Evaluating the Determinants of Substance Use in LGBTQIA+ Adolescents: A Scoping Review

Background: Research has consistently shown increased drug use among lesbian, gay, bisexual, transgender, intersex, queer/questioning, and asexual (LGBTQIA+) individuals. This is particularly the case among LGBTQIA+ adolescents. Substance use within this vulnerable community can propagate mental health issues, leading to psychiatric disorders, self-harm, and even suicide. Therefore, the objective of this scoping review was to evaluate the determinants of drug use among LGBTQIA+ adolescents. Methods: A comprehensive search of mainly primary research was conducted, using several databases. Peer-reviewed articles published between 2018 and 2023 were included. The scoping review was conducted using the framework outlined by Joanna Briggs Institute (JBI) and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses—Extension for Scoping Reviews (PRISMA-ScR) statement. Results: A total of 29 articles (including 400,194 participants) were included in the analysis. The articles reported that the main determinants of drug use among LGBTQIA+ adolescents include homelessness, peer–peer interactions, mental health, and protective factors. The articles reported that mental health issues, which were mainly triggered by rejection, were the main determinants of drug use among LGBTQIA+ adolescents. Conclusions: Findings from this scoping review provide relatively reliable evidence that homelessness, mental health, peer–peer interactions, and protective factors are the main determinants of illicit drug use among LGBTQ+ adolescents. Rigorous studies including large sample sizes and systematic reviews are needed to further confirm these findings and assist in developing interventions to combat the unusually high level of drug use among this group.