Persisting inequalities in past-year drug use by sexual identity: trends across England's 2007, 2014 and 2024 Adult Psychiatric Morbidity Surveys
Analysis of England's Adult Psychiatric Morbidity Surveys from 2007, 2014, and 2024 reveals that significant inequalities in past-year drug use persist between sexual minority and heterosexual adults, with sexual minorities consistently exhibiting rates at least double those of their heterosexual counterparts over the 17-year period.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of a preprint that has not been peer-reviewed. It is not medical advice. Do not make health decisions based on this content. Read full disclaimer
For decades, scientists have understood that people who identify as sexual minorities—those who are gay, lesbian, or bisexual—often face a heavier burden of stress than their heterosexual peers. This stress does not just come from personal feelings, but from the reality of living in a world where they may be treated unfairly, discriminated against, or forced to hide who they are. This constant pressure, known in research as minority stress, can wear people down over time, leading them to seek relief in ways that might harm their health, such as using drugs. While we know this pattern exists, a big question has remained unanswered: has the gap between these groups narrowed as society has become more accepting? With laws changing to protect same-sex relationships and public attitudes shifting toward greater openness, one might expect the health differences to shrink. Yet, without fresh data stretching across many years, it was impossible to know if these improvements in rights had actually translated into improvements in daily life and health behaviors for everyone.
To answer this, researchers turned to a massive collection of health surveys from England, looking at data gathered from thousands of households in 2007, 2014, and 2024. These surveys asked adults about their lives, their health, and their use of various substances, while carefully recording their sexual identity. The team focused specifically on whether people had used illegal drugs or misused prescription medications in the year before the interview. By comparing the answers from people who identified as heterosexual against those who identified as gay, lesbian, or bisexual, they could track whether the differences between these groups were getting smaller, staying the same, or perhaps even growing wider over nearly two decades.
The results revealed a stubborn reality: the gap in drug use has not closed. In 2024, the most recent year surveyed, nearly one in four sexual minority adults reported using drugs in the past year, compared to only about one in eleven heterosexual adults. This means that sexual minority people were still more than twice as likely to use drugs as their heterosexual counterparts. This pattern held true across the entire seventeen-year period studied. In 2007, the difference was already clear, and by 2024, despite significant changes in laws and social acceptance, the disparity remained just as large. The researchers found that this inequality was not limited to just one type of substance; it appeared across a wide range of drugs, from cannabis to cocaine and others.
When the researchers looked closer at the data, they found that the story was different for men and women. Among men, the gap that existed in 2007 seemed to have disappeared by 2024, with drug use rates for sexual minority men and heterosexual men becoming similar. However, the opposite happened for women. In 2007, sexual minority women used drugs at higher rates than heterosexual women, but by 2024, that gap had widened dramatically. The rate of drug use among sexual minority women rose significantly, reaching a level more than five times higher than that of heterosexual women. This increase was largely driven by the use of cannabis, which saw a sharp rise among sexual minority women while remaining relatively stable for heterosexual women.
The study also highlighted how age plays a role in these trends. For young heterosexual adults, drug use has actually gone down over the years, dropping from nearly a quarter of the group in 2007 to about one in six in 2024. In contrast, drug use among young sexual minority adults has remained stubbornly high, with about one in three reporting use in every survey year. This suggests that while the general population of young people is moving away from drug use, sexual minority youth are not seeing the same shift. Furthermore, the data showed a surprising rise in drug use among middle-aged adults in both groups, but the rates remained consistently higher for sexual minority people across all age groups.
These findings challenge the idea that legal equality and greater social acceptance automatically fix deep-seated health inequalities. The researchers suggest that while laws have changed, the everyday experiences of stigma, discrimination, and social exclusion may still be powerful forces driving these health disparities. The fact that the gap has persisted, and even widened for some groups like women, indicates that simply changing the law is not enough. The study points to a need for health services and prevention programs to specifically address the unique stressors faced by sexual minority people, particularly women and young people, rather than treating drug use as just an individual choice. Without understanding and addressing these underlying social causes, the health gap is likely to remain, regardless of how much progress society makes in other areas.
Drowning in papers in your field?
Get daily digests of the most novel papers matching your research keywords — with technical summaries, in your language.