Background: Several social and environmental factors influence drug use behaviors and contribute to frequent drug use among Two-Spirit, Lesbian, Gay, Bisexual, Transgender, Queer, and other (2SLGBTQ+) individuals. The purpose of the current study was to examine the relationship between the minority stress, drug use, and other socio-ecological factors. Methods: This study employed structural equation modelling on data (2021—2022) from a nationally representative pan-Canadian survey (N = 1542) on 2SLGBTQ+ health to examine the association between minority stress, drug use, and relevant socio-ecological predictors. A separate mediation analysis was conducted and controlled for socio-demographic characteristics. Results: SEM results showed parsimonious fit of data chi-square = 526.86 (df = 61, p < 0.0001), SRMR = 0.04, RMSEA = 0.07 (95% CI = 0.07, 0.08), AGFI = 0.92, and CFI = 0.95. The direct path of minority stress on drug use was significant (β = 0.07899, p = 0.0005) and other indirect effects were observed. Psychological distress significantly mediated the relationship through an indirect pathway (β = 0.07, p < 0.0001). Conclusions: Minority stress and drug use are inter-related through direct and indirect paths and psychological distress plays a crucial role in mediation. Study findings add valuable insight to the field of substance use and addiction by deepening our understanding of the mechanisms behind drug use in the population.
Chin-see et al. (2026) studied this question.