Introduction and Objective: Substance use (SU) and SU disorders (SUDs) adversely affect diabetes management and increase the risk of diagnosed diabetes (DM) complications. We estimated disparities in the prevalence of SU, SUDs, and SUD treatment among those with SUDs (SUDT) among US adults with DM by sociodemographic characteristics.Methods: We used 2021-2022 National Survey on Drug Use and Health self-reported data from 6,816 adults aged ≥18 years with DM. SU was defined as heavy alcohol use or binge drinking in the last 30 days or, in the past year, using any cannabis, cocaine in any form, heroin, hallucinogens, inhalants, or methamphetamine, or misusing prescription medications. A diagnosis of SUD was based on meeting criteria for use or misuse of any of these substances. Receipt of any SUDT (2022 only) was assessed among adults with any SUDs. We estimated crude prevalence (cPrev) for each outcome and adjusted prevalence ratios (aPR) using logistic regression adjusted for age, sex, race and ethnicity, education, self-rated health, family income, insurance coverage, and rurality.Results: Among those with DM, cPrev estimates (%, 95% CI) were 24.6 (23.1-26.2) for SU and 8.7 (7.8-9.8) for SUDs. Among those aged ≥65 years, cPrev estimates (%) were 14.6 (12.3-17.4) for SU, 23.3 (15.6-34.8) for SUDs, and 4.2 (1.3-13.0) for SUDT. Compared with those aged ≥65 years, aPRs (95% CI) of SU, SUDs, and SUDT were 3.4 (2.7-4.3), 2.0 (1.3-3.1), and 10.2 (2.3-46.0) for adults aged 18-34 years, and 3.0 (2.4-3.6), 1.6 (1.0-2.4), and 7.3 (1.5-36.3) for adults aged 35-49 years. Men, non-Hispanic (NH) White adults (vs. NH Asian adults), those in fair/poor health (vs. good), and those living in large metro areas (vs. nonmetro) had higher prevalence of SU.Conclusion: Among adults with DM, SU and SUDs, are common. SUDT among those with SUDs was low, especially among older adults. Addressing availability and accessibility of SUDT may improve health outcomes in adults with DM.
Y.J. Cheng: None. I. Zaganjor: None. J. Ko: None. R. Li: None. C.S. Holliday: None. K.M. Bullard: None.
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