December 6, 2017

Gay and Bisexual Men: Risk for Opioid Abuse

There has only been a limited amount of research concerning how opioid addiction and abuse affects the LGBTQ population. In a 2009 study in Chicago, researchers found that men who have sex with men are more likely than the general male population to experience substance abuse problems with prescription opioid pain relievers (analgesics).[1] A survey of men who have sex with men attending a gay pride festival in Colorado in 2011 also showed that a significant minority of this population uses prescription medications, most commonly opioid pain relievers, without a doctor’s consent. More than one third of the sample (38%) reported using prescription drugs for a nonmedical use (e.g. to change their mood or for insomnia) in their lifetime, most commonly prescription opioid pain relievers.[2] Men who use opioid non-medically are risking negative consequences of such use, including the potential for addiction, potentially dangerous interactions between prescription and recreational drugs, and greater risk for contracting HCV and HIV. Any history of substance abuse problems and treatment in gay and bisexual men is associated with a diagnosis of HIV.[3] However, injection drug users (such as heroin users) are one of the main groups at risk of HIV exposure in the United States; gay and bisexual men are the other most high-risk group. [4] A 2011 study of men who have sex with men in Australia showed that gay and bisexual men who injected drugs were more likely to be HCV-positive and HIV-positive than gay and bisexual men who did not inject drugs.[5]

Gay and Bisexual Men: Opioid Abuse Treatment

Male gay and bisexual injection drug users may especially benefit from expanded substance abuse and prevention services, because other strong risk factors for HIV and HCV are also likely to be present. The strong association between injecting drug use, risky sexual practices, and blood-borne virus infection suggests the need for a special emphasis on sexual health and harm reduction services within holistic substance abuse services for gay and bisexual men.[6] Prescription pain pill addiction may also contribute to high-risk sexual behavior and a higher risk of HIV/AIDS. HIV testing, education, and prevention should be provided alongside substance abuse treatment and MAT for this population.[7] — [1]Mackesy-Amit, M. E., Fendrich, M., Johnson, T. P. (2009). Substance-related problems and treatment among men who have sex with men in comparison to other men in Chicago. Journal of Substance Abuse Treatment. 36(2), 227–233. [2]Benotsch, E.G., Martin, A.M., Koester, S., Cejka, A., Luckman, D. (2011). Nonmedical use of prescription drugs and HIV risk behavior in gay and bisexual men. Sex Transm Dis. Feb;38(2), 105-10. [3]Mackesy-Amit, M. E,m et al. 2009. [4] Ibanez, G.E., Purcell, D.W., Stall, R., Parsons, J.T., Gomez, C.A. (2005). Sexual risk, substance use, and psychological distress in HIV-positive gay and bisexual men who also inject drugs. AIDS. Apr 19 Suppl 1, S49-55. [5] Lea, T., Mao, L., Bath, N., Prestage, G., Zablotska, I., de Wit, J.. Holt, M. (2013). Injecting drug use among gay and bisexual men in Sydney: prevalence and associations with sexual risk practices and HIV and hepatitis C infection. AIDS Behav. May 17(4),1344-51. [6] Lea, T., et al. 2013. [7]Mackesy-Amit, M. E., et al. 2009.