Introduction
Major knowledge gaps regarding medical and nonmedical prescription stimulant use and
illegal stimulant use (i.e., cocaine/crack/methamphetamine) by sexual identity and
gender have implications for individuals’ health and well-being. This study improves
stimulant use measurement by differentiating the type of stimulant use and focusing
on lesbian, gay, and bisexual subpopulations.
Methods
Data were pooled for adults in the 2015–2017 National Survey on Drug Use and Health
(n=126,463; analyzed in 2019). Gender-stratified logistic regression models examined
associations between sexual identity and past-year illegal stimulant use. Gender-stratified
multinomial logistic regression models estimated odds of (1) medical use only versus
no past-year prescription stimulant use, (2) any nonmedical stimulant use versus no
past-year use, and (3) any nonmedical stimulant use versus medical use only.
Results
Illegal stimulant use varied by sexual identity (men: gay, 9.2%; bisexual, 7.5%; heterosexual,
3.2%; women: gay/lesbian, 3.2%; bisexual, 7.8%; heterosexual, 1.5%), as did nonmedical
prescription stimulant use. Relative to same-gender heterosexuals, gay (AOR=2.61,
95% CI=2.00, 3.40) and bisexual (AOR=1.70, 95% CI=1.24, 2.33) men had higher odds
of past-year illegal stimulant use, as did gay/lesbian (AOR=1.63, 95% CI=1.16, 2.28)
and bisexual (AOR=2.70, 95% CI=2.23, 3.26) women. Sexual minorities reported higher
odds of nonmedical prescription stimulant use than heterosexuals. Any nonmedical prescription
opioid use was reported by 26.4% of people who reported nonmedical stimulant use and
27.0% of people who reported illegal stimulant use.
Conclusions
Lesbian, gay, and bisexual individuals had a higher prevalence of stimulant use than
their heterosexual counterparts. This has important implications for health disparities,
especially given the high levels of polysubstance use. Taking a multilevel approach
is crucial to reduce stimulant-related harms for lesbian, gay, and bisexual individuals.
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Article Info
Publication History
Published online: September 24, 2020
Identification
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© 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
