Sex differences in the effects of physical and sexual abuse on the odds of past 30-day opioid misuse among Florida justice-involved children

Abstract

Aim

Opioid misuse is a severe threat to justice-involved children and adolescents. Identifying risk factors and sex differences is critical to design accurate risk assessments and person-centered interventions. Stress theory and research posit that abuse may be linked to opioid misuse, and the consequences may be harsher for females. The study tests the hypothesis that physical and sexual abuse will individually and cumulatively increase the risk for opioid misuse, and females will have a higher risk than males.

Methods

A statewide sample of 79,960 justice-involved children in Florida were examined. Opioid misuse, illicit and non-medical use, was measured by urine analysis or self-disclosure within the past-30 days. Bivariate and multivariate logistic regression analyses were employed. Marginal effects were estimated to investigate the interaction between abuse and sex.

Results

Over 2000 youth met the criteria for opioid misuse. One-third of female opioid users experienced both physical and sexual abuse. Compared to those with no history of physical or sexual abuse, those who were physically abused had 43% higher odds of opioid misuse, those who were sexually abuse had 78% higher odds, and those who experienced both had twice as high odds of opioid misuse. The individual and combined effects of these abuse types were higher for females. For example, female youth who were sexually abused had 2.7-times higher odds of opioid misuse than males who were sexually abused.

Conclusion

Intervention efforts can be improved by integrating physical and sexual abuse into risk assessments and tailoring assessments by sex.

Keywords:

• Physical abuse
• sexual abuse
• opioid misuse
• adolescents
• juvenile justice

Acknowledgments

The data in this study were developed by and obtained from the Florida Department of Juvenile Justice (FLDJJ) in Tallahassee, Florida. Our team would like to especially acknowledge the dedicated professional at FLDJJ for managing the data and collaborating with investigators.

Disclosure statement

No potential conflict of interest was reported by the author(s). The content is solely the responsibility of the authors and does not necessarily represent the official views of the University of South Florida, the National Institutes of Health, or the Florida Department of Juvenile Justice.

Additional information

Funding

This research was supported by the National Institutes of Health National Institute on Drug Abuse under award number [R25DA035163] (Dr. Carmen Masson, PI).