Investigating Differential Protective Effects of Marriage on Substance Use by Sexual Identity Status

Abstract

Background: Research suggests that marriage is protective against substance use. However, few studies have examined whether this protective effect differs for sexual minorities, a population at increased risk for substance use. Using data from four waves of the cross-sectional U.S. National Alcohol Survey (NAS; 2000, 2005, 2010, and 2015), we investigated whether the protective effects of marriage varied by sexual identity.
 Methods: Sex-stratified logistic regression models were used to examine independent and interactive effects of current marital status (being married vs. not) and sexual minority status (lesbian/gay/bisexual vs. heterosexual) on high-intensity drinking, alcohol use disorder, and marijuana use in the past year.
 Results: Among both women and men, sexual minority status was generally associated with higher odds of these outcomes and marriage was consistently associated with lower odds. Differential effects of marriage by sexual identity with respect to marijuana use were found only among men; marriage was significantly associated with decreased odds of marijuana use among heterosexual men but increased odds among sexual minority men.
 Conclusions: Marriage may be less consistently protective against hazardous drinking and marijuana use among sexual minorities than heterosexuals. Findings underscore the importance of both quantitative and qualitative studies designed to better understand disparities in substance use across both sexual identity and relationship statuses.

Twenty Years of Legal Marriage for Same-Sex Couples in the United States: Evidence Review and New Analyses

“…One study did not find a protective effect of marriage on drinking behavior or marijuana use among LGBT individuals, and, for sexual-minority men, marriage was associated with increased odds of marijuana use (Trocki et al, 2020). Despite this, studies that measured problematic or disordered substance use show that marriage bans for same-sex partners increase substance use, whereas the availability of legal marriage decreases these adverse behaviors.…”

Comparing substance use outcomes by sexual identity among women: Differences using propensity score methods

“…Demographic factors that often protect against substance use among women also vary by sexual identity. For example, although family composition is changing rapidly in the context of social and political changes (e.g., legalization of same-sex marriage), SMW are less likely to be in committed/married relationships than heterosexual women ( Drabble et al, 2020 ; Hughes et al, 2020 ), and marital/relationship status may be less consistently protective against substance use, such as hazardous drinking and marijuana use, among SMW relative to heterosexual women ( Trocki et al, 2020 ; Veldhuis et al, 2020 ). In addition, although some research has found a lower risk of substance use (e.g., alcohol use disorders) among Black, Latinx, or Asian women than among White women, studies with SMW have found no differences, or even greater use, among racially minoritized SMW than in White SMW ( Hasin and Grant, 2015 ; Hughes et al, 2020 ; Mulia and Bensley, 2020 ).…”