LGBT PEOPLE, DRUG USE & HARM REDUCTION

Previous research suggests that lesbian, gay, bisexual, and transgender youth are at elevated risk for using illicit drugs and misusing prescription drugs relative to heterosexual youth. Previous research also indicates that LGBT youth who attend high schools with GSAs report having fewer alcohol problems and lower levels of cigarette smoking. The present study investigates whether the absence of a GSAs is associated with risk for illicit drug use and prescription drug misuse in a sample of 475 LGBT high school students (M age = 16.79) who completed an online survey.

The Journal of Primary Prevention, 2002

Despite many gaps in the research on substance abuse and sexual orientation, recent data suggest that, overall, substance use among lesbians and gay men—particularly alcohol use—has declined over the past two decades. However, both heavy drinking and use of drugs other than alcohol appear to be prevalent among young lesbians and gay men. Much less is known about bisexual and transgender women and men, but these groups appear to be at heightened risk for substance abuse. This paper describes current research on prevalence and patterns of substance use and abuse in LGBT populations, examines potential risk and protective factors associated with substance abuse in these populations, and discusses implications for prevention, including prevention research.

Australian and New Zealand journal of public health, 2021

esearch indicates meaningfully higher rates of licit and illicit substance use among sexual minority adolescents and young adults, as well as an earlier age of onset worldwide and in Australia. 1-3 The 2019 National Drug Strategy Household Survey reported that sexual minority Australians were significantly more likely than heterosexual people to smoke daily (22.9% vs. 13.5%). 4 Similarly, sexual minority people were also significantly more likely to exceed the lifetime (22.3% vs. 17.0%) and single occasion (37.5% vs. 24.9%) risk guidelines to reduce the harm from alcohol consumption. The survey also found significant disparities in the use of illicit substances in the previous 12 months, with 36% of sexual minority people indicating the use of illicit substances compared to 16.1% of their heterosexual peers (age-standardised). The National Drug Strategy Household Survey uses a nationally representative sample but does not provide data on gender diverse people or young people by sexual orientation. 4 These are consistent with studies from other countries as well as global studies demonstrating overall higher levels of alcohol use among sexual and gender minority (young) people compared to their heterosexual counterparts. 1,5,6 Published research on differences among sexual minority and gender subgroups is generally scarce, however, studies with such comparisons typically indicate that young people identifying as bisexual are at a greater risk of substance use than their gay or lesbian counterparts, and that disparities are larger among female groups than male groups. 1,7 The increased risk of substance use among this population is likely to be multifaceted, originating from socioeconomic, cultural, and environmental conditions as well as social and community networks, and individual lifestyle factors. 8 Previous research focussed on experiences related to people's sexual minority identity as an explanation for disparities in substance use. 9,10 In contrast to their heterosexual peers, young people identifying with a sexual minority orientation are exposed to higher levels of discrimination, marginalisation and oppression in a culture often perceived as homonegative and heterodominant. 11 A 2014 study conducted by the Australian Human Rights Commission found that sexual and gender minority young people in Australia frequently experience verbal and physical homophobic abuse (61% and 18%, respectively) while nine per cent

Substance use & misuse, 2017

Prescription drug, e-cigarette, smokeless tobacco, and synthetic marijuana use has risen dramatically in the United States over the past decade. This paper investigates the use of risky substances among adolescents, and examines disparities between sexual minority (i.e., mostly heterosexual and lesbian, gay, bisexual; LGB) and heterosexual adolescents in use of novel and emerging substances. Given the public health risk and the imminence of these substances in the media, emerging drug use was examined in a county wide sample of adolescents in a Southern state. A probability sample of middle and high school students (N = 3012; ages 11-18) using random cluster methods was obtained in a mid-sized school district in the Southeastern United States. LGB adolescents reported higher past-30 day and lifetime use of cigarettes (AORs =2.77, 2.90, respectively), smokeless tobacco (lifetime only: AOR = 1.88), e-cigarettes (lifetime only; AOR = 1.92), alcohol (AORs = 1.7, 2.20), marijuana (AORs =...

LGBT health, 2020

Purpose: Using representative school-based data and community-level primary data, we investigated how environmental factors (e.g., school and community climate) might be protective against substance use behaviors among a vulnerable population of adolescents. Methods: We analyzed a sample of 2678 sexual minority adolescents using a combination of student-level data (British Columbia Adolescent Health Survey) and primary community-level data (assessing lesbian, gay, bisexual, transgender, and queer [LGBTQ]-specific community and school environments). Using multilevel logistic regression models, we examined associations between lifetime substance use (alcohol, illegal drugs, marijuana, nonmedical use of prescription drugs, and smoking) and community-level predictors (community and school LGBTQ supportiveness). Results: Above and beyond student characteristics (e.g., age and years living in Canada), sexual minority adolescents residing in communities with more LGBTQ supports (i.e., more supportive climates) had lower odds of lifetime illegal drug use (for boys and girls), marijuana use (for girls), and smoking (for girls). Specifically, in communities with more frequent LGBTQ events (such as Pride events), the odds of substance use among sexual minority adolescents living in those communities was lower compared with their counterparts living in communities with fewer LGBTQ supports. Conclusions: The availability of LGBTQ community-level organizations, events, and programs may serve as protective factors for substance use among sexual minority adolescents. In particular, LGBTQ-supportive community factors were negatively associated with substance use, which has important implications for our investment in community programs, laws, and organizations that advance the visibility and rights of LGBTQ people.

LGBT Health, 2020

Purpose: Adolescent drug use remains a significant public health concern. Sexual minority youth (SMY) are at elevated risk for illicit drug use compared with their heterosexual peers. We investigated this pattern at the national level, exploring whether trends and disparities in drug use vary over time and by sexual identity. Methods: This study used Youth Risk Behavior Survey (YRBS) data, which were collected at seven time points from 2005 to 2017. Trends and disparities over time in the use of five drugs, as well as any drug use, were analyzed by self-reported sexual identity. Results: The results demonstrated a general decrease in drug use behaviors from 2005 to 2017. The greatest number of significant decreases was among heterosexual and bisexual students; the fewest were among gay and lesbian students. Disparities between heterosexual youth and SMY persisted across years, and were greater for gay and lesbian students in 2017 than for bisexual and not-sure youth. Conclusions: Our results represent the most comprehensive analysis of recent trends in drug use by sexual identity to date. Disparities in drug use remained significant despite overall downward trends within our sample. The significant decreases among bisexual students are not readily explained. We emphasize the need for ongoing research in this area, particularly given the currently volatile social position of sexual minority populations in the United States, and for culturally responsive and trauma-informed responses to SMY drug use.

PLOS, 2014

Research has shown that bisexuals have poorer health outcomes than heterosexuals, gays, or lesbians, particularly with regard to mental health and substance use. However, research on bisexuals is often hampered by issues in defining bisexuality, small sample sizes, and by the failure to address age differences between bisexuals and other groups or age gradients in mental health. The Risk & Resilience Survey of Bisexual Mental Health collected data on 405 bisexuals from Ontario, Canada, using respondent-driven sampling, a network-based sampling method for hidden populations. The weighted prevalence of severe depression (PHQ-9≥20) was 4.7%, possible anxiety disorder (OASIS≥8) was 30.9%, possible post-traumatic stress disorder (PCL-C≥50) was 10.8%, and past year suicide attempt was 1.9%. With respect to substance use, the weighted prevalence of problem drinking (AUDIT≥5) was 31.2%, and the weighted prevalence of illicit polydrug use was 30.5%. Daily smoking was low in this sample, with a weighted prevalence of 7.9%. Youth (aged 16–24) reported significantly higher weighted mean scores on depression and post-traumatic stress disorder, and higher rates of past year suicidal ideation (29.7% vs. 15.2%) compared with those aged 25 and older. The burden of mental health and substance use among bisexuals in Ontario is high relative to population-based studies of other sexual orientation groups. Bisexual youth appear to be at risk for poor mental health. Additional research is needed to understand if and how minority stress explains this burden.

Addictive Behaviors, 2004

Gay, lesbian, and bisexual (GLB) youths report elevated levels of substance use relative to heterosexual youths, but reasons for this disparity have received scant attention. This report longitudinally examined three hypothesized explanations for cigarette, alcohol, and marijuana use among 156 GLB youths. Counter to two hypotheses, neither a history of childhood sexual abuse nor recent experiences of gay-related stressful life events were associated with increased substance use over time. However, the hypothesis concerning the coming-out process was supported by significant nonlinear associations of involvement in gay-related (recreational and social) activities with changes in alcohol use at 12 months and changes in marijuana use at 6 months and 12 months. Specifically, as involvement in gay-related activities increased, alcohol and marijuana use was found to initially increase, but then, substance use declined as involvement in gay-related activities continued to increase. These findings offer a potential explanation for high levels of substance use among GLB youths and suggest potential areas for intervention to prevent or decrease substance use among these youths. D

Journal of Mental Health Counseling, 2008

The purpose of this study was to examine the relationship between heterosexist events, internalized homophobia, and substance use and abuse among 824 lesbian, gay, and bisexual (LGB) individuals. Participants completed the Schedule for Heterosexist Events (SHE), Internalized Homophobia Scale (IHP), Alcohol Use Disorders Identification Test (AUDIT), and the Drug Abuse Screening Test (DAST). A MANCOVA with age as a covariate and sexual orientation as a cofactor indicated there were significant differences in how lesbians, gay males, and bisexuals experienced heterosexism and internalized homophobia. In particular, gay males and lesbians reported experiencing more heterosexism than bisexuals, and gay males and bisexuals reported experiencing more internalized homophobia than lesbians. Participants who were classified as having at least one alcohol or drug use disorder were significantly more likely to have experienced heterosexism and internalized homophobia than those who were not cla...

Culture, Health & Sexuality, 2013

Research shows that sexual minorities are at greater risk for illicit substance use and related harm than their heterosexual counterparts. This study examines a group of active drug users to assess whether sexual identity predicts increased risk of substance use and harm from ecstasy, ketamine, alcohol, marijuana, cocaine and crack. Structured interviews were conducted with participants aged 15 years and older in Vancouver and Victoria, BC, Canada, during 2008-2012. Harm was measured with the World Health Organization's AUDIT and ASSIST tools. Regression analysis controlling for age, gender, education, housing and employment revealed lesbian, gay or bisexual individuals were significantly more likely to have used ecstasy, ketamine and alcohol in the past 30 days compared to heterosexual participants. Inadequate housing increased the likelihood of crack use among both lesbian, gay and bisexuals and heterosexuals, but with considerably higher odds for the lesbian, gay and bisexual group. Lesbian, gay and bisexual participants reported less alcohol harm but greater ecstasy and ketamine harm, the latter two categorised by the ASSIST as amphetamine and hallucinogen harms. Results suggest encouraging harm reduction among sexual minority, high-risk drug users, emphasising ecstasy and ketamine. The impact of stable housing on drug use should also be considered.