Objectives: In light of the opioid epidemic, it is essential to understand which subgroups of youth are at elevated risk for opioid use. Sexual minority groups have increased rates of substance use compared to heterosexual youth. Our study aims to examine the prevalence of both prescription opioid misuse and heroin use in adolescents. We then examine odds of prescription opioid misuse and heroin use adjusting for common covariates.
Methods: Using 2017 Youth Risk Behavior Surveillance System data, we examined lifetime odds of prescription opioid misuse and heroin use among sexual minority youth as defined by sexual identity and sexual behavior. We used logistic regression adjusting for age, sex, and race.
Results: 28.5% of gay/lesbian and 25.1% of bisexual youth reported misuse compared to 12.5% of heterosexual youth. Nearly 1 in 10 gay/lesbian youth reported a history of heroin use compared to 4.1% of bisexual and 1.1% of heterosexual young people. Among those who reported having a history of sexual contact, those with same sex contact and sexual contact with both sexes had elevated odds of lifetime heroin use compared to those with a history of opposite sex contact only (aOR: 3.77; 95% CI: 1.68, 8.44 and aOR: 7.44; 95% CI: 4.59, 12.06, respectively).
Conclusions: We demonstrated preliminary evidence sexual minority youth have significant opioid-related health disparities with greater odds of lifetime prescription opioid misuse and heroin use. As early exposure to opioids is associated with greater risk for developing an opioid use disorder and increased opioid-morbidity and mortality, it is critical that providers recognize and incorporate the unique needs for sexual minority youth into traditional treatment and prevention models.