Prescription opioid misuse among heterosexual versus lesbian, gay, and bisexual military veterans: Evidence from the 2015-2017 national survey of drug use and health

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.