BACKGROUND Little research examines risks of opioid misuse among military veterans, particularly among minority military veterans. The present study examines lifetime and past 12-month prescription opioid misuse among heterosexual versus non-heterosexual military veterans in the United States. METHOD Participants comprised 9729 U.S. military veterans aged 18 and older who completed the 2015-2017 National Survey on Drug Use and Health (NSDUH). Sample weights were applied to yield nationally representative estimates in the target population. Design-based multivariable logistic regression analysis was used to examine associations between sociodemographic characteristics and risk of prescription opioid misuse. RESULTS Bisexual veterans reported greater lifetime odds of having misused prescription opioids in their lives compared to their heterosexual peers (AOR: 4.04, 95% CI: 1.72-5.38). However, only bisexual women veterans reported elevated risk past 12-month misuse (AOR: 3.47, 95% CI: 1.28, 9.41). Although veterans aged 50 and older reported lower risk of lifetime prescription opioid misuse relative to 18-34 year olds (AOR: 0.33, 95% CI: 0.25-0.44), older veterans showed greater risk of past 12-month misuse (AOR: 1.23, 95% CI: 1.02-1.49). DISCUSSION To our knowledge, this study is the first to systematically examine differential risk factors of prescription opioid misuse between heterosexual and non-heterosexual military veterans. Results from this study suggest a critical need for greater investigations into the specific risks of opioid-related substance use for military veterans. This study highlights areas of research and practice that can improve health outcomes for military veterans and their communities.

中文翻译：

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异性恋与女同性恋，男同性恋和双性恋退伍军人之间的处方阿片类药物滥用：来自2015-2017年全国毒品使用和健康调查的证据。

背景技术很少有研究检查军人，特别是少数民族军人中阿片类药物滥用的风险。本研究调查了美国异性恋与非异性恋退伍军人之间的终生和过去12个月处方阿片类药物滥用情况。方法参与者包括9729名18岁及18岁以上的美国退伍军人，他们完成了2015-2017年全国药物使用和健康调查（NSDUH）。应用样本权重得出目标人群中全国代表性的估计值。基于设计的多变量logistic回归分析用于检验社会人口统计学特征与处方阿片类药物滥用风险之间的关联。结果与异性恋同龄人相比，双性恋退伍军人一生中滥用处方阿片类药物的终生几率更高（AOR：4.04，95％CI：1.72-5.38）。但是，只有双性恋女性退伍军人报告滥用后12个月的风险升高（AOR：3.47，95％CI：1.28，9.41）。尽管50岁及以上的退伍军人相对于18-34岁的老年人报告终身滥用阿片类药物的风险较低（AOR：0.33，95％CI：0.25-0.44），但老年的退伍军人显示过去12个月滥用的风险较高（AOR：1.23 ，95％CI：1.02-1.49）。讨论就我们所知，这项研究是第一个系统地检查异性恋和非异性恋退伍军人处方阿片类药物滥用的不同危险因素的研究。这项研究的结果表明，迫切需要对退伍军人使用类鸦片相关物质的具体风险进行更大的调查。这项研究突出了可以改善退伍军人及其社区健康状况的研究和实践领域。