Female-male differences in prescription pain reliever dependence levels: Evidence on newly incident adolescent and young adult users in the United States, 2002-2014.

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ID: 50467
2019
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Abstract
A comprehensive epidemiology of dependence on prescription opioid pain relievers requires evidence about age-specific female-male differences, possibly manifest during adolescent and early adult years. In this study, we identified newly incident extra-medical users of prescription pain relievers (EMPPR), all observed with onsets before the 22 birthday. We then quantified female-male differences in clinical features or manifestations of opioid dependence (OD), devised a measurement-equivalent OD dimension, and estimated age-specific female-male differences in OD levels.The population under study included 12-to-21-year-old non-institutionalized civilian community residents of United States sampled for recent nation-scale surveys. Confidential computer-assisted self-interviews identified newly incident EMPPR users (n = 10,188). Analysis-weighted estimation procedures yielded cumulative incidence proportions for each OD feature, evaluated measurement non-equivalence across subgroups, and estimated female-male differences age-by-age.(1) Tolerance and salience ('spending a lot of time') are most common OD features. (2) Measurement non-equivalence (bias) was found across sex- and onset-age groups. (3) With biasing features removed, we can see elevated OD levels for female new initiates, age-by-age. Subsidiary analyses suggested possibly accelerated progression toward higher OD levels when extra-medical PPR use starts before age 18.Dimensional approaches to OD and other drug use disorders have gained popularity but can be fragile when differential measurement biases are left uncontrolled. This study's bias-corrected dimensional view of female-male differences shows elevated OD levels among newly incident female EMPPR users relative to new male initiates. Future studies can check for accelerated progression to higher OD levels when EM use starts before age 18 years.
Reference Key
cheng2019femalemaledrug Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Cheng, Hui G;Parker, Maria A;Anthony, James C;
Journal Drug and alcohol dependence
Year 2019
DOI
S0376-8716(19)30225-X
URL
Keywords
United States adolescents young adults male-female differences measurement invariance opioid dependence opioid use disorders

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