Looking beyond sexualized drug use: exploring the relationship between substance use and subjective well-being among LGBTQ+ people in the UK

Background LGBTQ+ community experience higher levels of substance use and poorer well-being than the general population. Methods Variations in well-being by form of substance use (adjusting for confounders) were examined using data from a national UK survey of LGBTQ+ adults. Participants were asked about past year substance use to alter appearance ADU, have sex better SDU, help work or study WSDU, for the feelings or experience caused FEDU, nicotine use, alcohol (AUDIT-C) use, and well-being (ONS-5). Results Participants mean age was 33.5 years, 47% identified as bisexual (n = 561, 88% cis-gendered): 30% reported FEDU, 8.6% SDU, 7.1% WSDU, 3.0% ADU, 33% nicotine use (16% smoked, 26% vaped), and 79% alcohol use. FEDU was associated with anxiety (p = 0.028), ADU with anxiety (p = 0.015) and poorer subjective health (p = 0.031), and SDU with feeling life was more worthwhile (p = 0.011). WSDU was not associated with the well-being measures. Risky alcohol use was associated with anxiety (p = 0.042), and nicotine use with feeling less worthwhile (p = 0.046), less happy (p = 0.002), anxiety (p = 0.011), and poorer subjective health (p = 0.018). Conclusions Responses to substance use in LGBTQ+ community should be situated in better understanding and addressing the more common forms of substance use and anxiety.