Socioeconomic sequelae of drug abuse in a Swedish national cohort
(2020) In Drug and Alcohol Dependence 212.- Abstract
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... (More)
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.
(Less)
- author
- Edwards, Alexis C. LU ; Ohlsson, Henrik LU ; Sundquist, Jan LU ; Sundquist, Kristina LU and Kendler, Kenneth S.
- organization
- publishing date
- 2020-07-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Co-relative model, Drug abuse, Socioeconomic outcomes, Survival model
- in
- Drug and Alcohol Dependence
- volume
- 212
- article number
- 107990
- publisher
- Elsevier
- external identifiers
-
- pmid:32360456
- scopus:85083885935
- ISSN
- 0376-8716
- DOI
- 10.1016/j.drugalcdep.2020.107990
- language
- English
- LU publication?
- yes
- id
- 52ab05f0-381a-4535-b170-5acbbbc0c068
- date added to LUP
- 2020-05-28 11:16:33
- date last changed
- 2024-03-20 09:39:46
@article{52ab05f0-381a-4535-b170-5acbbbc0c068,
abstract = {{<p>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.</p>}},
author = {{Edwards, Alexis C. and Ohlsson, Henrik and Sundquist, Jan and Sundquist, Kristina and Kendler, Kenneth S.}},
issn = {{0376-8716}},
keywords = {{Co-relative model; Drug abuse; Socioeconomic outcomes; Survival model}},
language = {{eng}},
month = {{07}},
publisher = {{Elsevier}},
series = {{Drug and Alcohol Dependence}},
title = {{Socioeconomic sequelae of drug abuse in a Swedish national cohort}},
url = {{http://dx.doi.org/10.1016/j.drugalcdep.2020.107990}},
doi = {{10.1016/j.drugalcdep.2020.107990}},
volume = {{212}},
year = {{2020}},
}