Illicit drug use has increased among college students in recent decades with around 4.4% of college students reporting misuse of stimulants and 0.4% reporting illicit opioid use. Sexual and gender minority (SGM) individuals are at a higher risk of developing substance use disorders. This may be due to the prejudice and discrimination experienced by marginalized groups that may lead many to ineffective coping mechanisms like substance use. Additionally substance use patterns may differ between certain races and ethnicities. For example, some levels of substance use have been shown to be higher among Native American populations compared to non-Hispanic White populations. This study examines inequities in substance use disorder (SUD), diagnosis, opioid and cannabis misuse, SUD treatment utilization, and utilization of university mental health services among SGM American Indian, Alaska Native and Native Hawaiian (AI/AN/NH) college students.
The study’s sample consisted of 8,103 AI/AN/NH college students who participated in the American College Health Association’s National College Health Assessment survey (ACHA-NCHA). Respondents were asked to report SUD diagnosis or treatment in the past 12 months, opioid and cannabis use in the past 30 days, prescription pain killer use in the past 12 months, and any utilization of university mental health services. Participants were also asked to describe their gender identity and sexual orientation. Data was analyzed using multivariable logistic regression models.
Results of the data analysis showed that SUD diagnosis was more common among transgender and gender diverse students than those who identified as cisgender male or cisgender female. SUD diagnosis was also more common among sexual minorities compared to students who identified as heterosexual. Opioid and cannabis misuse was more likely to be reported among those who identified as transgender when compared to cisgender female peers. Odds of opioid and cannabis use were significantly increased among those who identified as bisexual or unsure/other. In addition, those who identified as gay/lesbian had higher odds of reporting cannabis misuse. There were no significant differences observed in regards to utilization of substance use treatment among SGM students and their cisgender peers. However, sexual minority students were more likelihood to utilize university mental health services than heterosexual peers.
Takeaway: American Indian, Alaska Native and Native Hawaiian college students who identify as sexual and gender minority may have higher odds of developing substance use disorder and may be more likely to report cannabis and opioid misuse.