Associations Between Divorce and Onset of Drug Abuse in a Swedish National Sample

• Published in: American journal of epidemiology Vol. 187; no. 5; pp. 1010 - 1018
• Main Authors: Edwards, Alexis C, Larsson Lönn, Sara, Sundquist, Jan, Kendler, Kenneth S, Sundquist, Kristina
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 01.05.2018; Oxford Publishing Limited (England)
• Subjects: addiction; Adolescents; Adult; Beroendelära; Demographics; Demography; Deviance; Divorce; Divorce - psychology; Drug abuse; family history; Female; Genetics; Health Sciences; Humans; Hälsovetenskap; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Original Contributions; Risk analysis; Risk Factors; Sex Characteristics; Substance Abuse; Substance-Related Disorders - epidemiology; Substance-Related Disorders - etiology; Sweden - epidemiology; widowhood; Widowhood - psychology; Young Adult; Sweden; divorce; drug abuse; family history; addiction; widowhood
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/aje/kwx321

Abstract Rates of drug abuse are higher among divorced individuals than among those who are married, but it is not clear whether divorce itself is a risk factor for drug abuse or whether the observed association is confounded by other factors. We examined the association between divorce and onset of drug abuse in a population-based Swedish cohort born during 1965–1975 (n = 651,092) using Cox proportional hazards methods, with marital status as a time-varying covariate. Potential confounders (e.g., demographics, adolescent deviance, and family history of drug abuse) were included as covariates. Parallel analyses were conducted for widowhood and drug-abuse onset. In models with adjustments, divorce was associated with a substantial increase in risk of drug-abuse onset in both sexes (hazard ratios > 5). Co-relative analyses (among biological relatives) were consistent with a partially causal role of divorce on drug-abuse onset. Widowhood also increased risk of drug-abuse onset, although to a lesser extent. Divorce is a potent risk factor for onset of drug abuse, even after adjusting for deviant behavior in adolescence and family history of drug abuse. The somewhat less-pronounced association with widowhood, particularly among men, suggests that the magnitude of association between divorce and drug abuse may not be generalizable to the end of a relationship.