Prescription Opioid Misuse Among Sexual and Gender Minority (SGM) Youth in the United States: A Nationally Representative Study.

PURPOSE: Recent research supports that sexual and gender minority (SGM) youth are at increased risk of prescription opioid misuse. Yet, the national prevalence of prescription opioid misuse in this population remains poorly described.

METHODS

Cross-sectional analysis of the 2023 Youth Risk and Behavior Survey (YRBS). Over 20,100 youth in grades 9-12 reported on their sexual and gender identities as well as current (past 30 days) and lifetime prescription opioid misuse. Weighted, multivariate Poisson regression analyses examined associations between SGM identities and current and lifetime opioid misuse controlling for demographic factors, other substance use behaviors, and depressive symptoms.

RESULTS

Prevalence of current and lifetime prescription opioid misuse was significantly higher among SGM youth compared to their non-SGM peers (7.0% vs. 3.7% for current misuse [p < 0.0001]; 17.8% vs. 9.7% for lifetime misuse [p < 0.0001]). Multivariate Poisson regression analyses support these findings for lifetime opioid misuse (aPR: 1.3; 95% CI: 1.1-1.6; p = 0.006) after controlling for covariates, but do not for current opioid misuse (aPR: 1.3; 95% CI: 0.9-1.8; p = 0.119). Across SGM identities, being gay or lesbian, bisexual, transgender, or questioning one's gender identity/sexuality was associated with higher prevalence rates of lifetime opioid misuse. Only participants questioning their sexuality or gender identity had significantly higher prevalence rates for current opioid misuse.

DISCUSSION: These findings suggest that SGM youth have disproportionately higher prevalence rates of prescription opioid misuse nationally, necessitating targeted public health interventions to address these disparities.