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

Alexis C. Edwards, Sara Larsson Lönn, Jan Sundquist, Kenneth S. Kendler, Kristina Sundquist

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16 Scopus citations


Rates of drug abuse are higher among divorced individuals than among those who are married, but it is not clear whether divorce itself is a risk factor for drug abuse or whether 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 during 1965-1975 (n = 651,092) using Cox proportional hazards methods, with marital status as a time-varying covariate. Potential confounders (e.g., demographics, adolescent deviance, and family history of drug abuse) were included as covariates. Parallel analyses were conducted for widowhood and drug-Abuse onset. In models with adjustments, divorce was associated with a substantial increase in risk of drug-Abuse onset in both sexes (hazard ratios > 5). Co-relative analyses (among biological relatives) were consistent with a partially causal role of divorce on drug-Abuse onset. Widowhood also increased risk of drug-Abuse onset, although 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.

Original languageEnglish
Pages (from-to)1010-1018
Number of pages9
JournalAmerican Journal of Epidemiology
Issue number5
StatePublished - 1 May 2018


  • addiction
  • divorce
  • drug abuse
  • family history
  • widowhood


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