5 - (IOP 29) Microaggressions and Alcohol/cannabis Use at the Daily Level Among Sexual and Gender Minority Older Adults

Purpose: At the daily level, sexual and gender minority (SGM) research has produced mixed findings regarding the associations between minority stress and substance use. One recent study demonstrated that this daily association may differ across individuals based on their typical motives for substance use and their frequency of use. However, this study focused on young adult sexual minority women and gender diverse individuals assigned female at birth and sexual identity related microaggressions. It is unclear whether the same pattern will apply to SGM more broadly, to microaggressions based on additional identities, or to other age groups. The current study aimed to test moderators of daily associations between microaggressions (based on a range of marginalized identities) and alcohol and cannabis use among a sample of older adult SGM, a population that has been neglected in research on substance use.

Methods: We used data from a 30-day ecological momentary assessment study with 109 SGM older adults (age 50+) to determine whether individual-level motives for substance use, frequency of use, or substance use disorder symptoms moderate the daily associations between microaggressions and alcohol/cannabis use, quantity consumed, and consequences.

Results: Alcohol use disorder (AUD) symptoms moderated the association between microaggressions, alcohol use, and alcohol consequences at the daily level. SGM who had probably AUD were more likely to drink and experiences more consequences on days when they had experienced a microaggression. These associations were not significant among SGM with fewer AUD symptoms. Demonstrating a similar pattern, cannabis use disorder (CUD) symptoms also moderated the association between microaggressions and cannabis use. Microaggressions also prospectively predicted heavier cannabis consumption during the next observation, but only among individuals with probable CUD.

Conclusions: Overall, results indicate that microaggressions are associated with substance use outcomes at the daily level only among individuals with probable alcohol and/or cannabis use disorders. This indicates that a shift is needed in our examination of associations between minority stress and alcohol and cannabis use among SGM, with a focus on SGM individuals most likely to respond to experiences of minority stress with substance use. Findings suggest that interventions designed to address alcohol and cannabis use among SGM would benefit from helping SGM to build skills for coping with minority stress without substance use.