Prevalence of Substance Use among Lesbian, Gay, and Bisexual High School Students in 2019 vs. 2021

Background: Studies suggest that LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning, plus) youth are at increased risk of engaging in alcohol and substance use. The COVID-19 pandemic forced many students to isolate in 2020 and 2021, and the impacts of this have been purported to be detrimental. This study examines the prevalence of alcohol and substance use among lesbian, gay, and bisexual (LGB) U.S. high school students before the pandemic in 2019 versus 2021. Methods: This cross-sectional descriptive study used results from the 2019 Youth Risk Behavior Survey (YRBS) and the 2021 Adolescent Behavior and Experiences Survey (ABES). The 2019 YRBS included 13,677 questionnaires from 136 schools, and the 2021 ABES included 7,705 questionnaires from 128 schools. We selected 15 questions concerning alcohol and substance use common to both surveys and compared results for LGB students in 2019 versus 2021. Results: We found a decrease in prevalence for all 15 alcohol and substance-use-related questions from 2019 to 2021. The most statistically significant differences were observed in E-cigarette use, marijuana use, and obtaining an illegal drug on school property. Conclusions: The results suggest substantial decreases in alcohol and substance use among LGB high school students from 2019 to 2021. These decreases have occurred in the context of the pandemic and reported increases in mental health problems among this population. These outcomes should prompt further research into how social interactions at school (or the lack thereof) among LGBTQ+ youth contribute to patterns of alcohol and substance use