There are indications that lesbian, gay, bisexual, transsexual, transgender, two-spirit, intersex and queer (LGBTTTIQ) persons may have higher rates of substance use, and hence be more vulnerable to substance use problems than the general population, although caution is advised in generalizing findings over a broad cross-section of people estimated to represent 10% of the population. More research about this population, particularly LGBTTTIQ Canadians, needs to be done.
Read entire overview
Blosnich, J., Lee, J. G. L. and Horn, K. (2013). A systematic review of the aetiology of tobacco disparities for sexual minorities. Tobacco Control, 22(2), 66-73. doi:
Chow, C., Vallance, K., Stockwell, T., Macdonald, S., Martin, G., Ivsins, A., Marsh, D. C., Michelow, W., Roth, E. and Duff, C. (2013). Sexual identity and drug use harm among high-risk, active substance users. Culture, Health & Sexuality, 15(3), 311-326. doi:
Rutherford, K., McIntyre, J., Daley, A. and Ross, L. E. (2012). Development of expertise in mental health service provision for lesbian, gay, bisexual and transgender communities. Medical Education, 46: 903–913. doi: 10.1111/j.1365-2923.2012.04272.x
Newcomb, M. E., Heinz, A. J., and Mustanski, B. (2012). Examining risk and protective factors for alcohol use in lesbian, gay, bisexual, and transgender youth: A longitudinal multilevel analysis. Journal of Studies on Alcohol and Drugs, 73(5), 783-793.
Kecojevic, A., Wong, C. F., Schrager, S. M., Silva, K., Jackson Bloom, J., Iverson, E. and Lankenau, S.E. (2012). Initiation into prescription drug misuse: Differences between lesbian, gay, bisexual, transgender (LGBT) and heterosexual high-risk young adults in Los Angeles and New York. Addictive Behaviors, 37(11), 1289-1293.
McLaughlin, K. A., Hatzenbuehler, M. L., Xuan, Z. and Conron, K. J. (2012). Disproportionate exposure to early-life adversity and sexual orientation disparities in psychiatric morbidity. Child Abuse & Neglect, 36(9), 645-655.
OByrne, P., & Holmes, D. Drug use as boundary play: A qualitative exploration of gay circuit parties. Substance use & Misuse v. 46 no. 12 (December 2011) p. 1510-1522. doi:10.3109/10826084.2011.572329
Advancing effective communication, cultural competence, and patient- and family-centered care for the Lesbian, Gay, Bisexual, and Transgender (LGBT) community: a field guide.
The Joint Commission, October 2011 [PDF].
Talley, A.; Tomko, R. et al. The influence of general identity disturbance on reports of lifetime substance use disorders and related outcomes among sexual minority adults with a history of substance use. Psychology of Addictive Behaviors v. 25. no. 3 (September 2011) p.530-541.
Heck, N.C., Flentje, A., Cochran, B.N. Offsetting risks: High school gay-straight alliances and lesbian, gay, bisexual, and transgender (LGBT) youth. School Psychology Quarterly v. 26 no. 2 (June 2011) p. 161-174.
Greenspan, N.R. et al. "It's not rocket science, what I do": Self-directed harm reduction strategies among drug using ethno-racially diverse gay and bisexual men. International Journal of Drug Policy v. 22 no. 1 (January 2011) p. 56-62.
Mullens, A.B., et. al. The Cannabis Expectancy Questionnaire for Men who have Sex with Men (CEQ-MSM): a measure of substance-related beliefs. Addictive Behaviors v. 35 no. 6 (June 2010) p. 616-19.
Kelly, B. C.; Parsons, J. T. Prevalence and predictors of non-medical prescription drug use among men who have sex with men. Addictive Behaviors v. 35 no. 4 (April 2010), p. 312-317.
Reed, E. et al. Alcohol and drug use and related consequences among gay, lesbian and bisexual college students: role of experiencing violence, feeling safe on campus, and perceived stress . Addictive Behaviors v. 35 no. 2 (February 2010), p. 168-171.
Fals-Stewart, W., et al. Behavioral couple therapy for gay and lesbian couples with alcohol use disorders. Journal of Substance Abuse Treatment v. 37 no. 4 (December 2009), p. 379-387.
Wood, E., et. al. Circumstances of First Crystal Methamphetamine Use and Initiation of Injection Drug Use Among High-risk Youth
Drug and Alcohol Review v. 27 no. 3 (May 2008) p. 270-76.
Julien, D., et. al. Adjustment among Mothers Reporting Same-Gender Sexual Partners: A Study of a Representative Population Sample from Quebec Province (Canada). Archives of Sexual Behavior v. 37 no. 6 (December 2008) p. 864-76.
Dillworth, T. M., et. al. Identification With Mainstream Culture and Preference for Alternative Alcohol Treatment Approaches in a Community Sample. Behavior Therapy v. 40 no. 1 (March 2009) p. 72-81.
Palamar, J. J., et. al. A Longitudinal Investigation of Powder Cocaine Use Among Club-Drug Using Gay and Bisexual Men. Journal of Studies on Alcohol and Drugs v. 69 no. 6 (November 2008) p. 806-13.
Same but different: substance use in queer and trans communities Visions: BC's Mental Health & Addictions Journal
Vol 6(2), 2010
LGBT : lesbian, gay, bisexual, transgender
Visions, BC's Mental Health & Addictions Journal
Vol 6(2), 2010
The Toronto Rainbow Tobacco Survey: A Report on Tobacco Use in Toronto's LGBTTQ Communities [PDF]
The Rainbow Tobacco Intervention Project, January 2007
Asking the Right Questions 2 (ARQ2): talking with clients about sexual orientation and gender identify in mental health, counseling and addiction settings
Centre for Addiction and Mental Health (CAMH), 2007
Breaking the Grip: Treating Crystal Methamphetamine Addiction Among Gay & Bisexual Men [PDF]
Gay & Lesbian Medical Association (GLMA), November 2006
LGTB Health Matters: An Education & Training Resource for Health & Social Service Sectors [PDF]
The Centre: A Community Centre Serving and Supporting Lesbian, Gay, Transgender, Bisexual People and Their Allies, January 2006
Use of Crystal Methamphetamine and Other Club Drugs among High School Students in Vancouver and Victoria [PDF]
BC Medical Journal, 48(1), January/February 2006
Outpatient Management of Crystal Methamphetamine Dependence among Gay and Bisexual Men: How Can It be Done?
Primary Psychiatry, U.S., 13(2): 75-80, 2006
LGBT Communities and Substance Use - What Health Has To Do With It! [PDF]
LGBT Health Association of B.C., February 2003
Journal of Gay & Lesbian Social Services
Journal of Gay & Lesbian Social Services, 14(4), 2003
Alcohol, Tobacco & Other Drug Problems & Lesbian, Gay, Bisexual, Transgender (LGBT) Individuals [PDF]
National Association of Lesbian and Gay Addiction Professionals (NALGAP), July 2002
Engaging Transgender Substance Users in Substance Use Treatment
International Journal of Transgenderism (IJT), 6(2), 2002
Lesbian & Bisexual Women and Substance Abuse [PDF]
B.C. Women's Addiction Foundation, 2009
Journal of Gay & Lesbian Psychotherapy
Journal of Gay & Lesbian Psychotherapy, 3(3/4), 2000
Caring for Lesbian Health: A Resource for Health Care Providers, Policy Makers and Planners [PDF]
Minister's Advisory Council for Women's Health, Ministry of Health and Ministry Responsible for Seniors, Government of British Columbia, September 1999
Alcohol, Tobacco & Other Drug Use in Lesbian, Gay, Bisexual & Transgender
Queensland Association for Healthy Communities (Australia) [Undated]
Critical Health Needs for MTF Transgenders of Color [PDF]
Health Studies for People of Color (HSPC), Center for AIDS Prevention Studies, UCSF, undated
CAMH study shows mental health services don't meet the needs of bisexual people (CAMH)
Canadian Rainbow Health Coalition (CRHC)
Diversity Our Strength LGBT Toolkit (Toronto Long-Term Care Homes and Services)
Drug Use Among GLBT people, Public Health, Seattle & King County
Gay Affirmative Practice Scale (GAP)
Guidelines for Psychotherapy with Lesbian, Gay, & Bisexual Clients
Is smoking part of your life? (Canadian Cancer Society)
LGBT Mental Health Syllabus
LGBT Substance Abuse Treatment, SAMHSA's National Clearinghouse for Alcohol & Drug Information (NCADI)
Lesbian, Gay, Bisexual and Transgender (LGBT) Older Adults, Aging in Canada
National Association of Lesbian and Gay Addiction Professionals (NALGAP), U.S.
Party Prevention Campaign, BBCM Foundation, Montreal
(click through to Party Safely section)
PRISM Alcohol and Drug Services
Rainbow Services, Centre for Addiction and Mental Health (CAMH)