Increased Coping Motives During the COVID-19 Pandemic Widen Cannabis Disparities Between Sexual Minoritized and Nonminoritized Young Adults: A Bimonthly Assessment of Data Preceding and Spanning the Pandemic

Objective: Since the start of the coronavirus pandemic, some U.S. adults have increased alcohol and cannabis use frequency to cope with distress. Among sexual minoritized young adults (SM YAs), coping-related use may be greater due to disproportionate negative social and financial consequences of the pandemic. Nonetheless, it remains unclear whether pandemic substance use has increased among SM YAs compared to non-SM YAs relative to prepandemic levels and whether heightened coping motives mediate these potential differences. Method: A total of 563 YAs (18-24 years at baseline; 31.0% SM) provided survey data collected across 12 bimonthly assessments. Six assessments were measured in 2015 or 2016 and six across the coronavirus pandemic (2020-2021). Controlling for prepandemic assessments matched by calendar month, latent structural equation models examined group differences in alcohol and cannabis frequency and consequences across the COVID-19 period and tested coping motives as mediators of these differences. Results: Substance use and consequences were similar during the pandemic relative to prepandemic levels across groups. Nonetheless, compared to non-SM individuals, SM participants reported greater cannabis frequency, consequences, and cannabis coping motives during the pandemic independent of prepandemic levels. Cannabis use and consequences were each explained largely by coping motives during the pandemic among SM compared to non-SM YAs. These patterns were not found for alcohol outcomes. Conclusions: The COVID-19 pandemic has widened cannabis disparities between SM and non-SM YAs, due in part to pandemic-related increases in coping motives. Responsive public policy is needed that may prevent and remit SM cannabis disparities during societal crises. Public Health Significance Statement This study indicates that the coronavirus pandemic has widened preexisting gaps in coping motives for cannabis use and cannabis use frequency among sexual minoritized compared to sexual nonminoritized young adults. This study also shows that cannabis use is largely explained by heightened coping motives for use during the pandemic, independent of prepandemic levels of use and motives, highlighting need for responsive intervention and policy aimed at reducing impacts of societal crises on substance use among sexual minoritized communities.