Newly identifying as LGBQ+ was associated with nearly triple the risk of starting cannabis use
In a prospective cohort of 1,896 young adults, those who newly adopted an LGBQ+ identity had 2.9 times the risk of initiating cannabis use compared to consistently heterosexual peers.
Quick Facts
What This Study Found
Consistently LGBQ+ individuals had higher frequency of cannabis use (OR 1.36) compared to consistently heterosexual peers. Those who newly identified as LGBQ+ had 2.9 times the risk of initiating cannabis use (aRR 2.90). Those who transitioned from LGBQ+ to heterosexual identity reported lower substance use frequency.
Key Numbers
1,896 young adults. Consistently LGBQ+ cannabis OR: 1.36. New LGBQ+ identity: cannabis initiation aRR 2.90 (95% CI 1.81-4.64). LGBQ+ to heterosexual: lower alcohol (OR 0.35) and tobacco (OR 0.15) use.
How They Did This
Two-wave prospective cohort of 1,896 young adults (mean age 21.2). Baseline October 2018-October 2019; follow-up May-October 2020. Four groups: consistently heterosexual (1,567), consistently LGBQ+ (244), heterosexual to LGBQ+ (65), LGBQ+ to heterosexual (20).
Why This Research Matters
Sexual identity is dynamic in young adulthood, and the period of identity change appears to carry heightened substance use risk. This suggests a window for targeted prevention during identity exploration.
The Bigger Picture
The finding that substance use risk is specifically elevated during identity transition, not just among LGBQ+ individuals generally, suggests that the process of identity change itself may involve stress or social context changes that increase risk.
What This Study Doesn't Tell Us
Small identity-change groups (65 and 20). Two time points cannot capture the full trajectory of identity development. Follow-up during COVID-19 pandemic may confound results. Self-reported identity and substance use.
Questions This Raises
- ?What drives elevated substance use risk specifically during identity transition?
- ?Would LGBQ+ affirming support during identity exploration reduce substance use initiation?
Trust & Context
- Key Stat:
- 2.9x cannabis initiation risk during identity transition
- Evidence Grade:
- Prospective cohort with validated measures but small identity-change groups and pandemic-era follow-up.
- Study Age:
- Published in 2022, data from 2018-2020.
- Original Title:
- Changes in sexual identity and substance use during young adulthood.
- Published In:
- Drug and alcohol dependence, 241, 109674 (2022)
- Authors:
- Krueger, Evan A, Repati, Mykala L, Harlow, Alyssa F(7), Unger, Jennifer B, Lee, Jungeun Olivia, Pedersen, Eric R, Conn, Bridgid M, Wong, Carolyn, Young, Lindsay E, Barrington-Trimis, Jessica L, Leventhal, Adam M
- Database ID:
- RTHC-03982
Evidence Hierarchy
Enrolls participants and follows them forward in time.
What do these levels mean? →Frequently Asked Questions
Are LGBQ+ young adults more likely to use cannabis?
Yes. Consistently LGBQ+ young adults had 36% higher odds of cannabis use than heterosexual peers. Those who newly identified as LGBQ+ had nearly triple the risk of starting cannabis for the first time.
Why might changing sexual identity affect substance use?
The study suggests that the process of identity transition, not just being LGBQ+, carries elevated risk. The specific mechanisms, whether minority stress, new social contexts, or other factors, need further research.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-03982APA
Krueger, Evan A; Repati, Mykala L; Harlow, Alyssa F; Unger, Jennifer B; Lee, Jungeun Olivia; Pedersen, Eric R; Conn, Bridgid M; Wong, Carolyn; Young, Lindsay E; Barrington-Trimis, Jessica L; Leventhal, Adam M. (2022). Changes in sexual identity and substance use during young adulthood.. Drug and alcohol dependence, 241, 109674. https://doi.org/10.1016/j.drugalcdep.2022.109674
MLA
Krueger, Evan A, et al. "Changes in sexual identity and substance use during young adulthood.." Drug and alcohol dependence, 2022. https://doi.org/10.1016/j.drugalcdep.2022.109674
RethinkTHC
RethinkTHC Research Database. "Changes in sexual identity and substance use during young ad..." RTHC-03982. Retrieved from https://rethinkthc.com/research/krueger-2022-changes-in-sexual-identity
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.