A New Study Shows How Substance Use Impacts Sexual Minorities — And It Needs More Attention

While LGBTQ representation has been reaching new heights in the past few years, from fictional TV characters to IRL politicians, the United States has yet to achieve true equality for people in the LGBTQ community. Scientists have long been interested in researching just how these inequalities manifest in the life experiences of sexual minorities, particularly when it comes to substance use. A new study from the University of Michigan examined the severity of the relationship between sexual orientation and alcohol, drug, and tobacco use disorders.

Published in the journal LGBT Health, the study relied on national survey data spanning from 2012 to 2013. For the study’s purposes, “sexual minorities” were defined as people who identified as lesbian, gay, or bisexual, as well as people who were “not sure” how they identified their sexual orientation. Approximately six percent of the 36,309 American adult survey respondents were categorized as a sexual minority. The researchers used the data to determine how sexual identity, sexual attraction, and sexual behavior were related to substance use in the study subjects. While multiple studies have found evidence linking sexual minority individuals with higher risks for substance use, the new study assessed the severity of drug, alcohol, and tobacco use disorders among these communities relative to their heterosexual peers. According to the National Institutes of Health, stressors like social stigma, harassment, and discrimination are among the challenges that contribute to sexual minorities’ heightened risk for health issues including substance use.

The researchers concluded that substance use disorders were, in fact, more common and more severe in sexual minority populations. In the study, bisexual and “not sure” adults in particular were more likely to have severe alcohol and tobacco use disorders, and there were notably little scientifically significant differences between subjects who were “not sure” and individuals who identified as bisexual. Relative to straight people in the survey, “unsure” people were five times more likely to report having a severe alcohol use disorder, as well as almost four times as likely to have a severe tobacco or drug problem. Self-identified lesbian and gay individuals were more than two times as likely to have a severe alcohol or tobacco use disorder than heterosexuals.

"Our findings provide strong evidence that a higher proportion of sexual minority individuals, particularly bisexual individuals and those who are not sure of their sexual identities, have severe alcohol and tobacco use disorders, and those who are 'not sure' also have a higher proportion of severe drug use disorders," Carol Boyd, one of the study co-authors and professor of nursing at the University of Michigan, said in a statement.

While more research is needed to further understand the relationship between substance use disorders and how they may interact with sexual orientation, the study offers some new insight that may help researchers develop more targeted studies in the future. The findings also highlight how individualized treatment strategies for substance use disorders may be another important avenue for health professionals to consider, especially when working with bisexual and people who are unsure of their sexual identity.

If you or someone you know is seeking help for substance use, call the SAMHSA National Helpline at 1-800-662-HELP(4357).