عنوان انگلیسی مقاله:
Socioeconomic sequelae of drug abuse in a Swedish national cohort
ترجمه فارسی عنوان مقاله:
عوارض اجتماعی و اقتصادی سوء مصرف مواد مخدر در یک گروه ملی سوئد
Sciencedirect - Elsevier - Drug and Alcohol Dependence, 212 (2020) 107990. doi:10.1016/j.drugalcdep.2020.107990
Alexis C. Edwardsa,*, Henrik Ohlssonb, Jan Sundquistb, Kristina Sundquistb,c,1, Kenneth S. Kendlera
Background: Drug abuse is frequently associated with negative sequelae such as reduced socioeconomic functioning.
The extent to which these associations are attributable to a causal role of the disorder versus confounding
factors that increase risk for both drug abuse and negative socioeconomic outcomes is unclear.
Methods: Drug abuse cases were identified using Swedish national medical, pharmacy, and criminal registers.
Applying Cox proportional hazard models, we tested the association between drug abuse and four outcomes:
early retirement, social assistance, unemployment, and income at age 50. We used co-relative models to determine
whether familial confounding factors accounted for observed associations.
Results: In models adjusted for birth year, education, and early onset externalizing behavior, drug abuse was
strongly associated with early retirement (hazard ratios [HR]=5.13–6.28), social assistance (HR=6.74–7.89),
and income at age 50 (beta=−0.19 to −0.12); it was more modestly associated with unemployment
(HR=1.05–1.20). For social assistance and income (both sexes), and early retirement (women only), a model in
which the association was partly attributable to familial factors fit the data well; residual associations support a
partially causal role of drug abuse. For unemployment and early retirement among men, there was little evidence
of familial confounding.
Conclusions: The negative socioeconomic sequelae of drug abuse are likely due in part to familial confounding
factors in conjunction with a causal relationship and/or unmeasured non-familial confounders. Relative contributions
from distinct mechanisms differed across socioeconomic outcomes, which could have implications for
understanding the potential impact of prevention and intervention efforts.
Keywords: Drug abuse | Socioeconomic outcomes | Co-relative model | Survival model