Results suggest that stress is robustly associated with new and ongoing SUDs for both women and men, across all major classes of substances. The interaction between stressful life events and gender for new vs. absent DSM-5 AUD diagnoses newly identifies that women with two or more stressful life events compared to zero or one event were 4 times more likely to have a new AUD, while men with two or more stressful life events compared to zero or one event were 2.5 times more likely to have a new AUD. While epidemiologic findings from the present investigation do not imply causal or temporal relationships, the results are consistent with work indicating that stress plays a robust role in the development and maintenance of SUDs, and that both women and men may use substances to regulate stress. Importantly, this study highlights that effective interventions for substance use should consider the role of stress in individuals with new or ongoing SUD diagnoses, across all major substances.
