Addressing Substance Use in Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning Youth.

Due to myriad stressors and social determinants of health, lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) youth are at heightened risk for substance use disorders (SUDs) compared to their cisgender, heterosexual peers. We review current literature on SUDs among LGBTQ+ youth, as well as comprehensive treatment strategies for this marginalized community. We discuss evidence-based interventions across the care continuum, including culturally responsive relapse prevention and harm reduction frameworks that prioritize engagement and safety. Our discussion highlights the critical role of prevention; trauma-informed care to address minority stress; and family-based interventions in fostering resilience alongside community supports and individual skills-building.