Sexual minority status, illicit drug use, and depressive symptoms

Abstract

Youth who are lesbian, gay, bisexual, and who identify with other sexual orientations (LGB+) are at higher risk for illicit drug use and have higher rates of mental illness. The current study examined the prevalence of illicit drug use among LGB + persons and assessed the moderating effect of mental illness. Cross-sectional data from the 2015, 2017, and 2019 Youth Risk Behavioral Surveillance System were aggregated. The outcome was any reported use of cocaine, inhalants, heroin, methamphetamines, ecstasy, or hallucinogens. The primary exposure was self-reported sexual orientation category (i.e. heterosexual, gay/lesbian, bisexual, and not sure). Self-reported depressive symptoms were tested as a moderator. Logistic regression models assessed main and interactive effects. Gay or lesbian students [AOR = 1.87 95% CI: 1.45, 2.43], bisexual students [AOR = 2.07 95% CI: 1.77, 2.42], and those unsure of their sexual orientation [AOR = 1.99 95% CI: 1.65, 2.39] had increased odds of illicit drug use. Odds were higher among LGB + youth who did not have depressive symptoms (p < 0.001). Odds of illicit substance use was significantly greater in youth identifying as gay and lesbian, bisexual, and students who were not sure about their sexual orientation and among LGB + youth without depressive symptoms. Targeted, but non-stigmatizing, prevention programs are needed.

Keywords:

• Youth
• substance use
• depression
• LGBTQ
• sexual minorities

Disclosure statement

The authors report no conflicts of interest.

Data availability statement

Data used in this analysis is publicly available on the YRBSS website (https://www.cdc.gov/healthyyouth/data/yrbs/index.htm).

Additional information

Funding

This work was supported by the National Institute of Mental Health of the National Institutes of Health under award number 1R15MH124033-01A1. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Notes on contributors

Jonathan K. Noel

Jonathan Noel is an associate professor at Johnson & Wales University and a public health researcher with experience in addiction, legal, and social epidemiology. He has been involved in numerous international evaluations of alcohol policy and has advocated for stronger marketing restrictions on alcohol and tobacco products. Jonathan’s current research interests include risk and protective factors of substance use, the role of policy in creating or eliminating health disparities, and the measurement of intrinsic sociodemographic characteristics. Dr. Noel received his master’s (2009) and doctorate (2017) in public health from the University of Connecticut.

Stephanie E. Tudela

Stephanie E. Tudela is a recent graduate of Johnson & Wales University. She is interested in the application of novel research methods to explore the intersection between substance use, mental health, and sexuality.

Samantha R. Rosenthal

Samantha R. Rosenthal is a trained epidemiologist with a substantive background in mental health, substance use, health behavior surveillance, behavioral health service utilization, as well as expertise in large datasets and statistical analysis. Her research focuses primarily on young adult health, the role of technology use in behavioral health, and the social determinants of health.