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Sexual orientation and adolescent substance use: A meta-analysis and methodological review

Marshal, MP and Friedman, MS and Stall, R and King, KM and Miles, J and Gold, MA and Bukstein, OG and Morse, JQ (2008) Sexual orientation and adolescent substance use: A meta-analysis and methodological review. Addiction, 103 (4). 546 - 556. ISSN 0965-2140

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Aims: Several decades of research have shown that lesbian, gay and bisexual (LGB) adults are at high risk for substance use and substance use disorders (SUDs). These problems may often start prior to young adulthood; however, relatively little is known about risk for substance use in LGB adolescents. The primary aims of this paper were to conduct a meta-analysis of the relationship between sexual orientation and adolescent substance use and a systematic review and critique of the methodological characteristics of this literature. Methods: Medical and social science journals were searched using Medline and PsychInfo. Studies were included if they tested the relationship between sexual orientation and adolescent substance use. Eighteen published studies were identified. Data analysis procedures followed expert guidelines, and used National Institutes of Health (NIH)-sponsored meta-analysis software. Results: LGB adolescents reported higher rates of substance use compared to heterosexual youth (overall odds ratio = 2.89, Cohen's d = 0.59). Effect sizes varied by gender, bisexuality status, sexual orientation definition and recruitment source. None of the studies tested mediation and only one tested moderation. One employed a matched comparison group design, one used a longitudinal design, and very few controlled for possible confounding variables. Conclusions: The odds of substance use for LGB youth were, on average, 190% higher than for heterosexual youth and substantially higher within some subpopulations of LGB youth (340% higher for bisexual youth, 400% higher for females). Causal mechanisms, protective factors and alternative explanations for this effect, as well as long-term substance use outcomes in LGB youth, remain largely unknown. © 2008 The Authors.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Marshal, MPmpm1@pitt.eduMPM1
Friedman, MSmsf11@pitt.eduMSF11
Stall, Rrstall@pitt.eduRSTALL
King, KM
Miles, J
Gold, MA
Bukstein, OG
Morse, JQ
Centers: Other Centers, Institutes, Offices, or Units > Center for LGBT Health Research
Date: 1 April 2008
Date Type: Publication
Journal or Publication Title: Addiction
Volume: 103
Number: 4
Page Range: 546 - 556
DOI or Unique Handle: 10.1111/j.1360-0443.2008.02149.x
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
School of Medicine > Medicine
School of Medicine > Psychiatry
Refereed: Yes
ISSN: 0965-2140
Article Type: Review
MeSH Headings: Adolescent; Adult; Age Factors; Female; Humans; Male; Sex Factors; Sexuality--psychology; Substance-Related Disorders--psychology
Other ID: NLM NIHMS101961, NLM PMC2680081
PubMed Central ID: PMC2680081
PubMed ID: 18339100
Date Deposited: 15 Jul 2013 19:59
Last Modified: 02 Feb 2019 15:55


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