Severity of DSM-5 cannabis use disorders in a nationally representative sample of sexual minorities

Background: Our study is the first using a national sample to examine the severity of Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) cannabis use disorder (CUD) in sexual minorities. Drawing from current literature, we expected that bisexual individuals would have the highest prevalence of CUD and the most severe form of CUD. Methods: The National Epidemiological Survey on Alcohol and Related Conditions-III (NESARC-III; 2012?2013) provides a nationally representative adult sample (N?=?36,309), including one of the largest samples of sexual minorities. The NESARC-III is large enough to compare subpopulations of sexual minorities on dimensions of substance use disorder severity. Results: Lesbians and gay men were more likely to report mild CUD, whereas bisexuals and respondents ?not sure? of their sexual identity were more likely to report severe CUD when compared with heterosexuals. Sexual minorities and heterosexuals who reported lifetime use of medical cannabis had higher odds of having a severe CUD. Sexual minorities had significantly higher odds of lifetime medical cannabis use (adjusted odds ratio [AOR]?=?2.39, 95% confidence interval [CI]?=?1.42?3.66, P?