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Social support may moderate the impact of stress on SUD among SM adults. This study assessed associations between social support and DSM\u20105 SUD by sex and sexual minority identity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross\u2010sectional study using data from the 2012\u201313 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC\u2010III).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting and participants<\/jats:title><jats:p>A nationally representative cross\u2010sectional sample of adults (<jats:italic>n<\/jats:italic>\u00a0=\u00a036\u2009309) in the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>SUD were defined based on the DSM\u20105 criteria for alcohol use (AUD), tobacco use (TUD) and drug use (DUD) disorders. Structural social support was measured as the type and frequency of kin and non\u2010kin contact, and functional social support was measured by the Social Provision Scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>SM adults had higher odds of all SUD compared to heterosexual adults [AUD\u00a0=\u00a01.535, 95% confidence interval (CI)\u00a0=\u00a01.782\u20131.844; TUD\u00a0=\u00a01.512, 95% CI\u00a0=\u00a01.234\u20131.854; DUD\u00a0=\u00a01.520, 95% CI\u00a0=\u00a01.139\u20132.028]; SM women experienced the highest proportion of all SUD (AUD\u00a0=\u00a027.1%, TUD\u00a0=\u00a029.1%, DUD\u00a0=\u00a010.9%). Type of social support was differentially associated with SUD by sex and sexual identity status. Higher social provision was associated with lower rates of AUD [adjusted odds ratio (aOR)\u00a0=\u00a00.771, 95% CI\u00a0=\u00a00.705\u20130.844], TUD (aOR\u00a0=\u00a00.747, 95% CI\u00a0=\u00a00.694\u20130.804] and DUD (aOR\u00a0=\u00a00.558, 95% CI\u00a0=\u00a00.490\u20130.636). Marriage was associated with lower SUD among heterosexual men (AUD, aOR\u00a0=\u00a00.500, 95% CI\u00a0=\u00a00.432\u20130.579; TUD, aOR\u00a0=\u00a00.603, 95% CI\u00a0=\u00a00.521\u20130.699; DUD, aOR\u00a0=\u00a00.504, 95% CI\u00a0=\u00a00.369\u20130.689) and women (AUD, aOR\u00a0=\u00a00.637, 95% CI\u00a0=\u00a00.529\u20130.767; TUD\u00a0=\u00a00.0.584, 95% CI\u00a0=\u00a00.507\u20130.671; DUD, aOR\u00a0=\u00a00.515, 95% CI\u00a0=\u00a00.372\u20130.712). Compared to heterosexual adults, SM women with at least one child under the age of 18\u00a0years had higher odds of TUD (aOR\u00a0=\u00a01.990, 95% CI\u00a0=\u00a01.325\u20132.988). SM\u2010related discrimination was not associated with SUD among some SM subgroups, but discrimination among male heterosexually identifying individuals reporting same\u2010sex attraction or behavior was associated AUD (aOR\u00a0=\u00a04.608, 95% CI\u00a0=\u00a01.615\u201313.14).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In the United States there are significant associations between functional support (quality or provision of support) and structural support (type and frequency of social networks) and substance use disorder (SUD) which differ by sex and sexual identity status.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.14819","type":"journal-article","created":{"date-parts":[[2019,10,10]],"date-time":"2019-10-10T01:19:36Z","timestamp":1570670376000},"page":"546-558","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["Functional and structural social support, substance use and sexual orientation from a nationally representative sample of US adults"],"prefix":"10.1111","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6060-9852","authenticated-orcid":false,"given":"Erin M.","family":"Kahle","sequence":"first","affiliation":[{"name":"Center for Sexuality and Health Disparities, School of Nursing University of Michigan  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phil","family":"Veliz","sequence":"additional","affiliation":[{"name":"Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing University of Michigan  Ann Arbor MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9622-4652","authenticated-orcid":false,"given":"Sean Esteban","family":"McCabe","sequence":"additional","affiliation":[{"name":"Center for Sexuality and Health Disparities, School of Nursing University of Michigan  Ann Arbor MI USA"},{"name":"Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing University of Michigan  Ann Arbor MI"},{"name":"Institute for Research on Women and Gender University of Michigan  Ann Arbor MI USA"},{"name":"Institute for Healthcare Policy and Innovation University of Michigan  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2651-6614","authenticated-orcid":false,"given":"Carol J.","family":"Boyd","sequence":"additional","affiliation":[{"name":"Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing University of Michigan  Ann Arbor MI"},{"name":"Institute for Research on Women and Gender University of Michigan  Ann Arbor MI USA"},{"name":"Addiction Center, Department of Psychiatry, School of Medicine University of Michigan  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.10.038"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.16m10657"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2018.01.012"},{"key":"e_1_2_7_5_1","first-page":"532","article-title":"Differences in substance use between sexual orientations in a multi\u2010country sample: findings from the global drug survey 2015","volume":"39","author":"Demant D.","year":"2017","journal-title":"J Public Health (Oxf)"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2018.05.014"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2018.03.009"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2017.12.036"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2018.05.008"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2009.02596.x"},{"key":"e_1_2_7_11_1","volume-title":"Sexual orientation an estimates of adult substance use and mental health: results from the 2015 National Survey on Drug Use and Health","author":"Medley G. 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