Stimulant, Alcohol, and Cannabis Use Associated with Depression in Sexual Minority Men and Transgender Women

A new study from researchers at Northwestern University’s Institute for Sexual and Gender Minority Health and Wellbeing (ISGMH) finds that reducing substance use is associated with decreases in symptoms of depression among sexual minority men and transgender women.

When sexual minority men and transgender women stopped or reduced their substance use, they experienced a decrease in symptoms of depression, according to a new paper published in the Journal of Studies on Alcohol and Drugs and led by Christina Dyar, Ph.D., research assistant professor at ISGMH.

"Reduction and Cessation of Alcohol, Cannabis, and Stimulant Use: Prospective Associations With Changes in Depressive Symptoms Across Two Cohort Studies of Sexual and Gender Minorities" used data from two large cohorts of young sexual and gender minorities funded by the National Institute on Drug Abuse: RADAR, a cohort of racially diverse sexual minority men and transgender women in Chicago, and Element, a cohort of Black sexual minority men in Atlanta.

“We found that a reduction in stimulant use predicted a reduction in depressive symptoms six months later, but that depression did not predict stimulant use,” said Dyar. “This suggests that stimulant use may contribute to depression rather than the reverse. In addition, sexual minority men and transgender women who decreased or ceased alcohol use or ceased using cannabis experienced reductions in symptoms of depression around the same time. However, unlike stimulant use, decreases in alcohol and cannabis use did not predict longer-term reductions in symptoms of depression. This suggests that depression and alcohol and cannabis use may mutually influence one another."

These results suggest that, rather than treating substance use and depression separately, interventions which simultaneously tackle both may prove most effective for this population.

“The results of this study,” Dyar continued, “indicate that clinical interventions that help sexual minority men and transgender women reduce or cease substance use may simultaneously reduce symptoms of depression and contribute to improved mental health.”

Further, although substance use interventions have tended to make quitting the ultimate goal, these findings suggest that interventions that aim to decrease substance use may also benefit mental health.

Study co-authors include Heather Bradley, Ph.D.; Ethan Morgan, Ph.D.; Patrick S. Sullivan, D.V.M., Ph.D.; and Brian Mustanski, Ph.D.