Increases in Alcohol and Cannabis Use Associated with Deteriorating Mental Health among LGBTQ2+ Adults in the Context of COVID-19: A Repeated Cross-Sectional Study in Canada, 2020-2021.

Trevor Goodyear,Rod Knight,Travis Salway,Anne Gadermann,Allie Slemon,Emily Jenkins,Chris Richardson,Shivinder Dhari

doi:10.3390/ijerph182212155

Abstract

Lesbian, gay, bisexual, trans, other queer, and Two-Spirit (LGBTQ2+) people are particularly at risk for the psycho-social consequences of the COVID-19 pandemic, though population-tailored research within this context remains limited. This study examines the extent of, and associations between, increased alcohol and cannabis use and deteriorating mental health among LGBTQ2+ adults in Canada during the COVID-19 pandemic. Data are drawn from LGBTQ2+ respondents to a repeated, cross-sectional survey administered to adults living in Canada (May 2020–January 2021). Bivariate cross-tabulations and multivariable logistic regression models were utilized to examine associations between increased alcohol and cannabis use, and self-reported mental health, overall coping, and suicidal thoughts. Five-hundred and two LGBTQ2+ participants were included in this analysis. Of these, 24.5% reported increased alcohol use and 18.5% reported increased cannabis use due to the pandemic. In the adjusted analyses, increased alcohol use was associated with poor overall coping (OR = 2.28; 95% CI = 1.28–4.07) and worse self-reported mental health (OR = 1.98; 95% CI = 1.21–3.25), whereas increased cannabis use was associated with suicidal thoughts (OR = 2.30; 95% CI = 1.16–4.55). These findings underscore the need for population-tailored, integrated substance use and mental health supports to address interrelated increases in alcohol/cannabis use and worsening mental health among LGBTQ2+ adults, in the context of the COVID-19 pandemic and beyond.

Highlights

This study draws on data from a repeated cross-sectional monitoring survey, “Assessing the Impacts of COVID-19 on Mental Health”, which examines the self-assessed mental health impacts of COVID-19 among adults 18 years of age and older living in Canada
Comparisons between the mental health and substances use practices of LGBTQ2+ respondents and those of non-LGBTQ2+ respondents are explored in depth in a forthcoming analysis by our team [48], whereas the current analysis addresses population-specific knowledge gaps by narrowing in on LGBTQ2+
This paper draws on three rounds of data from a nationally representative, crosssectional monitoring survey—assessing the mental health impacts of the COVID-19 pandemic in Canada—to examine associations between increased alcohol/cannabis use and select adverse mental health outcomes among the sub-sample of LGBTQ2+ adult survey respondents

Summary

Introduction

The COVID-19 pandemic and associated public health measures are poised to deleteriously impact population-level mental health, as seen in research showing increases in overall levels of anxiety, depression, and suicidal thinking [1,2,3]. The pandemic and its social and economic consequences have noteworthy implications related to substance use. People are reporting using substances to cope with new and/or intensified experiences of stress, fear, boredom, and isolation; and/or to facilitate experiences of pleasure and connectedness during these challenging times [4,5].

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