{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T08:04:35Z","timestamp":1767859475217,"version":"3.49.0"},"reference-count":45,"publisher":"BMJ","issue":"4","funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["173073"],"award-info":[{"award-number":["173073"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2024,1,12]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Substance use is increasing among sexual and gender minority youth (SGMY). This increase may be due to changes in social norms and socialisation, or due to SGMY exploring the potential therapeutic value of drugs such as psychedelics. We identified predictors of psychedelics, MDMA and ketamine use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data were obtained from 1414 SGMY participants who completed the ongoing longitudinal 2SLGBTQ+ Tobacco Project in Canada between November 2020 to January 2021. We examined the association between 80 potential features (including sociodemographic factors, mental health-related factors and substance use-related factors) with the use of psychedelics, MDMA and ketamine in the past year. Random forest classifier was used to identify the predictors most associated with reported use of these drugs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>18.1% of participants have used psychedelics in the past year; 21.9% used at least one of the three drugs. Cannabis and cocaine use were the predictors most strongly associated with any of these drugs, while cannabis, but not cocaine use, was the one most associated with psychedelic use. Other mental health and 2SLGBTQ+ stigma-related factors were also associated with the use of these drugs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The use of psychedelics, MDMA and ketamine among 2SLGBTQ+ individuals appeared to be largely driven by those who used them together with other drugs. Depression scores also appeared in the top 10 factors associated with these illicit drugs, suggesting that there were individuals who may benefit from the potential therapeutic value of these drugs. These characteristics should be further investigated in future studies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jech-2023-220748","type":"journal-article","created":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T13:25:16Z","timestamp":1706016316000},"page":"248-254","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Factors associated with the use of psychedelics, ketamine and MDMA among sexual and gender minority youths in Canada: a machine learning analysis"],"prefix":"10.1136","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5223-5755","authenticated-orcid":false,"given":"Christoffer","family":"Dharma","sequence":"first","affiliation":[{"name":"University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada"},{"name":"Centre for Addiction and Mental Health, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Liu","sequence":"additional","affiliation":[{"name":"Centre for Addiction and Mental Health, Toronto, Ontario, Canada"},{"name":"Department of Human Biology, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9032-3959","authenticated-orcid":false,"given":"Daniel","family":"Grace","sequence":"additional","affiliation":[{"name":"University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Logie","sequence":"additional","affiliation":[{"name":"Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada"},{"name":"United Nations University Institute for Water Environment and Health, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Abramovich","sequence":"additional","affiliation":[{"name":"University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada"},{"name":"Centre for Addiction and Mental Health, Toronto, Ontario, Canada"},{"name":"University of Toronto Department of Psychiatry, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Mitsakakis","sequence":"additional","affiliation":[{"name":"Toronto Health Economics and Technology Assessment (THETA) Collaborative, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce","family":"Baskerville","sequence":"additional","affiliation":[{"name":"School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9589-2122","authenticated-orcid":false,"given":"Michael","family":"Chaiton","sequence":"additional","affiliation":[{"name":"University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada"},{"name":"Centre for Addiction and Mental Health, Toronto, Ontario, Canada"},{"name":"Institute for Medical Science, University of Toronto, Toronto, Ontario, Canada"},{"name":"Ontario Tobacco Research Unit, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,1,23]]},"reference":[{"key":"2025100311040545000_78.4.248.1","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1080\/09540261.2021.1919062","article-title":"Psilocybin and MDMA for the treatment of trauma-related psychopathology","volume":"33","author":"Bird","year":"2021","journal-title":"Int Rev Psychiatry"},{"key":"2025100311040545000_78.4.248.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2019.02.005"},{"key":"2025100311040545000_78.4.248.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2019.07.076"},{"key":"2025100311040545000_78.4.248.4","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1080\/14737175.2020.1826931","article-title":"The emerging role of Psilocybin and MDMA in the treatment of mental illness","volume":"20","author":"Gill","year":"2020","journal-title":"Expert Rev Neurother"},{"key":"2025100311040545000_78.4.248.5","doi-asserted-by":"crossref","unstructured":"Grabski M , Borissova A , Marsh B , et al . Ketamine as a mental health treatment: are acute psychoactive effects associated with outcomes? A systematic review. Behav Brain Res 2020;392. doi:10.1016\/j.bbr.2020.112629","DOI":"10.1016\/j.bbr.2020.112629"},{"key":"2025100311040545000_78.4.248.6","unstructured":"Center for Behavioral Health Statistics and Quality . national survey on drug use and health: Detailed tables. Rockville, MD, 2018."},{"key":"2025100311040545000_78.4.248.7","unstructured":"Canadian Centre on Substance Use and Addiction . Canadian drug summary: cocaine | Canadian centre on substance use and addiction. 2022. Available: https:\/\/ccsa.ca\/canadian-drug-summary-cocaine"},{"key":"2025100311040545000_78.4.248.8","unstructured":"Canadian Centre on Substance Use and Addiction . Methamphetamine (Canadian drug summary) | Canadian centre on substance use and addiction. 2020. Available: https:\/\/www.ccsa.ca\/methamphetamine-canadian-drug-summary-0"},{"key":"2025100311040545000_78.4.248.9","unstructured":"Canadian Centre on Substance Use and Addiction . 3-4 Methylenedioxy-methamphetamine (MDMA, ecstasy or Molly) (Canadian drug summary) | Canadian centre on substance use and addiction. 2022. Available: https:\/\/ccsa.ca\/3-4-methylenedioxy-methamphetamine-mdma-ecstasy-or-molly-canadian-drug-summary"},{"key":"2025100311040545000_78.4.248.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2010.07.013"},{"key":"2025100311040545000_78.4.248.11","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1097\/00004583-199906000-00016","article-title":"Psychiatric Comorbidity among adolescents with substance use disorders: findings from the MECA study","volume":"38","author":"Kandel","year":"1999","journal-title":"Journal of the American Academy of Child & Adolescent Psychiatry"},{"key":"2025100311040545000_78.4.248.12","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.jaac.2016.01.006","article-title":"Association of lifetime mental disorders and subsequent alcohol and illicit drug use: results from the National Comorbidity survey\u2013adolescent supplement","volume":"55","author":"Conway","year":"2016","journal-title":"Journal of the American Academy of Child & Adolescent Psychiatry"},{"key":"2025100311040545000_78.4.248.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2017.01.028"},{"key":"2025100311040545000_78.4.248.14","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1111\/ssqu.12329","article-title":"LGBT novel drug use as Contextualized through control, strain, and learning theories*: LGBT novel drug use","volume":"98","author":"Rukus","year":"2017","journal-title":"Social Science Quarterly"},{"key":"2025100311040545000_78.4.248.15","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1080\/00224499.2014.886321","article-title":"Gender minority social stress in adolescence: disparities in adolescent bullying and substance use by gender identity","volume":"52","author":"Reisner","year":"2015","journal-title":"J Sex Res"},{"key":"2025100311040545000_78.4.248.16","doi-asserted-by":"crossref","first-page":"106414","DOI":"10.1016\/j.addbeh.2020.106414","article-title":"Engagement with LGBTQ community moderates the association between Victimization and substance use among a cohort of sexual and gender minority individuals assigned female at birth","volume":"107","author":"Phillips II","year":"2020","journal-title":"Addictive Behaviors"},{"key":"2025100311040545000_78.4.248.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2009.12.019"},{"key":"2025100311040545000_78.4.248.18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2008.02149.x"},{"key":"2025100311040545000_78.4.248.19","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.jpsychires.2022.06.013","article-title":"Correlates of past year suicidal thoughts among sexual and gender minority young adults: A machine learning analysis","volume":"152","author":"Kundu","year":"2022","journal-title":"J Psychiatr Res"},{"key":"2025100311040545000_78.4.248.20","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph182111315","article-title":"Access to mental health and substance use resources for 2Slgbtq+ youth during the COVID-19 pandemic","volume":"18","author":"Chaiton","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2025100311040545000_78.4.248.21","unstructured":"Greenwell BM , Boehmke BC , McCarthy AJ . A simple and effective model-based variable importance measure. n.d. Available: http:\/\/arxiv.org\/abs\/1805.04755"},{"key":"2025100311040545000_78.4.248.22","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph20136194","article-title":"Table 2 fallacy in descriptive epidemiology: bringing machine learning to the table","volume":"20","author":"Dharma","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"2025100311040545000_78.4.248.23","unstructured":"Kuhn M . The Caret package. 2019. Available: https:\/\/topepo.github.io\/caret\/"},{"key":"2025100311040545000_78.4.248.24","unstructured":"van S . Flexible imputation of missing data. Boca Raton, Fla: CRC Press, 2012: 316."},{"key":"2025100311040545000_78.4.248.25","doi-asserted-by":"crossref","first-page":"343","DOI":"10.32614\/RJ-2020-013","article-title":"Variable importance plots\u2014an introduction to the VIP package","volume":"12","author":"Greenwell","year":"2020","journal-title":"The R Journal"},{"key":"2025100311040545000_78.4.248.26","doi-asserted-by":"crossref","DOI":"10.32614\/RJ-2017-016","article-title":"An R package for constructing partial dependence plots","volume":"9","author":"Greenwell","year":"2017","journal-title":"The R Journal"},{"key":"2025100311040545000_78.4.248.27","unstructured":"New Atlas . Psilocybin for major depression granted breakthrough therapy by FDA [Internet]. Psilocybin for major depression granted breakthrough therapy by FDA. 2019. Available: https:\/\/newatlas.com\/science\/psilocybin-major-depression-mdd-usona-breakthrough-therapy-fda\/"},{"key":"2025100311040545000_78.4.248.28","unstructured":"Business Wire . FDA grants breakthrough therapy designation to Usona Institute\u2019s Psilocybin program for major depressive disorder. 2019. Available: https:\/\/www.businesswire.com\/news\/home\/20191122005452\/en\/FDA-grants-Breakthrough-Therapy-Designation-to-Usona-Institutes-psilocybin-program-for-major-depressive-disorder"},{"key":"2025100311040545000_78.4.248.29","unstructured":"Branch L . Consolidated Federal laws of Canada, controlled drugs and substances act. 2023. Available: https:\/\/laws-lois.justice.gc.ca\/eng\/acts\/c-38.8\/page-7.html#docCont"},{"key":"2025100311040545000_78.4.248.30","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0233463","article-title":"Characterizing motivations for Cannabis use in a cohort of people who use illicit drugs: A latent class analysis","volume":"15","author":"Lake","year":"2020","journal-title":"PLOS ONE"},{"key":"2025100311040545000_78.4.248.31","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052695"},{"key":"2025100311040545000_78.4.248.32","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1177\/1363459321996753","article-title":"I was just doing what a normal gay man would do, right?: the Biopolitics of substance use and the mental health of sexual minority men","volume":"26","author":"Gaspar","year":"2022","journal-title":"Health (London)"},{"key":"2025100311040545000_78.4.248.33","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-022-06580-2","article-title":"Exploring protective associations between the use of classic Psychedelics and cocaine use disorder: a population-based survey study","volume":"12","author":"Jones","year":"2022","journal-title":"Sci Rep"},{"key":"2025100311040545000_78.4.248.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.108715"},{"key":"2025100311040545000_78.4.248.35","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.addbeh.2018.09.020","article-title":"Epidemiology of Hallucinogen use in the U.S. results from the National epidemiologic survey on alcohol and related conditions III","volume":"89","author":"Shalit","year":"2019","journal-title":"Addict Behav"},{"key":"2025100311040545000_78.4.248.36","doi-asserted-by":"publisher","DOI":"10.1177\/0269881114568039"},{"key":"2025100311040545000_78.4.248.37","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.129.5.674"},{"key":"2025100311040545000_78.4.248.38","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0116198","article-title":"Adapting and validating a scale to measure sexual stigma among Lesbian, Bisexual and queer women","volume":"10","author":"Logie","year":"2015","journal-title":"PLoS One"},{"key":"2025100311040545000_78.4.248.39","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6932a1"},{"key":"2025100311040545000_78.4.248.40","unstructured":"Center on Substance Use and Addiction . Mental health and substance use during COVID-19 | Canadian centre on substance use and addiction. 2022. Available: https:\/\/www.ccsa.ca\/mental-health-and-substance-use-during-covid-19"},{"key":"2025100311040545000_78.4.248.41","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1080\/15299716.2016.1225622","article-title":"Concealment of sexual minority identities in interviewer-administered government surveys and its impact on estimates of suicide Ideation among Bisexual and gay men","volume":"16","author":"Hottes","year":"2016","journal-title":"Journal of Bisexuality"},{"key":"2025100311040545000_78.4.248.42","doi-asserted-by":"crossref","unstructured":"Fendrich M , Mackesy-Amiti ME , Johnson TP . Validity of self-reported substance use in MSM. Ann Epidemiol 2008:752\u20139. doi:10.1016\/j.annepidem.2008.06.001","DOI":"10.1016\/j.annepidem.2008.06.001"},{"key":"2025100311040545000_78.4.248.43","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1007\/s10508-017-0993-6","article-title":"Have mischievous responders Misidentified sexual minority youth disparities in the National longitudinal study of adolescent to adult health? Arch sex Behav","volume":"47","author":"Fish","year":"2018","journal-title":"Arch Sex Behav"},{"key":"2025100311040545000_78.4.248.44","doi-asserted-by":"crossref","unstructured":"Robinson-Cimpian JP . Inaccurate estimation of disparities due to mischievous responders: several suggestions to assess conclusions. Educational Researcher 2014:171\u201385. doi:10.3102\/0013189X14534297","DOI":"10.3102\/0013189X14534297"},{"key":"2025100311040545000_78.4.248.45","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1093\/aje\/kwy200","article-title":"Effects of multiple forms of information bias on estimated prevalence of suicide attempts according to sexual orientation: an application of a Bayesian Misclassification correction method to data from a systematic review","volume":"188","author":"Salway","year":"2019","journal-title":"Am J Epidemiol"}],"container-title":["Journal of Epidemiology and Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jech-2023-220748","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T18:04:19Z","timestamp":1759514659000},"score":1,"resource":{"primary":{"URL":"https:\/\/jech.bmj.com\/lookup\/doi\/10.1136\/jech-2023-220748"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,23]]},"references-count":45,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,3,8]]},"published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1136\/jech-2023-220748"],"URL":"https:\/\/doi.org\/10.1136\/jech-2023-220748","relation":{},"ISSN":["0143-005X","1470-2738"],"issn-type":[{"value":"0143-005X","type":"print"},{"value":"1470-2738","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,23]]}}}