20 Nov Rutgers Study Finds ADHD and Substance Use Intertwined For Many Sexual Minority Men

MedicalResearch.com Interview with:

Dr. Krause

Kristen D. Krause, PhD, MPH (she/her/hers)
Assistant Professor, Department of Urban-Global Public Health
Deputy Director, Center for Health, Identity, Behavior and Prevention Studies (CHIBPS)
Rutgers School of Public Health
Deputy Editor, Annals of LGBTQ Public and Population Health
Deputy Editor, Behavioral Medicine

MedicalResearch.com: What is the background for this study?

Response: Young sexual minority men often face myriad challenges including stigma, heightened risk for mental health issues, and an increased likelihood of substance use. This study set out to shine a light on how ADHD symptoms might factor into these risks—a topic rarely examined directly in this population.

MedicalResearch.com: What are the main findings?

Response:  We found that ADHD symptoms are not only common, but they are associated with increased odds of both early and frequent substance use, spanning everything from cigarettes to alcohol and more illicit substances. These results don’t just fill a gap, they invite attention to a complex interplay of identity, mental health, and behavior.

MedicalResearch.com: What should readers take away from your report?

Response: ADHD and substance use are intertwined for many young sexual minority men, and ignoring either piece of the puzzle may mean overlooking opportunities for support. Any approach to care or prevention in this group should appreciate the role that neurodevelopmental symptoms play, especially alongside minority stress. If service providers want interventions to be effective, it’s crucial to address social context and not just individual behavior.

MedicalResearch.com: What recommendations do you have for future research as a results of this study?

Response: Moving forward, it would be valuable to see research that follows participants over time, diving deeper into why and how ADHD symptoms contribute to substance use risk. A combination of clinical interviewing, validated diagnostic methods, and biological measures could clarify what’s driving the association. Exploring whether distinct subgroups (for instance, gay vs. bisexual men) face unique pathways will help build tailored interventions, and considering the impact of stigma or discrimination may explain some of the disparities. 

Disclosures: This study stands out for its sample diversity and comprehensive analysis, though it’s important to acknowledge several limitations, especially the cross-sectional design and that this data was collected several years ago in the urban context of New York City. No conflicts of interest were disclosed in this article.

Citation: Brandt, S. A., Stults, C. B., Krause, K. D., Martino, R. J., Mulbah, D. M., & Halkitis, P. N. (2025). ADHD symptoms and substance use among young sexual minority men: The P18 cohort study. Journal of Gay & Lesbian Mental Health, 1–27. https://doi.org/10.1080/19359705.2025.2536486

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Last Updated on November 20, 2025 by Marie Benz MD FAAD