Differences in substance use between sexual orientations in a multi-country sample: findings from the Global Drug Survey 2015

Background This study examines substance use disparities among homosexual, bisexual and heterosexual adolescents and young adults from nine countries. Methods Data from 58 963 respondents (aged 16 and 35 years) to the 2015 'Global Drug Survey' were utilized. Rates of lifetime, last-year, last-month use and age of onset of 13 different substances were compared across sexual identity subgroups. Results Adolescents and young adults with a sexual minority identity generally reported higher rates of substance use and an earlier age of onset compared to their heterosexual counterparts. Differences in substance use were larger among female groups than male groups, and rates of substance use were generally higher among bisexuals than homosexuals of both genders. Conclusion Higher rates of substance use in bisexuals compared with homosexuals among both genders and larger differences between female groups highlight the importance of differentiating between sexual minority identities in substance use research, and in designing substance misuse interventions for people with a sexual minority identity.