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Substance use in lesbian, gay, and bisexual populations: An update on empirical research and implications for treatment.
Open accessAbstract
Historically, substance use problems were thought to be more prevalent in lesbian, gay, and bisexual (LGB) populations, and correcting skewed perceptions about substance abuse among LGB individuals is critically important. This review provides an update on empirical evidence on LGB substance use patterns and treatment outcome, with specific focus on clinical implications of findings. Compared to earlier studies, the recent research included in this review has used more sophisticated methodologies and more representative samples, and also has investigated multiple dimensions of sexual orientation in relation to substance use patterns. Findings from recent research suggest that lesbians and bisexual women are at greater risk for alcohol and drug use disorders and related problems, and that gay and bisexual men are at greater risk for illicit drug use and related problems. Several sociocultural factors have emerged as correlates of substance use patterns in LGB populations (e.g., affiliation with gay culture, HIV status), and several demographic characteristics (e.g., female, older age) do not appear to be as robust of protective factors against substance abuse for LGB individuals compared to heterosexual populations. Bisexual identity and/or behavior in particular seem to be related to increased risk for substance abuse. In terms of treatment outcome, limitations of extant research prevent conclusions about the relative impact of LGB-specific interventions, and further research that includes women and uses more equivalent comparison interventions is needed. Clinical implications of research findings are discussed for case identification, selection of treatment goals (e.g., moderation vs. abstinence), targets for intervention, and specific treatment modalities.
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“Several studies support the unhealthy nature of these community-driven stressors by uncovering associations between gay and bisexual men’s degree of exposure to the gay community and syndemic conditions, such as eating disorders (Feldman & Meyer, 2007), substance use (Green & Feinstein, 2012), and HIV risk behavior (Egan et al., 2011).”
From A transdiagnostic minority stress treatment approach for gay and bisexual men's syndemic health conditions (2015) · cites this paper as Green & Feinstein, 2012
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“substance use problems are associated with chronic expectations of gay-related rejection and internalized homophobia (Brubaker, Garrett, & Dew, 2009; Green & Feinstein, 2012; Pachankis, Hatzenbuehler, & Starks, 2014b)”
From A transdiagnostic minority stress treatment approach for gay and bisexual men's syndemic health conditions (2015) · cites this paper as Green & Feinstein, 2012
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“(2) substance use problems (Green & Feinstein, 2012)”
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Fredriksen-Goldsen, K. I., Kim, H.-J., Barkan, S. E., Muraco, A., & Hoy-Ellis, C. P. (2013) · American Journal of Public Health · doi:10.2105/ajph.2012.301110 · Cited by 965
“It may be that the rate of decline in drinking among older gay and bisexual men is slower than among older heterosexual men.(52) In addition, we found that older lesbians had higher rates of excessive drinking than did older bisexual women, which is also inconsistent with reports from population-based studies of young…”
ResultBisexuality, Minority Stress, and Health
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Metadata
- Authors
- Green, K. E., & Feinstein, B. A.
- Affiliations
- VA Boston Healthcare System (US)
- Stony Brook University (US)
- Venue
- Psychology of Addictive Behaviors
- Published
- 2012-06
- Volume
- 26
- Issue
- 2
- Pages
- 265-278
- ISSN
- 0893-164X (ISSN-L)
- 1939-1501
- PMC
- PMC3288601
- OpenAlex
- W1964930089
- Cited by
- 400
- References
- 65
- Citations by year
- 2026: 15 · 2025: 26 · 2024: 37 · 2023: 27 · 2022: 33 · 2021: 39 · 2020: 34 · 2019: 34 · 2018: 33 · 2017: 37 · 2016: 28 · 2015: 24 · 2014: 20 · 2013: 9 · 2012: 4
- FWCI
- 14.40
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychology of Addictive Behaviors (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (T32 AA07569)
- National Science Foundation
- Topics
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Keywords
- substance use, lesbian, gay, and bisexual populations, sexual orientation, alcoholism, drug use disorders, bisexual identity, gay culture, HIV status, sociocultural risk factors, substance abuse treatment outcomes, treatment selection
- MeSH terms
- Age Factors, Bisexuality, Female, Homosexuality, Humans, Male, Minority Groups, Psychological Theory, Risk Factors, Social Environment, Social Identification, United States, HIV Infections, Substance-Related Disorders, Empirical Research
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