ArticleThe International journal on drug policy2023
High-risk polysubstance use among LGBTQ+ people who use drugs in the United States: An application of syndemic theory.
Article in The International journal on drug policy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 15 citations in OpenAlex.
- Barriers and facilitators to medication-assisted treatment for cocaine use disorder among men who have sex with men: a qualitative study.Addiction science & clinical practice · 2024Trial
- Influence of sex, anxiety, and risk-taking behavior on opioid and alcohol polysubstance consumption patterns.Addiction neuroscience · 2026Article
- Intersecting Epidemics: Examining the Impact of Internalized Homophobia and Depression Symptoms on HIV Testing Through a Suicide Syndemic Among Young Black Men Who Have Sex with Men.Journal of racial and ethnic health disparities · 2026Article
- Disproportionate use of polysubstance combinations varies by sexual identity among US adults.PloS one · 2026Article
- Anxiety and risk-taking behavior maps onto opioid and alcohol polysubstance consumption patterns in male and female mice.bioRxiv : the preprint server for biology · 2025Article
- Introduction to the special section on polysubstance use: Emerging trends, psychosocial drivers, and treatment challenges.The International journal on drug policy · 2025Article
- Sexual identity, sexual behavior, and drug use behaviors among people who use drugs in the rural U.S.Journal of substance use and addiction treatment · 2025Article
- Barriers to uptake of harm reduction techniques for GBMSM who use drugs in night-clubs and sex-on-premises venues in London and the Southeast: a mixed-methods, qualitative study.Harm reduction journal · 2025Article
- Higher prevalence of polysubstance use among older lesbian, and gay US adults.Drug and alcohol dependence reports · 2024Article
- Experiences of and recommendations for LGBTQ+-affirming substance use services: an exploratory qualitative descriptive study with LGBTQ+ people who use opioids and other drugs.Substance abuse treatment, prevention, and policy · 2024Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundCompared to heterosexual and cisgender people, lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) people are more likely to develop problems with high-risk polysubstance use. According to syndemic theory, this disparity in high-risk polysubstance use is produced by the LGBTQ+ community's increased vulnerability to experiencing psychosocial (e.g., discrimination, unwanted sex) and structural (e.g., food insecurity, homelessness) conditions, greater likelihood of coping with concurrent health problems (e.g., human immunodeficiency virus [HIV]), and decreased opportunities to develop protective factors (e.g., social support, resilience).
methodsData from 306 LGBTQ+ participants living in the United States (U.S.) with a lifetime history of alcohol and drug use were analyzed; 21.2% reported lifetime problems with 10 different drugs. Bootstrapped hierarchical multiple regression was used to test demographic correlates and syndemic predictors of high-risk polysubstance use. One-way ANOVA and post-hoc comparison tests were used to test subgroup differences by gender.
resultsResults indicated that income, food insecurity, sexual orientation-based discrimination, and social support were associated with high-risk polysubstance use, explaining 43.9% of the variance of high-risk polysubstance use. Age, race, unwanted sex, gender identity-based discrimination, and resilience were not significant. Group comparison tests revealed that, compared to nonbinary people and cisgender sexual minority men and women, transgender individuals experienced significantly higher levels of high-risk polysubstance use and sexual orientation-based discrimination but significantly lower levels of homelessness and social support.
conclusionThis study provided further evidence for conceptualizing polysubstance use as an adverse outcome of syndemic conditions. Harm reduction strategies, anti-discrimination laws, and gender-affirming residential treatment options should be considered in U.S. drug policy. Clinical implications include targeting syndemic conditions to reduce high-risk polysubstance use among LGBTQ+ people who use drugs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.