Exploring associations between sexual orientation, substance use, loneliness, and sense of belonging in a large college sample

AI Summary

Positive mental health and a stronger sense of belonging were associated with lower odds of past 30-day illicit substance use excluding marijuana.
Positive mental health and belonging did not protect against past two-week alcohol consumption or binge drinking.
Students older than 20 had lower binge-drinking odds; campuses should target underage alcohol programming and bolster belonging to reduce illicit substance use.

J Am Coll Health. 2026 May 31:1-14. doi: 10.1080/07448481.2026.2678238. Online ahead of print.

ABSTRACT

Objective: We examined illicit substance use (including and excluding marijuana), mental health, alcohol consumption, and binge-drinking among postsecondary institution students, by sexual orientation. Participants: Students that completed the 2022-2023 Healthy Minds Study (N = 76,406), with complete demographic, substance use, and mental health responses. Methods: Weighted logistic regression models assessed the relationship between sexual orientation and substance use and mental health. Results: Positive mental health and a sense of belonging were protective against past 30-day substance use reporting (excluding marijuana), but the same protection was not seen in past two-week alcohol consumption and binge-drinking behavior. Respondents older than 20 years old had significantly lower odds of binge-drinking. Conclusions: Campuses should continue devoting appropriate resources to programming geared toward underage students for the dangers of excessive alcohol consumption. Additional strategies bolstering students’ sense of belonging on campuses may also be protective against students’ use of illicit substances.

PMID:42218786 | DOI:10.1080/07448481.2026.2678238

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