Citation

Schuler MS, Rice CE, Evans-Polce RJ, Collins RL. Drug Alcohol Depend. 2018; 189: 139-146.

Affiliation

RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA. Electronic address: collins@rand.org.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.drugalcdep.2018.05.008

PMID

29944989

Abstract

BACKGROUND: Sexual minorities (SMs) experience elevated rates of substance use behaviors and disorders relative to heterosexuals; minority stress is theorized to contribute to these disparities. As SMs are not a homogenous group, analyses that aggregate SMs across sexual identity, age, or gender obscure important variation among this population. To date, age- and gender-specific disparities have not been rigorously examined using a large national sample.

METHODS: Using data on 67,354 adults (ages 18-49) from the 2015 and 2016 National Survey of Drug Use and Health we examined age- and gender-specific disparities in smoking, heavy episodic drinking, marijuana use, illicit drug use, and alcohol/substance use disorder. Age groups were ages 18-25, 26-34, and 35-49. Using logistic regression, we estimated age- and gender-specific odds ratios for gay/lesbian and bisexual individuals, relative to heterosexuals; analyses adjusted for demographic characteristics.

RESULTS: Bisexual women had significantly elevated odds of all outcomes at all ages, relative to heterosexual women. Gay/lesbian individuals had significantly elevated odds for nearly all outcomes compared to same-gender heterosexuals at ages 18-25, but not consistently at older ages. For bisexual men, significant disparities compared to heterosexual men were only observed at ages 35-49 for marijuana use and alcohol/substance use disorder.

CONCLUSIONS: We found notable within-group differences regarding SM disparities. While disparities were most pronounced in young adulthood for gay/lesbian individuals and mid-adulthood for bisexual men, bisexual women uniquely experienced disparities across all ages. Minority stress experiences may vary with respect to gender, age/cohort, and sexual identity, resulting in differential risk for substance use.

Copyright © 2018 Elsevier B.V. All rights reserved.

Language: en

Keywords

Disparities; LGB; Sexual minorities; Substance use; Substance use disorders