Sexual identity and drug use harm among high-risk, active substance users

Abstract

Research shows that sexual minorities are at greater risk for illicit substance use andrelated harm than their heterosexual counterparts. This study examines a group ofactive drug users to assess whether sexual identity predicts increased risk of substanceuse and harm from ecstasy, ketamine, alcohol, marijuana, cocaine and crack.Structured interviews were conducted with participants aged 15 years and older inVancouver and Victoria, BC, Canada, during 2008–2012. Harm was measured withthe World Health Organization’s AUDIT and ASSIST tools. Regression analysiscontrolling for age, gender, education, housing and employment revealed lesbian, gayor bisexual individuals were significantly more likely to have used ecstasy, ketamineand alcohol in the past 30 days compared to heterosexual participants. Inadequatehousing increased the likelihood of crack use among both lesbian, gay and bisexualsand heterosexuals, but with considerably higher odds for the lesbian, gay and bisexualgroup. Lesbian, gay and bisexual participants reported less alcohol harm but greaterecstasy and ketamine harm, the latter two categorised by the ASSIST as amphetamineand hallucinogen harms. Results suggest encouraging harm reduction among sexualminority, high-risk drug users, emphasising ecstasy and ketamine. The impact of stablehousing on drug use should also be considered.