(PS8-27) A Cross-sectional Examination of Minority Stress, Coping, and Substance Use Reduction and Cessation Attempts

Sexual and gender minority (SGM) individuals are at a significantly higher risk for cannabis and alcohol use disorders than cisgender or heterosexual individuals, and there is a strong link between minority stress, heavier substance use, and higher risk for substance use disorders. They also more frequently endorse coping motives for use, which may be a result of frequent minority stress experiences. However, while these are known to contribute to substance use problems, their relationship with attempts to quit or reduce substance use has gone largely unstudied.  The current study aims to address this gap in the literature by examining associations between minority stress, coping motives, and alcohol and cannabis cessation and reduction attempts in a sample of sexual and gender minority individuals.

This study used cross-sectional data from sexual minority cisgender women and gender diverse individuals (N=401). We measured five outcomes related to alcohol and cannabis cessation and/or reduction: self-reported prior quit attempts, reduction attempts, consideration of reducing or quitting use, 30-day success during a quit or reduction attempt, and subsequent return to use. To better understand reduction and cessation attempts in the SGM population, we examined these outcomes in association with 1) coping motives for use, and 2) experiences of microaggressions. Data were analyzed using logistic regression models. Covariates included age, sexual identity, gender, and race/ethnicity.

Participants reporting higher current coping motives for alcohol use were more likely to have attempted to quit or reduce use in the past. In those who reported a cessation or reduction attempt, coping motives were associated with both a lower likelihood of maintaining abstinence or reduction for at least 30 days and a higher likelihood of returning to use following the attempt. For cannabis use, coping motives were associated with a higher likelihood of past quit attempts, reduction attempts, and consideration of reducing or quitting. Those who reported high coping motives for cannabis use were also more likely to have returned to use after a quit attempt. Experiences of microaggressions, related to both sexual identity and gender, were associated with a higher likelihood of endorsing alcohol reduction attempts and cannabis quit attempts.

These results suggest that participants with high coping motives for substance use may have a high desire to quit while also being less able to maintain abstinence during or after a quit attempt. While the relationship is less clear, minority stress seems to be related to desire to quit, and its strong association with past reduction and cessation attempts warrants further research. Further, we examined cross-sectional associations between recent microaggressions and coping motives and lifetime cessation/reduction outcomes. This is the opposite of the theorized directionality of these associations, so future work should examine these associations prospectively. However, given the dearth of research on correlates of cessation and reduction attempts among SGM individuals, this work is an important first step in understanding the effect of minority stress and its consequences on substance use cessation and reduction.