Reducing risk for illicit drug use and prescription drug misuse: High school gay-straight alliances and lesbian, gay, bisexual, and transgender youth

• Assessed association between gay-straight alliances (GSAs) and illicit drug use.
• LGBT youth without a GSA evidenced greater risk for illicit substance use.
• They also evidenced greater risk for prescription drug misuse.
• GSAs appear to promote favorable health outcomes for LGBT youth.

Previous research suggests that lesbian, gay, bisexual, and transgender (LGBT) youth are at elevated risk for using illicit drugs and misusing prescription drugs relative to heterosexual youth. Previous research also indicates that LGBT youth who attend high schools with a gay-straight alliance (GSA) report having fewer alcohol problems and lower levels of cigarette smoking. The present study investigates whether the absence of a GSA is associated with risk for illicit drug use and prescription drug misuse in a sample of 475 LGBT high school students (M age = 16.79) who completed an online survey. After controlling for demographic variables and risk factors associated with illicit drug use, the results of 12 logistic regression analyses revealed that LGBT youth attending a high school without a GSA evidenced increased risk for using cocaine (adjusted odds ratio [adjOR] = 3.11; 95% confidence interval [95% CI] = 1.23–7.86), hallucinogens (adjOR = 2.59; 95% CI = 1.18–5.70), and marijuana (adjOR = 2.22; 95% CI = 1.37–3.59) relative to peers attending a high school with a GSA. Youth without a GSA also evidenced increased risk for the misuse of ADHD medication (adjOR = 2.00; 95% CI = 1.02–3.92) and prescription pain medication (adjOR = 2.00; 95% CI = 1.10–3.65). These findings extend the research base related to GSAs and further demonstrate the importance of providing LGBT youth with opportunities for socialization and support within the school setting. Important limitations of the present study are reviewed.