title: Gender discrimination, educational attainment, and illicit drug use among U.S. women.
abstract: While gender inequality has been a topic of concern for decades, little is known about the relationship between gender discrimination and illicit drug use. Further, whether this association varies by education level is unknown.
  
  
  
  Among 19,209 women participants in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (2004-2005), we used logistic regression to test the association between gender discrimination (measured with four items from the Experiences of Discrimination instrument) and three outcomes: past-year illicit drug use, frequent drug use, and drug use disorders. We then tested whether associations differed by education level.
  
  
  
  Gender discrimination was reported by 9% of women and was associated with past-year drug use [adjusted odds ratio (aOR) = 2.67; 95% confidence interval (CI) 2.17-3.29], frequent drug use (aOR = 2.82; CI 1.99-4.00), and past-year drug use disorders (aOR = 3.15; CI 2.16-4.61). All specific domains of gender discrimination (on the job, in public, with institutions, being called a sexist name) were associated with all drug use outcomes. The association between gender discrimination and past-year drug use was stronger among women with less than a high school education (aOR = 6.33; CI 3.38-11.85) compared to those with more education (aOR = 2.45; CI 1.97-3.04; pinteraction< 0.01).
  
  
  
  Gender discrimination is consistently and strongly associated with illicit drug use and drug use disorders among U.S. women, with significantly higher odds for drug use among women with less than a high school education. Future research should examine whether explicitly addressing distress from discrimination could benefit women in drug treatment, especially among clients with lower educational attainment.
authors.affiliation: Department of Epidemiology, Columbia University, 722 W. 168th St., Office 1030-F, New York, NY, 10032, USA. hcarliner@mail.harvard.edu.
authors.forename: Hannah
authors.identifier: 0000-0001-8741-0392
authors.initials: H
authors.lastname: Carliner
authors.affiliation: New York State Psychiatric Institute, 1051 Riverside Drive #123, New York, NY, 10032, USA.
authors.forename: Aaron L
authors.initials: AL
authors.lastname: Sarvet
authors.affiliation: Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, USA.
authors.forename: Allegra R
authors.initials: AR
authors.lastname: Gordon
authors.affiliation: Department of Epidemiology, Columbia University, 722 W. 168th St., Office 1030-F, New York, NY, 10032, USA.|New York State Psychiatric Institute, 1051 Riverside Drive #123, New York, NY, 10032, USA.|Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA.
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Hasin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004522:Educational Status; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008875:Middle Aged; D063507:Sexism / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States; D055815:Young Adult
chemical_list: D013287:Illicit Drugs
keywords: Drug use disorders; Educational status; Gender; Psychological stress; Sex discrimination