misuse among TGD people requires systematic improvements in healthcare access, including efforts to create TGD-inclusive BHtx environments with providers who are equipped to recognize and treat the social and structural drivers of TGD health inequities, including opioid pain medication misuse.