{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:36:16Z","timestamp":1792787776670,"version":"4.5.0"},"reference-count":60,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Cancer Institute","award":["R01CA276500"],"award-info":[{"award-number":["R01CA276500"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["LGBT Health"],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>This study examined associations between sexual identity and both substance use and mental health outcomes via nationally representative data from adolescents and young adults, using a six-response sexual identity assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Data were from 11,328 adolescents (12\u201317 years) and 13,131 young adults (18\u201325 years) completing the 2023 National Survey on Drug Use and Health. Sexual identity had six-response options: heterosexual, lesbian\/gay, bisexual, using a different term, unsure\/don\u2019t know, and do not understand the question. Substance use variables included alcohol, cannabis, nicotine, prescription drug misuse, polysubstance use, and substance use disorder (SUD). Mental health variables included major depressive episodes, suicidal ideation, and serious psychological distress (measured only among young adults). Multivariable logistic regression models were fitted to examine whether substance use and mental health differed by sexual identity. Analyses adjusted for sociodemographics, occurred separately by age group and sex, and heterosexual individuals were the reference category.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Youth identifying as lesbian, gay, bisexual, unsure\/don\u2019t know, or using a different term had significantly higher rates of all mental health concerns than their heterosexual peers, with 80% of adjusted odds ratios above 3.0. Substance use-sexual identity links were less consistent, although lesbian and bisexual females were more likely than heterosexual females to have past-year SUD. Individuals not understanding the sexual identity question had lower rates than their heterosexual peers on 15 of 36 outcomes (41.7%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Screening and indicated prevention for mental health concerns and SUD are needed for sexual minority youth, along with the development of culturally sensitive interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23258292261419535","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T14:34:38Z","timestamp":1770734078000},"page":"157-166","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Differences in Substance Use and Mental Health by Sexual Identity Among U.S. Adolescents and Young Adults"],"prefix":"10.1177","volume":"13","author":[{"given":"Ty S.","family":"Schepis","sequence":"first","affiliation":[{"name":"Department of Psychology, Texas State University, San Marcos, Texas, USA."},{"name":"Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brady T.","family":"West","sequence":"additional","affiliation":[{"name":"Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA."},{"name":"Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA."},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason A.","family":"Ford","sequence":"additional","affiliation":[{"name":"Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA."},{"name":"Department of Sociology, University of Central Florida, Orlando, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip T.","family":"Veliz","sequence":"additional","affiliation":[{"name":"Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA."},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA."},{"name":"Department of Sociology, University of Central Florida, Orlando, Florida, USA."},{"name":"Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean Esteban","family":"McCabe","sequence":"additional","affiliation":[{"name":"Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA."},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA."},{"name":"Department of Sociology, University of Central Florida, Orlando, Florida, USA."},{"name":"Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"e_1_3_4_2_2","volume-title":"Understanding the Well-being of LGBTQI+ Populations","author":"National Academies of Sciences, Engineering, and Medicine","year":"2020","unstructured":"National Academies of Sciences, Engineering, and Medicine. 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