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Substance Use

Examining gender disparities in health and COVID-19 pandemic impact among those with substance use disorders: National Survey on Drug Use and Health, 2021 Brandi Moore* Brandi Moore Farzana Kapadia

Background: Despite growing attention to the overall health and wellbeing of people with substance use disorders (SUD), there has been limited focus on understanding potential gender-based health disparities among this population. Thus, we examined the extent of such gender-based disparities among persons with SUD, particularly after the COVID-19 pandemic.

Methods: Employing 2021 National Survey on Drug Use and Health data restricted to n=10,311 adults meeting DSM-5 criteria for past-year drug and/or alcohol use disorder, weighted prevalence estimates of key substance use, health, and COVID-19 pandemic-related outcomes were calculated by gender. Further, using multivariable logistic regression models, we examined the relationship between gender and these outcomes while controlling for key sociodemographic variables.

Results: In 2021, 14.20% of women and 19.06% of men met DSM-5 criteria for SUD. Compared to men, women were more likely to report: recent STI (AOR=1.88; 95%CI:1.22-2.89), recent emergency department visits (AOR=1.26, 95%CI:1.02-1.55), recent unmet need for mental healthcare (AOR=2.05; 95%CI:1.68-2.50), serious/moderate mental illness (AOR=2.08; 95%CI:1.78-2.44), and presence of ≥1 chronic health condition (AOR=1.33; 95%CI:1.13-1.57). Also, compared to men, women were more likely to report negative impacts from the COVID-19 pandemic including: frequent, serious financial worries (AOR=1.53; 95%CI 1.28-1.83), increased alcohol intake (AOR=1.51; 95%CI:1.26-1.82), declines in mental health (AOR=2.12; 95%CI:1.78-2.52), and moderate/severe impacts on health due to a lack of access to mental healthcare (AOR=1.42; 95%CI:1.08-1.89) or medical care (AOR=1.83, 95%CI:1.31-2.56).

Conclusion: Persistent gender-based health disparities exist among those with SUD. Future research on the health/wellbeing of persons with SUD should account for and further investigate such disparities, especially during periods of social and economic shocks such as the COVID-19 pandemic.