Article Date: 26 Mar 2008 - 2:00 PDT

The odds of substance use for lesbian, gay and bisexual (LGB) youth are on average 190 percent higher than for heterosexual youth, according to a study by University of Pittsburgh researchers published in the current issue of Addiction. What's more, for some sub-populations of LGB youth, the odds were substantially higher, including 340 percent for bisexual youth and 400 percent for lesbians, researchers found.

"Homophobia, discrimination and victimization are largely what are responsible for these substance use disparities in young gay people," said Michael P. Marshal, Ph.D., assistant professor of psychiatry at the Western Psychiatric Institute and Clinic of UPMC, who led the study. "History shows that when marginalized groups are oppressed and do not have equal opportunities and equal rights, they suffer. Our results show that gay youth are clearly no exception."

In a meta-analysis of 18 previous studies from 1994 to 2006, which tested the association between sexual orientation and teen substance use, Pitt researchers found that gay youth reported higher rates of cigarette, alcohol and marijuana use, as well as other illicit drugs, including cocaine, methamphetamines and injection drugs. Almost all of the studies in their review were cross-sectional, suggesting that very little is known about the long-term patterns or consequences of drug use in this vulnerable population. Furthermore, the authors conducted a systematic review of the prevention and intervention guidelines published by the American Medical Association, the National Institute on Drug Abuse, the National Institute on Alcohol and Alcoholism and the Institute of Medicine. They found that none of the institutions mentioned sexual orientation as a potential risk factor for substance use in teens, and did not provide information for researchers and health care professionals on how to prevent such problems.

"It is important to remember that the vast majority of gay youth are happy and healthy, despite the stressors of living in a violent, homophobic society," noted Dr. Marshal. "More than anything, gay youth need love, support and acceptance from their family members and friends. It also is imperative that health care providers offer a safe, confidential environment to discuss health care needs with gay teens."

Co-authors of the study include Oscar G. Bukstein, M.D., M.P.H., Jonathan Miles, Ph.D., and Jennifer Q. Morse, Ph.D., University of Pittsburgh Department of Psychiatry; Mark S. Friedman, Ph.D., and Ron Stall, Ph.D., M.P.H., Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health; Melanie A. Gold, D.O., Division of Adolescent Medicine, University of Pittsburgh School of Medicine; and Kevin M. King, Ph.D., University of Washington.

Dr. Marshal was supported in part by funding provided by the National Institute of Alcohol Abuse and Alcoholism.

Western Psychiatric Institute and Clinic (WPIC) is considered to be one of the nation's foremost university-based psychiatric care facilities and one of the world's leading centers for research and treatment of mental health disorders. WPIC houses the Department of Psychiatry of the University of Pittsburgh School of Medicine and is the flagship of UPMC Behavioral Health, the psychiatric specialty division of the University of Pittsburgh Medical Center.

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