The trajectory of substance use disorder among people formerly in foster care: A survival analysis.

IF 2.5 4区医学 Q2 PSYCHIATRY International Journal of Social Psychiatry Pub Date : 2025-02-01 Epub Date: 2024-10-25 DOI:10.1177/00207640241287088

Sogol Olamazadeh, Ahmed N Hassan, Bernard Le Foll

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Abstract

Background: Substance use disorder (SUD) represents a significant public health challenge, especially among individuals who have faced early life adversities. Foster care aims to provide a supportive environment for children; however, the relationship between a history of foster care and SUD development remains unclear.

Aims: This study aims to examine the likelihood of developing SUD among individuals with a history of foster care, who have used substances during their lifetime, compared to those raised by biological parents.

Method: Using data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), we analyzed the prevalence of social demographics and clinical variables among individuals who have used alcohol, nicotine, or cannabis. We calculated the probabilities of developing SUD for each factor, including exposure to foster care. Various covariates that could impact SUD occurrence were also assessed. The duration from initial substance use to SUD onset was calculated for both groups. Survival analysis curves were generated for each substance to depict the probability of SUD development over time.

Results: Our analysis revealed that foster care may act as a protective factor against Cannabis Use Disorder (CUD), with a hazard ratio of 0.25 (95% CI [0.07, 0.88]). No significant associations were found with Alcohol Use Disorder (AUD) or Nicotine Use Disorder (NUD). Both foster and non-foster care groups exhibited higher probabilities of developing NUD compared to the general population. For cannabis users, the probability of developing CUD stabilizes after approximately 10 years. Family history of SUD and clinical predictors such as mood disorders consistently showed significant associations across all substance groups, highlighting their importance in SUD development.

Conclusion: Our findings suggest that foster care may offer some protective benefits, particularly against CUD, emphasizing the need for further research into its protective factors and the development of targeted interventions to reduce SUD prevalence in this population.

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曾接受寄养者的药物使用障碍轨迹：生存分析。

背景：药物滥用障碍（SUD）是一项重大的公共卫生挑战，尤其是在那些早年面临生活逆境的人当中。寄养的目的是为儿童提供一个支持性的环境；然而，寄养史与药物滥用障碍发展之间的关系仍不清楚。研究目的：本研究旨在探讨与亲生父母抚养的儿童相比，有寄养史且一生中使用过药物的儿童患药物滥用障碍的可能性：我们利用美国国家酒精及相关疾病流行病学调查-III（NESARC-III）的数据，分析了曾使用过酒精、尼古丁或大麻的人群中社会人口统计学和临床变量的流行率。我们计算了每个因素（包括寄养）导致罹患 SUD 的概率。我们还评估了可能影响 SUD 发生的各种协变量。我们还计算了两组人群从最初使用药物到出现药物依赖性障碍的持续时间。为每种物质生成了生存分析曲线，以描述随着时间推移出现 SUD 的概率：我们的分析表明，寄养可能是预防大麻使用障碍（CUD）的一个保护因素，其危险比为 0.25（95% CI [0.07，0.88]）。与酗酒症（AUD）或尼古丁使用障碍（NUD）没有明显关联。与普通人群相比，寄养和非寄养群体患 NUD 的概率都较高。对于大麻使用者来说，罹患 CUD 的概率在大约 10 年后趋于稳定。在所有药物组别中，SUD 家族史和情绪障碍等临床预测因素始终显示出显著的关联性，突出了它们在 SUD 发展过程中的重要性：我们的研究结果表明，寄养可能具有一定的保护作用，尤其是对 CUD 的保护作用，因此有必要进一步研究其保护因素，并制定有针对性的干预措施，以降低这一人群的 SUD 患病率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Social Psychiatry PSYCHIATRY-

CiteScore

12.30

自引率

1.30%

发文量

120

期刊介绍： The International Journal of Social Psychiatry, established in 1954, is a leading publication dedicated to the field of social psychiatry. It serves as a platform for the exchange of research findings and discussions on the influence of social, environmental, and cultural factors on mental health and well-being. The journal is particularly relevant to psychiatrists and multidisciplinary professionals globally who are interested in understanding the broader context of psychiatric disorders and their impact on individuals and communities. Social psychiatry, as a discipline, focuses on the origins and outcomes of mental health issues within a social framework, recognizing the interplay between societal structures and individual mental health. The journal draws connections with related fields such as social anthropology, cultural psychiatry, and sociology, and is influenced by the latest developments in these areas. The journal also places a special emphasis on fast-track publication for brief communications, ensuring that timely and significant research can be disseminated quickly. Additionally, it strives to reflect its international readership by publishing state-of-the-art reviews from various regions around the world, showcasing the diverse practices and perspectives within the psychiatric disciplines. This approach not only contributes to the scientific understanding of social psychiatry but also supports the global exchange of knowledge and best practices in mental health care.