Abstract
Nonmedical prescription opioid use is a pressing public health issue in the United States. Transgender youth, including adolescent girls and young women who were assigned male at birth and currently identify as women, female, transgender women, or another diverse gender identity along the transfeminine gender spectrum, are more likely than their cisgender peers to report illicit substance use and meet diagnostic criteria for substance use disorders. However, relatively little is known about the experiences of these populations in the current era of opioid addiction and misuse. To report the prevalence of and risk factors associated with lifetime nonmedical prescription opioid use in a high-risk community sample of transgender adolescent girls and young women who are sexually active. This cross-sectional study used 2012 to 2015 baseline data from Project LifeSkills, a randomized clinical trial of a behavioral intervention to reduce the risk of HIV acquisition and transmission among a diverse sample of transgender adolescent girls and young women recruited from Boston, Massachusetts, and Chicago, Illinois. A total of 297 transgender girls and women aged 16 to 29 years who were sexually active were included in this analysis. Data were analyzed from June 2019 to August 2019. Transgender woman identification. Self-reported lifetime nonmedical prescription opioid use. Among 297 transgender adolescent girls and young women (mean [SD] age, 23.4 [3.5] years), 145 (48.8%) identified as non-Hispanic/Latinx black, 76 (25.6%) identified as non-Hispanic/Latinx white, 37 (12.5%) identified as Hispanic/Latinx, 7 (2.4%) identified as non-Hispanic/Latinx Asian, and 32 (10.8%) identified as multiracial or other race/ethnicity. Thirty-five participants (11.8%) reported lifetime nonmedical prescription opioid use. Young transgender women who smoked cigarettes monthly or less (adjusted odds ratio, 3.92; 95% CI, 1.10-13.89) and who smoked daily (adjusted odds ratio, 5.69; 95% CI, 1.87-17.33) had greater odds of nonmedical prescription opioid use compared with those who did not smoke. Additionally, participants who identified as a sexual orientation other than heterosexual, gay, lesbian, or bisexual had significantly greater odds of lifetime nonmedical prescription opioid use compared with those who identified as heterosexual (adjusted odds ratio, 3.69; 95% CI, 1.07-12.72). These findings suggest that transgender adolescent girls and young women have similar prevalence of lifetime nonmedical prescription opioid use compared with the US general population prevalence of 12.5%. These findings may serve as a call-to-action for public health surveillance studies and evidence-based interventions to be comprehensively tailored to examine and respond to specific trends of substance use, particularly opioid use disorder, among transgender populations.
Highlights
These findings suggest that transgender adolescent girls and young women have similar prevalence of lifetime nonmedical prescription opioid use compared with the US general population prevalence of 12.5%
Deaths attributable to accidental drug overdose, those involving opioids, have reached epidemic levels in the United States, with more than 350 000 documented opioid overdose deaths between 2000 and 2015.1,2 The opioid overdose epidemic has been described as a triple-wave epidemic, with a first wave of opioid overdoses associated with prescription opioids beginning in the late 1990s and early 2000s, a second wave of opioid overdoses associated with heroin beginning the middle of the 2000s, and a third wave of opioid overdoses associated with fentanyl, fentanyl analogues, and other synthetic opioids beginning in the early 2010s
In the unadjusted logistic regression models, participants recruited in Chicago, Illinois, had lower odds of nonmedical prescription opioid use compared with participants who were recruited in Boston, Massachusetts
Summary
Deaths attributable to accidental drug overdose, those involving opioids, have reached epidemic levels in the United States, with more than 350 000 documented opioid overdose deaths between 2000 and 2015.1,2 The opioid overdose epidemic has been described as a triple-wave epidemic, with a first wave of opioid overdoses associated with prescription opioids beginning in the late 1990s and early 2000s, a second wave of opioid overdoses associated with heroin beginning the middle of the 2000s, and a third wave of opioid overdoses associated with fentanyl, fentanyl analogues, and other synthetic opioids beginning in the early 2010s.3 There is significant regional variation in the burden of opioid addiction and misuse, with the highest age-adjusted death rates due to opioid overdose observed in New England and the Midwest.[1,2]Nonmedical prescription opioid use is a pressing public health issue in the United States.[4]. Deaths attributable to accidental drug overdose, those involving opioids, have reached epidemic levels in the United States, with more than 350 000 documented opioid overdose deaths between 2000 and 2015.1,2 The opioid overdose epidemic has been described as a triple-wave epidemic, with a first wave of opioid overdoses associated with prescription opioids beginning in the late 1990s and early 2000s, a second wave of opioid overdoses associated with heroin beginning the middle of the 2000s, and a third wave of opioid overdoses associated with fentanyl, fentanyl analogues, and other synthetic opioids beginning in the early 2010s.3. There is significant regional variation in the burden of opioid addiction and misuse, with the highest age-adjusted death rates due to opioid overdose observed in New England and the Midwest.[1,2]. Documenting the prevalence of nonmedical prescription opioid use among young adults at increased risk and identifying factors associated with use may help inform programs and policies designed to reduce opioid use and drug-related harms in this population
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
