The Effects of Victimization, Suicidality, and Race on Marijuana and Alcohol Use Among Sexual Minority Youth

Background and Purpose: Sexual minority youth (SMY) are at greater risk for suicide attempts and alcohol and marijuana use when compared with heterosexual youth. Victimization is associated with suicidality and alcohol and marijuana use among SMY, and some SMY use substances to cope with distressing feelings associated with suicidality. The additive stress of experiencing marginalization associated with two minority statuses may elevate risk for suicidality and alcohol and marijuana use among SMY of color. Despite knowledge on the bivariate associations among suicidality, victimization, and alcohol and marijuana use for SMY and youth of color separately, limited research has examined these variables among SMY of color together. Therefore, the purpose of this study is to examine the effects of suicidality, victimization, and race/ethnicity on alcohol and marijuana use and to test race/ethnicity and victimization as moderators of the relationship between suicidality and alcohol and marijuana use.

Methods: Data were drawn from the 2015 and 2017 waves of the Youth Risk Behavior Survey (YRBS). Participants included 2,340 SMY who identified as non-Latinx Black, Latinx, or non-Latinx White. Dependent variables included: past 30 day use of 1) marijuana and 2) alcohol. Independent variables included: race (non-Latinx Black, Latinx, or non-Latinx white); experience of victimization; and suicidality (ideation, plan, and attempt). Age and sex were included as control variables and logistic regressions tested current alcohol and marijuana use. Two additional logistic regressions were estimated with race/ethnicity and victimization as moderators. Survey weights were applied for analyses.

Results: The main effects model indicated that having experienced victimization (OR=1.38, p<0.05, 95% CI: 1.00-1.91), greater age (OR=1.30, p<0.001, 95% CI: 1.16-1.44), and having attempted suicide (OR=1.65, p<.05, 95% CI: 1.03-2.67) each predicted greater odds of alcohol use. Having a suicide plan (OR=0.58, p<.05, 95% CI: .38-.88) predicted lower odds of alcohol use. Greater age (OR=1.26, p<0.001, 95% CI: 1.13-1.41), female gender (OR=1.61, p<0.01, 95% CI: 1.15-2.26), and a prior suicide attempt (OR=1.97, p<0.01, 95% CI: 1.26-3.06) predicted greater odds of marijuana use. Results from the moderator models showed that Latinx SMY who experienced victimization and reported suicide ideation had significantly higher odds of using marijuana (OR=8.57, p<0.05, 95% CI: 1.66-44.17) and alcohol (OR=11.49, p<0.01, 95% CI: 2.11-62.72) when compared to white SMY who experienced victimization and reported suicide ideation. For marijuana use, but not alcohol use, the same pattern was found when comparing Latinx SMY to Black SMY. However, none of these relationships were significantly different between Black and white SMY.

Conclusions and Implications: In this study, Latinx SMY who experienced victimization and suicide ideation were more likely to use marijuana and alcohol than whites. Additionally, for the entire sample, having attempted suicide was associated with increased use of alcohol and marijuana. Future research should explore if suicidal SMY of color are using as a way to cope with negative mood in the context of their marginalization. Overall, findings support the need to investigate the effects of victimization and suicidality on mental health, including risk for alcohol and marijuana use, among SMY of color.