Lesbian, gay or bisexual youth are at increased risk of using multiple substances

September 14, 2018 by Michelle Klampe, Oregon State University

Young people who identify as lesbian, gay or bisexual are at increased risk of using substances such as alcohol, nicotine and marijuana, a new study from Oregon State University has found.

These youth are also at higher risk of polysubstance use, meaning they are more likely to use more than one substance than their heterosexual peers. The study was just published in the journal Drug and Alcohol Dependence.

"This data shows definitively that polysubstance use is an issue among many youth who identify as sexual minorities, meaning they are facing added health risks," said Sarah Dermody, an assistant professor in the School of Psychological Science in OSU's College of Liberal Arts. "But there are also differences among the subgroups of youth who identify as sexual minorities, suggesting we need to look beyond the averages to understand what factors may be influencing substance use in this population."

Sexual minority is an umbrella term for those who identify with any sexual identity other than heterosexual or who report same-sex attraction or behavior. For the purposes of the study, the researchers focused on those youth who identified as lesbian, gay or bisexual.

Dermody studies risky behaviors such as alcohol and nicotine use with the goal of better understanding factors that contribute to the substances' use and how best to intervene when the use is problematic.

Among youth, alcohol, marijuana and nicotine are the three most commonly used drugs. That is a concern because youth who use those substances are at risk of negative health and social outcomes, including addiction and poor cognitive, social and academic function.

Recent research has shown that sexual minority youth reported nearly three times more substance use than heterosexual youth. The disparity may be due in part to stress from discrimination, violence and victimization rooted in their sexual minority status, Dermody said.

The goal of the new study was to better understand the risks associated with polysubstance use, or the use of three or more types of drugs, among sexual minority youth. It is an area of research that is largely unexamined, Dermody said.

"The experiences of youth who identify as lesbian, gay or bisexual are underreported in research, generally," she said. "In research we tend to focus on the averages. In this study, we're trying to better understand the intersectionality of sexual orientation, race and gender with substance use. Are some sexual minority youth at more risk than others for substance use?"

Dermody analyzed results from the Centers for Disease Control's 2015 Youth Risk Behavior Surveillance System, which monitors key health and risk behaviors among youth, including substance abuse. The 2015 national survey of more than 15,000 youth was the first wave of the survey to include a question about sexual identity, giving researchers new insight into how a youth's sexual identity might impact substance use.

The data showed that there is a sizeable number of youth, both heterosexual and sexual minority, who don't use any substances at all, Dermody said.

But among those who do, she found that those identified as sexual minority youth were at higher risk of using each type of drug—alcohol, marijuana and cigarettes—compared to heterosexual youth. They are also at higher risk of polysubstance abuse overall.

And within the youth population, some groups were at more risk than others for using one, two or all three substances. For example, bisexual youth faced the largest increase in risk of polysubstance abuse as well as combinations of two substances, while those who identified as lesbian or gay were only at higher risk for some combinations.

"The findings suggest that it may be good practice for health care providers who serve these youth to do assessments for substance use as part of regular health screenings," Dermody said.

Further research is needed to determine what factors may be contributing to increased substance use among youth identifying as sexual minorities, and why those factors may impact some more than others.

"Are the lesbian, gay and bisexual youth using substances also facing additional adversity? Or are there protective factors that play a role in keeping some of these from using ?" Dermody said. "We want to better understand what may be driving the differences in the substance use."

Explore further: Tobacco use in youth higher among sexual minorities

More information: Sarah S. Dermody, Risk of polysubstance use among sexual minority and heterosexual youth, Drug and Alcohol Dependence (2018). DOI: 10.1016/j.drugalcdep.2018.07.030

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