Gender and race/ethnic differences in the persistence of alcohol, drug, and poly-substance use disorders.

Abstract

To examine gender and racial/ethnic differences in the effect of substance use disorder (SUD) type on SUD persistence. Data were provided by 1025 women and 1835 men from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to examine whether gender and race/ethnicity (Non-Hispanic White, Black, Hispanic) moderate the effects of DSM-IV defined past-12 month SUD type (alcohol, drug, poly-substance) on SUD persistence at 3-year follow-up, controlling for covariates. Using gender-stratified weighted binary logistic regression, we examined predictors of SUD persistence, tested an SUD type by race/ethnicity interaction term, and calculated and conducted Bonferroni corrected pairwise comparisons of predicted probabilities. SUD persistence rates at 3-year follow-up differed for SUD type by gender by race/ethnicity sub-group, and ranged from 31% to 81%. SUD persistence rates were consistently higher among poly-substance users; patterns were mixed in relation to gender and race/ethnicity. Among women, alcohol disordered Hispanics were less likely to persist than Whites. Among men, drug disordered Hispanics were less likely to persist than Whites. Also, Black men with an alcohol or drug use disorder were less likely to persist than Whites, but Black men with a poly-substance use disorder were more likely to persist than Hispanics. The effect of SUD type on SUD persistence varies by race/ethnicity, and the nature of these relationships is different by gender. Such knowledge could inform tailoring of SUD screening and treatment programs, potentially increasing their impact.