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. 2023 Dec:177:107729.
doi: 10.1016/j.ypmed.2023.107729. Epub 2023 Oct 16.

Polysubstance use by sexual identity among US adults, 2021

Juhan Lee  1 , Rebecca J Evans-Polce  2 , Jennifer Ahlquist  3 , Maria A Parker  4
Affiliations

Polysubstance use by sexual identity among US adults, 2021

Juhan Lee et al. Prev Med. 2023 Dec.

Abstract

Objective: Understanding polysubstance use among US sexual minority adults is important to serve as a population-level baseline to promote health equity around substance use prevention and public health strategies. This study quantifies the number of substances used by sexual identity among US adults.

Methods: We used the 2021 National Survey on Drug Use and Health and included adults (aged ≥18) (unweighted n = 47,291). We conducted multivariable Poisson regression models to examine the number of substances used in the past year (count variable; range: 0-18) by sexual identity ("heterosexual", "gay/lesbian", "bisexual", "unknown" [don't know, refused, blank]), after adjusting for covariates (i.e., age, sex, race/ethnicity, income level, education level, having insurance status, living in urban area, past-year distress level (Kessler-6), any drug or alcohol use disorder in the past year, and sexual attraction).

Results: Of the total sample (51.4% were female, 12.1% were non-Hispanic Black and 17.0% were Hispanic adults), 88.3% were heterosexual, 2.4% were gay/lesbian, 5.0% were bisexual adults, and 4.3% reported "unknown" sexual identity. After adjusting for covariates, a greater number of substances were used in the past year among gay/lesbian individuals (aIRR = 1.44, 95% CI = 1.09, 1.75), bisexual individuals (aIRR =1.34, 95% CI = 1.26, 1.41), and individuals reporting an "unknown" sexual identity (aIRR = 1.22, 95% CI = 1.09, 1.36) (vs. heterosexual adults).

Conclusions: Tailored substance use prevention and public health strategies specializing in sexual minority populations are warranted.

Keywords: Epidemiology; Health disparities; LGBTQ; Polysubstance use; Substance use.

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Conflict of interest statement

Declaration of Competing Interest None.

References

    1. Crummy EA, O’Neal TJ, Baskin BM, Ferguson SM. One Is Not Enough: Understanding and Modeling Polysubstance Use. Front Neurosci. 2020;14. doi:10.3389/fnins.2020.00569 - DOI - PMC - PubMed
    1. Wilson N, Kariisa M, Seth P, Smith H, Davis NL. Drug and Opioid-Involved Overdose Deaths - United States, 2017–2018. MMWR Morb Mortal Wkly Rep. Published online 2020. doi:10.15585/mmwr.mm6911a4 - DOI - PMC - PubMed
    1. Connor J, Gullo M, Chan G, Young R, Hall W, Feeney G. Polysubstance Use in Cannabis Users Referred for Treatment: Drug Use Profiles, Psychiatric Comorbidity and Cannabis-Related Beliefs. Front Psychiatry. 2013;4. 10.3389/fpsyt.2013.00079 - DOI - PMC - PubMed
    1. Salom CL, Betts KS, Williams GM, Najman JM, Alati R. Predictors of comorbid polysubstance use and mental health disorders in young adults—a latent class analysis. Addiction. 2016;111(1):156–164. doi:10.1111/add.13058 - DOI - PubMed
    1. Mimiaga MJ, Reisner SL, Vanderwarker R, et al. Polysubstance use and HIV/STD risk behavior among Massachusetts men who have sex with men accessing Department of Public Health mobile van services: implications for intervention development. AIDS Patient Care STDS. 2008;22(9):745–751. doi:10.1089/apc.2007.0243 - DOI - PubMed