Key takeaway
You are looking at a chart about people like you, and you are afraid it is a verdict. In 2023, LGB+ people were more likely than straight people to have a past-year substance use disorder. Young adults in that group were the most likely. Get care for what you use.
Last updated: Mon Oct 05 2026 00:00:00 GMT+0000 (Coordinated Universal Time)
You are looking at a chart that talks about people like you, and you need to know whether it is a verdict. It is not. You still deserve care for what you actually use.
If you are in immediate danger, call 911. If you might hurt yourself, call or text 988.
The chart is about a group, not about your night
On the 2023 national survey, after an age adjustment, LGB+ people were more likely than straight people to have a substance use disorder in the past year. Straight means straight or heterosexual. Among LGB+ people, young adults 18 to 25 were the most likely. Most people in the group do not have a substance use disorder. If you have been telling yourself you do not need treatment, you are in large company: among LGB+ people with a substance use disorder who did not get it and were asked, nearly all did not think they needed it. You can still ask tonight.
If both are true, say both
4.9 million LGB+ adults, 23.8 percent of those 18 or older, had both a substance use disorder and any mental illness. If both are true for you, say both when you ask for care that treats them together.
You do not have to use a specialized program. You can ask the privacy questions at a general program too. If a program treats your identity as the illness, or offers to change your orientation, leave that conversation. Read affirming care before you skip the questions about privacy and the name you use. Ask what a program may tell a caller. Sexual identity is not automatically part of a substance use record.
Search FindTreatment.gov when you want a program. Call or text (800) 653-9376 if you want help finding substance use care and you want privacy asked about out loud.
Additional Resources
Sources cited on this page:
- SAMHSA: 2023 NSDUH highlighted population slides, LGB+ population aged 12 or older
- SAMHSA: NSDUH 2023 highlighted population slides index
- SAMHSA: A Provider's Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals (2012)
- SAMHSA FindTreatment.gov
- SAMHSA National Helpline
- 988 Suicide & Crisis Lifeline
- SmarterRecovery about page (referral disclosure)
Common Questions
Does a higher survey rate mean identity causes addiction?
No. The 2023 survey compares groups. It does not find a cause, and it does not diagnose you. Being lesbian, gay, or bisexual, or using another term, is not the treatment plan. Ask a program about privacy, the name you use, and any prescribed hormones.
What did the 2023 survey find about substance use disorder?
On the age-adjusted comparison, LGB+ people were more likely than straight people to have a past-year substance use disorder. Straight means straight or heterosexual. Among LGB+ people age 12 or older, young adults 18 to 25 were the most likely to have a past-year substance use disorder or a drug use disorder. Severity was too imprecise to publish, so avoid calling those disorders mostly mild or mostly severe.
What about mental health in the same slides?
4.9 million LGB+ adults, 23.8 percent of LGB+ adults 18 or older, had both a substance use disorder and any mental illness. A different figure, 72.1 percent, is LGB+ young adults 18 to 25 who had a substance use disorder or any mental illness. Do not quote 72.1 percent as the share who had both.
Were LGB+ people also more likely to binge drink?
Not in the age-adjusted comparison. LGB+ people were just as likely to binge drink as straight people. Binge means five or more drinks for males, or four or more for females, on the same occasion on at least one day in the past 30 days. Among LGB+ people who drank in the past month, more than half were binge drinkers. Equal likelihood is not the same as rare.
Can I compare these numbers with older surveys?
No. Beginning in 2023, sexual-identity questions were asked of all respondents, not only adults, and the question was revised. Adult sexual-identity estimates from 2023 should not be compared with earlier years. The survey also leaves out active-duty military, people in long-term hospitals, people in prison, and people who are homeless and not in shelters.