Addiction in the LGBTQ+ Community

The connection between LGBTQ and addiction issues is regrettably common.

The stress of the day-to-day battles with discrimination continues to fuel substance abuse in the LGBTQ community. Also, they experience higher rates of substance use as compared with the heterosexual population.

In addition, culturally sensitive LGBTQ substance abuse treatment can go a long way in LGBTQ addiction recovery. If you feel your substance abuse issues are tied to your experience as an LGBTQ individual, reach out to us at 405-583-4390 today. You do not need to struggle with addiction alone.

LGBTQ substance abuse statistics

Substance-use patterns reported by sexual minority adults are statistically higher than those reported by heterosexual adults.

The LGBTQ substance abuse studies find 37.6 percent of sexual minority adults 18 and older report past-year marijuana use. Moreover, sexual minority adults aged 18 or older report past-year opioid use. Including misuse of prescription opioids or heroin use, at 9 percent of the community.

University of Akron Associate Professor of Sociology Robert L. Peralta studied why alcohol use disorder is so high among the LGBTQ community.
Furthermore, Peralta examined a population sample of 375,000 Americans from 2015-2017.

The study finds that between the ages of 25 and 50, sexual minorities are more likely to struggle with alcohol use disorder than their heterosexual peers.
Bisexual women aged 24 to 29 also have a greater propensity for Alcohol Use Disorder compared to heterosexuals of the same age and gender.
New research from the University of Michigan (UM) made a similar find. UM’s study examines the severity of substance abuse in the LGBTQ community and people who aren’t sure how they identify.

In short, the study finds that people who identified as bisexual or were unsure about their sexual identity were at the most significant risk for a substance use disorder. However, individuals who were uncertain of their sexual identity are five times as likely to have a severe AUD. They also are about four times as likely to report an intense tobacco or drug problem when compared to heterosexuals.

LGBTQ and Addiction Stressors, Triggers

University of Akron’s Peralta is quick to explain that sexual orientation by itself is not what causes substance abuse, rather the social implications and challenges of being a sexual minority.

“People tend to use data to say, ‘here’s how sexual minorities are different from us,’ so it’s important to stress that to be a sexual minority in and of itself is not a risk factor,” Peralta said. “The consequences, the stress of that minority status are what create problems such as AUD.”

Moreover, the social consequences for people who identify as LGBTQ can consist of social stigma and discrimination. They also face a greater risk of harassment and violence. As a result of these and other stressors, sexual minorities are at increased risk for various behavioral health problems.

Gay and transgender people have to deal with minority stress every day. Minority stress is generally defined as the negative effects associated with the adverse social conditions experienced by individuals of a marginalized social group. This stress is easily triggered by a general social prejudice against being gay or transgender.

Also, antigay and antitransgender social prejudice stems from the belief that being gay or transgender is wrong or unethical. It can be expressed in subtle ways or by verbal and physical violence.

Sexual minorities with substance use disorders are also more likely to have co-occurring psychiatric disorders. Gay and bisexual men report greater odds of frequent mental distress and depression than their heterosexual counterparts. The same holds true for lesbian and bisexual women.

It can be important that LGBTQ individuals in rehab be screened for other psychiatric problems. If a person has a dual diagnosis disorder, the two issues can be efficiently treated at the same time.

Risks for Young and Old LGBTQ

LGBTQ teens are especially vulnerable to experiencing addiction issues. They may be two times as likely to be bullied, excluded, or assaulted at school. They are also nearly 40 percent less likely to have an adult in their family to whom they can turn.

According to the Human Rights Campaign Foundation, LGBTQ teens may be twice as likely to experiment with drugs and alcohol. Research shows that, compared to heterosexuals, LGBTQ young adults have:

  • Three times the odds of heavy alcohol use
  • Six times the odds of marijuana use
  • Nine times the odds of injection drug use
  • Three times the odds of cocaine use

Conflict and rejection by the family can be incredibly hard on adolescent LGBTQ.

On the other end of the age spectrum, researchers at NYU looked at LGBTQ and addiction among older adults. The study determined that older sexual minority adults were twice as likely to misuse or abuse cannabis and prescription opioids compared to heterosexual adults.

“Our research confirms that a higher prevalence of substance use among lesbian, gay, and bisexual adults can continue into later life. Similar to LGBTQ adolescents and young adults, such prevalence may be related to stressors like discrimination and stigma based on sexual orientation in addition to stressors related to aging. Including social isolation and age-related stigma,” said Benjamin Han, the study’s lead author.

Older LGBTQ adults are also at risk of drug misuse and excessive alcohol consumption. A 2011 report found that 10 percent of older LGBTQ community members were excessive drinkers. Twelve percent also used drugs that were not prescribed. Given the age that most of these seniors are, chronic pain can occur due to the misuse of opioids.

Compassionate Care

LGBTQ individuals often enter treatment with more severe substance use disorders (SUD). Some common SUD treatment methods have proven to be effective in recovery. These include motivational interviewing, social support therapy, contingency management and cognitive-behavioral therapy.

The Substance Abuse and Mental Health Services Administration produced a manual called “A Provider’s Introduction to Substance Abuse Treatment for Lesbian Gay Bisexual and Transgender Individuals.” The manual is aimed at making more addiction treatment centers LGBTQ friendly. Studies find that offering specialized groups for gay and bisexual men typically produce better outcomes.

Research suggests treatment should address factors in these LGBTQ patients’ lives, such as homophobia/transphobia, family problems, violence and social isolation.

Principles of Care

The manual also introduces what it calls Principles of Care, which are:

Be flexible and client-centered

Clients will present with a wide range of substance use and psychosocial needs. Some clients may need individual counseling or may benefit from supportive treatment. Services need to be flexible but consistent and thorough.

Be coordinated, integrated, and comprehensive

Providers working in a multidisciplinary setting should use a team approach to meet each client’s needs.

Be consistent with each client’s cultural needs and expectations

Programs may need to employ multilingual and multicultural staff as well as individuals representing LGBTQ populations.

Promote self-respect and personal dignity

Recognize an individual’s self-worth and contributions to his or her community. Programs must ensure that staff and the service delivery system do not stigmatize the clients further.

Promote healthier behaviors

Service providers can work with clients to practice healthier behaviors, practice safe sex, strengthen supportive relationships and to comply with medication regimens for HIV and psychotropic communities.

Empower persons in substance abuse treatment to make decisions in collaboration with the service provider

Service providers must include clients in treatment planning.

Reduce barriers to services for hard-to-reach populations

LGBTQ populations are varied and spread out among different communities. This creates the need to develop effective outreach and retention mechanisms.

Develop and deliver services that are clinically informed and research-based

It is important not to assume that services that are effective for the larger population will be as effective or appropriate for the LGBTQ  populations. Evaluations of current LGBTQ substance abuse treatment services for the LGBTQ community may need to be undertaken.

Work to create a treatment/recovery community

Programs can play a role in developing a community of individuals, agencies and organizations that work together to develop an LGBTQ addiction recovery treatment/recovery community. Making use of individuals who have successfully completed treatment, providing provide positive examples for clients currently in treatment or receiving services.

LGBTQ-Focused Treatment Programs

Discrimination, stigmatization, isolation. These are just some of the factors that play into the high rates of LGBTQ and addiction. That’s important to remember because being part of a sexual minority isn’t a risk hazard. How society responds to LGBTQ sexual identity is the risk for drug abuse.

That’s why finding an LGBTQ substance abuse treatment program that recognizes the LGBTQ experience is so important.

LGBTQ-sensitive programs are aware of, knowledgeable about, and accepting. They acknowledge the existence of LGBTQ people and treat them with respect and dignity. While methods are usually similar to how all clients are handled, they recognize the difficulties and challenges facing minority communities. Some programs may also have specific therapy groups aimed at these communities.

Additionally, there are LGBTQ affirmative programs. They actively promote self-acceptance of an LGBTQ identity as a key part of recovery. These programs affirm an individual’s sexual orientation, gender identity, and choices. They also validate their values and beliefs and acknowledge that sexual orientation develops at an early age.

As part of the LGBTQ addiction recovery process, some clients will need to address their feelings about their sexual orientation and gender identity. For some, this will include addressing the effects of internalized homophobia. Clinicians sometimes see relapses in LGBTQ persons with lingering negative feelings about their sexual orientation or gender identity.

For more information on LGBTQ-centered substance abuse treatment, please reach out to to us. We can help get your life back on the right track and in the direction of successful recovery.

Written by Janet Perez


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