Adults over 50 who identify as lesbian, gay, or bisexual may be at greater risk of substance use than those who are heterosexual, according to a new study led by New York University (NYU) Grossman School of Medicine and the Center for Drug Use and HIV/HCV Research (CDUHR) at NYU School of Global Public Health.
Substance use adds complexity to caring for older adults, who are undergoing physical changes, are more likely to have chronic diseases, and may take more prescription medications, which can interact with such substances and lead to adverse events.
“These age-related changes place older adults at increased vulnerability to the harms of substance use,” said Benjamin Han, M.D., M.P.H., the study’s lead author and an assistant professor in the Department of Medicine’s Division of Geriatric Medicine and Palliative Care and the Department of Population Health at NYU Langone Health.
“This is even more true for vulnerable populations who experience stigma, like those identifying as lesbian, gay, or bisexual, and may already experience a range of health disparities and have barriers to accessing health care.”
The findings, published in the Journal of General Internal Medicine, are consistent with previous studies showing that LGBTQ adolescents and young adults are more likely to use a range of substances compared to their heterosexual counterparts.
“Our research confirms that a higher prevalence of substance use among lesbian, gay, and bisexual adults can continue into later life,” said Han, who is also a CDUHR researcher.
“Similar to LGBTQ adolescents and young adults, such prevalence may be related to stressors like discrimination and stigma based on sexual orientation in addition to stressors related to aging, including social isolation and age-related stigma.”
For the study, the researchers looked at data from the National Survey on Drug Use and Health (2015 to 2017), an annual survey of a representative sample of individuals in the United States, which asks questions about sexual identity, including if individuals identify as lesbian, gay, or bisexual.
The team focused on data from adults ages 50 and older to determine their past-year use of cannabis, alcohol, cocaine, and methamphetamine, as well as non-medical use of prescription opioids, sedatives (such as sleep medications), stimulants, and tranquilizers (such as anti-anxiety medications, including benzodiazepines).
Researchers then compared the prevalence of past-year substance use among adults in the cohort identifying as lesbian, gay, or bisexual to those identifying as heterosexual. The sample included 25,880 participants with 2.5 percent identifying as lesbian, gay, or bisexual.
The findings show that middle-aged and older adults identifying as lesbian, gay, or bisexual were more likely to use various substances studied than were heterosexual adults.
In particular, older sexual minority adults were more than twice as likely to use cannabis nonmedically (13.9 percent vs. 5.5 percent), twice as likely to use prescription tranquilizers nonmedically (3.6 percent vs. 1.1 percent), and more likely to use prescription opioids nonmedically (4.7 percent vs. 2.3 percent) compared to older heterosexual adults.
“These findings should inform prevention and harm reduction efforts in this community and should not be used to stigmatize such individuals,” said CDUHR researcher Joseph Palamar, Ph.D., M.P.H., the study’s senior author and an associate professor in the Department of Population Health at NYU Langone Health.
“We hope that this new research, published during Pride Month, will remind people about the stressors many people still face in 2020 based on their sexual orientation.”
“Even though times are changing and things have been getting better for the LGBTQ community, older individuals in this population may still be affected from past experiences of intolerance.”
The team emphasizes that the goal of this study is not to further stigmatize, but to draw attention to the needs of communities who have been underserved. They recommend the use of both patient-centered and public health approaches to prevent or reduce any potential harms associated with unhealthy substance use among older lesbian, gay, and bisexual adults.
Soure: New York University
Source: PsychCentral Lesbian, Gay, Bisexual Older Adults May See Greater Risk of Substance Abuse