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Peer-reviewedCC BY 4.0Journal of Clinical Psychology

The Link Between Opioid Misuse and Suicidal Ideation Is Strongest Among Sexual Minorities

  • Katherine Musacchio Schafer1,2
  • Rachel M. Schott3
  • Julia C. Dodd3
  • Jameson K. Hirsch4
4 affiliations
  1. 1Department of Biomedical Informatics Vanderbilt University Medical Center Nashville Tennessee USA
  2. 2Department of Psychiatry and Behavioral Sciences Vanderbilt University Medical Center Nashville Tennessee USA
  3. 3Department of Psychology East Tennessee State University Johnson City Tennessee USA
  4. 4Department of Psychiatry and Behavioral Sciences, Quillen College of Medicine East Tennessee State University Johnson City Tennessee USA
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Abstract

Opioid misuse and suicidal ideation (SI) are significant public health concerns in the United States, and incidence rates may be elevated among sexual minority people. We used data from the 2021 National Survey on Drug and Health (heterosexual, n = 39,647, lesbian/gay n = 1329, bisexual n = 3774) to investigate rates of opioid misuse and suicidal ideation (SI) across sexual identity groups. We found that opioid misuse (heterosexual, 3.0%, lesbian/gay, 5.2%; bisexual, 5.7%) and SI (heterosexual, 4.0%; lesbian/gay, 13%; bisexual, 23%) were highest among bisexual participants, followed by lesbian/gay participants, followed then by heterosexual participants. Further, opioid misuse and SI were associated across sexual identity groups (entire sample: r = 0.08, p < 0.001; heterosexual: r = 0.07, p < 0.001; lesbian/gay: r = 0.11, p < 0.001; bisexual: r = 0.082, p = 0.003). Notably, the association between opioid misuse and SI was strongest among sexual minority respondents. This work confirms a deleterious linkage between opioid misuse and SI and indicates that sexual minority participants were at greater risk for opioid misuse and SI as compared to heterosexual individuals. Clinicians should be cognizant of the risk of comorbid opioid misuse and SI in their sexual minority patients, as they develop and implement intervention strategies.

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Cite

BibTeXRIS
BibTeX
@article{schafer2026link,
  title = {{The Link Between Opioid Misuse and Suicidal Ideation Is Strongest Among Sexual Minorities}},
  author = {Katherine Musacchio Schafer and Rachel M. Schott and Julia C. Dodd and Jameson K. Hirsch},
  journal = {Journal of Clinical Psychology},
  year = {2026},
  month = aug,
  doi = {10.1002/jclp.70217},
  url = {https://doi.org/10.1002/jclp.70217},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - The Link Between Opioid Misuse and Suicidal Ideation Is Strongest Among Sexual Minorities
AU  - Katherine Musacchio Schafer
AU  - Rachel M. Schott
AU  - Julia C. Dodd
AU  - Jameson K. Hirsch
PY  - 2026
DA  - 2026/08/22
JO  - Journal of Clinical Psychology
DO  - 10.1002/jclp.70217
UR  - https://doi.org/10.1002/jclp.70217
AB  - Opioid misuse and suicidal ideation (SI) are significant public health concerns in the United States, and incidence rates may be elevated among sexual minority people. We used data from the 2021 National Survey on Drug and Health (heterosexual, n = 39,647, lesbian/gay n = 1329, bisexual n = 3774) to investigate rates of opioid misuse and suicidal ideation (SI) across sexual identity groups. We found that opioid misuse (heterosexual, 3.0%, lesbian/gay, 5.2%; bisexual, 5.7%) and SI (heterosexual, 4.0%; lesbian/gay, 13%; bisexual, 23%) were highest among bisexual participants, followed by lesbian/gay participants, followed then by heterosexual participants. Further, opioid misuse and SI were associated across sexual identity groups (entire sample: r = 0.08, p < 0.001; heterosexual: r = 0.07, p < 0.001; lesbian/gay: r = 0.11, p < 0.001; bisexual: r = 0.082, p = 0.003). Notably, the association between opioid misuse and SI was strongest among sexual minority respondents. This work confirms a deleterious linkage between opioid misuse and SI and indicates that sexual minority participants were at greater risk for opioid misuse and SI as compared to heterosexual individuals. Clinicians should be cognizant of the risk of comorbid opioid misuse and SI in their sexual minority patients, as they develop and implement intervention strategies.
SN  - 0021-9762
SN  - 1097-4679
ER  -