Bisexual women in the United States are most likely to abuse opioids due to stress and stigma, scientists said, with 14% reporting misuse of drug prescriptions in the last year.
The New York University School of Medicine found past-year misuse of opioids, including painkillers such as morphine and oxycodone, was lowest among heterosexuals at 5%, with bisexual men at 8% and gays and lesbians at 9%.
"When we find that bisexual women are at highest risk for opioid misuse, it actually fits in line with privilege and power and the structures that people have to endure," said Dustin Duncan, an expert in sexuality and health at the university.
"They want to cope with that stress, and one coping mechanism that's possible is the use of opioids," Duncan, the report's lead author, told the Thomson Reuters Foundation.
The United States has the highest per capita rate of opioid use in the world, with an average of 40 deaths each day from prescription opioid overdoses, a four-fold increase since 1999, researchers say.
US President Donald Trump has declared the opioid crisis a public health emergency and broadened access to medical treatment, as well as calling for the execution of drug dealers.
Opioids are involved in more overdose deaths than any other drugs and many people who become dependent on prescription opioids move on to injecting heroin, the study in the American Journal of Preventive Medicine said.
Bisexual women may face particularly high levels of stress, not fully belonging to either straight or lesbian circles, and experiencing both homophobia from the straight community and biphobia from lesbians and gay men, it said.
In addition, bisexual women may be under greater stress than bisexual men as they live in a society in which women are not equally valued, Duncan said.
The research adds to a growing body of evidence regarding higher rates of reported substance abuse by sexual minorities, and of depression, anxiety and self-harm among bisexual people.
Joseph Palamar, another of the study's authors, said bisexual people also report higher levels of recreational drug use than gay or lesbian people - a significant risk factor for opioid misuse.
"Opioids are a completely different story, because they are classically addicting," said Palamar, an associate professor at New York University who has written several papers on drug use.
"You could really be playing with fire if you're using opioids in a recreational manner."
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