MSM more likely than men in general to experience problems related to use of sedatives, tranquilizers and pain relievers

We compared problems with substance use, and history of substance use treatment in a sample of urban MSM with a general population sample of men drawn from the same urban area. Men in both samples completed audio computer-assisted self-interviews (ACASI), including questions on substance use, problems related to substance use experienced in the past 12 months (symptoms of dependence), and lifetime substance treatment. The seven items reflecting DSM-IV criteria of drug dependence were repeated for each of five substance classes: alcohol, marijuana, cocaine, heroin, and pills (tranquilizers, sedatives, and pain relievers).

Compared to men in the general population sample, MSM were significantly more likely to experience problems related to the use of sedatives, tranquilizers, or prescription pain relievers. No differences were evident for problems related to the use of alcohol, marijuana, or cocaine. Twenty-six percent (9/35) of MSM who used tranquilizers, sedatives, or prescription pain relievers reported at least one problem, and 12% (4/35) reported three or more problems, suggestive of dependence. In contrast, of the 23 men in the general population sample who reported use of tranquilizers, sedatives, or prescription pain relievers, one man reported one problem.

Among MSM, history of substance treatment was associated with a positive HIV test, and treatment usually preceded HIV diagnosis. The relationship between HIV status and substance treatment may be due to more risky sexual behavior among men with severe substance use problems. HIV testing and counseling services should be offered by alcohol and drug treatment providers that serve urban MSM.