Research Review

Older Gay & Lesbian Adults at Greater Risk of Polysubstance Use: Study

Gay and lesbian adults over age 65 are nearly 28 times more likely than heterosexual peers to engage in polysubstance use, a Yale team finds in a new study published in Drug and Alcohol Dependence Reports.

Researchers say polysubstance use— ie, use of more than one substance—is a major public health concern that disproportionately affects those in marginalized groups. "Polysubstance use is related to adverse health outcomes, including mental health illnesses (eg, depression and anxiety disorders) and increased risk of death," says Luis Miguel Mestre, PhD, a postdoctoral fellow in the Yale Department of Psychiatry and principal investigator of the study.

Researchers from Yale School of Medicine and Yale School of Public Health examined data from over 86,000 participants in the National Survey of Drug Use and Health, 2021–2022, to compare polysubstance use among lesbian, gay, and bisexual (LGB) older adults with their heterosexual same-age peers and younger counterparts.

They found gay and lesbian adults over age 65 were 27.94 times more likely to report polysubstance use in the last 30 days than their heterosexual peers. Researchers say polysubstance use among gay and lesbian older adults didn't differ significantly from their younger counterparts: "Older heterosexual adults significantly decrease their polysubstance use prevalence compared to their younger heterosexual counterparts," Mestre says. “We don’t see the same reduction in polysubstance use for older bisexual and gay/lesbian adults compared to their younger bisexual and gay/lesbian counterparts.”

The team says polysubstance use was not as common in bisexual older adults: "Older bisexual adults do not have a significant difference in polysubstance use prevalence compared with their heterosexual or younger counterparts," Mestre says.

Researchers say the discrimination, victimization, and lower community engagement faced by older gay and lesbian adults likely plays a role. "We recommend implementing antidiscrimination policies, including in housing and other services, that can address these concerns," Mestre says, "as well as promoting trust among health care services through training and education campaigns and by promoting identity affirmation for older LGB adults."

Source: Yale School of Medicine