Associations Between Divorce and Onset of Drug Abuse in a Swedish National Sample

Rates of drug abuse are higher among divorced than married individuals, but it is not clear whether divorce itself is a risk factor for drug abuse or if the observed association is confounded by other factors. We examined the association between divorce and onset of drug abuse in a population-based Swedish cohort born 1965–1975 (n = 651,092) using Cox proportional hazard methods, with marital status as a time-varying covariate. Potential confounders (e.g., demographics, adolescence deviance, family history of drug abuse) were included as covariates. Parallel analyses were conducted for widowhood and drug abuse onset. In adjusted models, divorce was associated with a substantial increase in risk of drug abuse onset in both sexes (hazard ratios >5). Co-relative analyses were consistent with a partially causal role of divorce on drug abuse onset. Widowhood also increased risk of drug abuse onset, though to a lesser extent. Divorce is a potent risk factor for onset of drug abuse, even after adjusting for deviant behavior in adolescence and family history of drug abuse. The somewhat less pronounced association with widowhood, particularly among men, suggests that the magnitude of association between divorce and drug abuse may not be generalizable to the end of a relationship.