Numerous studies have shown that the LGBTQ community faces higher risks of developing substance abuse disorders or suffering from addiction when compared to those identified as heterosexual and the general population as a whole. Even more concerning is that individuals of a sexual minority are far more likely to have severe types of drug-related disorders.
Why is substance abuse so prevalent among this population? It’s a tough question with a multitude of factors at play. In this article, we’ll explore the highly nuanced issue of why substance abuse is so common in the queer community as well as the types of substance abuse treatment that are best suited to help their unique circumstances.
Addiction & LGBTQ Statistics
A 2019 study conducted by the Substance Abuse and Mental Health Services Administration looked at the drug use habits of LGTBQ individuals aged 18 and older. Their findings were alarming. Amongst this at-risk population, more than 50% struggled with illicit drugs; nearly 65% struggled with alcohol use and 16% struggled with both types of substances. This translates to:
- 1 out of every 2 struggling with illicit drugs (1.4 million people)
- 3 out of every 5 struggling with alcohol (1.7 million people)
- 1 out of every 6 struggling with both drugs and alcohol (426,000 people)
This is a dramatic difference from the general U.S. population where only 3% have had at least one illicit drug disorder and 5% have an alcohol disorder. (Source)
Compared to their heterosexual counterparts, the University of Michigan found that those who identified as gay or lesbian were 2X likely to have a severe alcohol or tobacco use order (bisexuals were 3X more likely to do so). Another study showed that transgender students were 2.5X more likely to use methamphetamines and cocaine than their heterosexual peers, although research regarding transgender drug use rates is severely lacking.
Which Drugs Are The LGBTQ Community Using Most Often?
- Marijuana (6.3 million users)
- Psychotherapeutic drugs (2.3 million)
- Hallucinogens (1.2 million)
- Cocaine (1 million)
- Inhalants (632,000)
- Methamphetamines (411,000)
- Heroin (141,000)
Rates of certain types of drug use such as alcohol have held steady to the rates of previous years. However, opioids (particularly that of heroin but also including prescription pain killers), marijuana, LSD, and prescription stimulants show an upward trend that is an area of concern for health officials.
Causes of Drug Abuse by the LGBTQ + Community
There are many reasons why the LGBTQ+ community may be more at risk for substance abuse than the general population. Social stressors such as homophobia and discrimination are some of the main reasons behind the high addiction rates but still only paint a portion of the picture.
Rejection, or more accurately, fear of rejection, is often a driving force behind LGBTQ drug use. Fear of rejection from family, friends, peers, and society as a whole has often led individuals to turn to drugs as a way to self-medicate their anxiety.
This fear of rejection also frequently results in these individuals turning to bars and nightclubs. Regarded as safe-havens for queer folk, these are environments where drug and alcohol use are commonplace. Drug use is normalized, if not expected. The combination of social pressure and chronic stress or anxiety could also play a starring role in LGBTQ individuals turning to drug use.
Unequal access to health along with high rates of mental health issues can result in this at-risk population feeling more isolated and less secure. This is known as minority stress, a concept the acknowledges that marginalized groups face higher levels of stress. The negative psychological effects of minority stress, particularly on the LGTBQ population are well-documented.
The LGBTQ community faces many challenges. These challenges can add to their stress. The challenges just prevent those who identify as a sexual minority from being who they are.
Some of these critical challenges include, but are not limited to:
- Alienation from certain programs
- Cultural competency
- Discrimination in Healthcare
- Discrimination in housing
- Employment discrimination
- Minority stress
- Relationship recognition discrimination
Understanding the different challenges that sexual minorities face can help the general population better understand how to help them. Those who do not fall into this group often overlooked these challenges. They don’t understand how difficult the situation can be. They may also not understand how these challenges can affect one’s mental health and stress levels.
1. The Prevalence Stress & Mental Illnesses
One of the main reasons why LGBTQ addiction is so prevalent is because many sexual minorities struggle with mental health disorders. These disorders may be brought on by a lack of support or having to be in high-stress situations. Adults in the sexual minority class often struggle with untreated mental illnesses. They may be afraid to seek help due to their sexual orientation.
“In comparison to heterosexual adults, sexual minority adults have more than double the risk of struggling with a mental health disorder.”
Results from the 2015 National Survey on Drug Use and Health (NSDUH)
There are many reasons why mental illnesses are more prevalent in this community. LGBTQ+ individuals are more likely to feel isolated. They may feel suicidal and depressed or may even loathe themselves. Their poor perception of self will cause them to be three times more likely to experience a debilitating anxiety disorder or major depression.
Mental health disorders can be separated into two categories: any mental illness (AMI) and serious mental illness (SMI). The same study conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) found that:
- 2.5 million LGBT adults struggled with AMI excluding SMI
- 1.4 million LGBT adults struggle with SMI
This corresponds to 24.3% and 13.1% of the LGBTQ+ population, respectively. That’s a huge chunk of the population.
In comparison to heterosexual individuals, LGBTQ+ individuals may be less likely to seek treatment as well. They are more likely to hide from their problems in fear of outing themselves.
How Do Mental Health Illness and Substance Use Disorders Affect Another?
A co-occurring disorder is when a mental health disorder and a substance use disorder are present at the same time. This is also known as a dual diagnosis and can make addiction treatment—already a complex and delicate process—even more challenging.
The reason being that mental illness and addiction are comorbid conditions; both cause or worsen the other. Addiction can cause certain neurochemical imbalances that give way to mental illness (depression, anxiety, even schizophrenia). Vice versa, a person with a mental illness can be inherently more vulnerable to addiction or predisposed to risky behavior that would encourage drug use in the first place.
As such, dealing with a substance abuse disorder suddenly has far more layers to it, many of which cannot be treated through behavioral therapy alone. Health professionals have recognized the unique needs of these individuals, giving way to specialized dual diagnosis addiction treatment. This approach seeks to normalize chemical levels within the body and mind without aggravating either disorder.
Example of Addiction & Mental Illness Comorbidity
Say that a patient struggles with a mental health disorder, he or she may have low dopamine or serotonin levels. This may cause him to feel depressed, sluggish, or fatigue. The low levels may cause these people to turn to drugs. Drug or alcohol abuse can artificially inflate chemical levels in the brain. This allows the individual to feel like themselves again.
However, once the drugs start to leave the person’s system, the neurochemical levels will start to deplete once more. This can cause the individual to feel worse than before.
It’s important to note that the opposite could be true. An individual could start off with an addiction. The constantly fluctuating neurochemical levels can lead to the development of a mental illness. Alcohol and drug addiction can completely change one’s brain chemistry. Regular substance abuse can lead to consistently low neurochemical levels.
Drug or alcohol use can also interfere with the body’s ability to manage and regulate neurochemical production. It’s a vicious cycle that can be difficult to stop.
2. Alienation from Certain Programs
Once LGBTQ+ individuals come out, they often face quite a lot of discrimination and prejudice. They may become alienated from certain groups or programs that they were well-acquainted with before. It’s not unusual for individuals to be alienated from their religious organizations.
Alienation from a religious community, rejection from loved ones, and ostracization from family and friends can lead to low self-esteem. It can also lead to a lack of self-acceptance. All of these factors can contribute to growing stress and self-loathing. Many LGBTQ+ individuals require therapy and counseling to learn how to love themselves again.
3. Cultural Competency
One of the main reasons why gay and transgender individuals delay getting help is because of how the healthcare system is set up. Transgender and gay individuals are often hesitant to get help because they are aware of the fact that they may meet ignorant Healthcare individuals. These medical professionals may be unaware of their specific needs or may even be hostile towards them if they disagree with their sexual orientation.
For example, some recovery meetings do not provide any outward indication that they are willing to include sexual minorities. As a result, many LGBT individuals may feel as if they do not have as much access to getting sober.
Due to culture and competency, many gay individuals are transgenders may not feel comfortable in enrolling in any type of program. They do not end up addressing the root causes of their addiction.
4. Discrimination in Healthcare
Another huge issue is the lack of access to affordable and culturally competent health care. Homosexual, bisexual, and transgender adults are roughly twice as likely to be without any type of health insurance coverage. Many do not have any type of private insurance at all.
Many employers do not provide health insurance benefits to same-sex domestic partners. Also, some health insurance companies that do offer this type of benefit will charge a higher premium. Health care plans may not cover the type of treatment that LGBTQ individuals need.
And as mentioned above, many health care professionals are not trained to serve LGBTQ+ patients. This negatively impacts their quality of care. Bisexual and transgender health care programs are often difficult to find. This type of health system is often unavailable.
5. Housing Discrimination
Those who are denied stable and affordable housing often have a much more difficult time maintaining employment, maintaining a secure and safe family environment, and accessing health care. Unfortunately, many people in the LGBT community claim that they experience some form of discrimination and housing. The discrimination either comes from their sexual orientation or their gender identity.
The numbers don’t lie. 50% of individuals who identify as being gay and 70% of individuals who identify as being transgender report facing housing discrimination.
6. Employment Discrimination
As many as 43% of gays and 90% of transgenders may experience discrimination or harassment.
While sexual orientation is technically protected class, it is technically legal in 29 States for gay and transgender individuals to be denied employment. They can also be fired due to their sexual orientation or gender identity. This adds to their overall stress.
Workplace discrimination is a huge threat. It can lead to job instability. This can put someone in an unfavorable position. They may be constantly worried about their income. This issue will also affect their family.
7. Minority Stress
Being a minority comes with a lot of stress as well. The stress usually comes from general social prejudice. It can also come with discriminatory policies and laws. Minority stress is very real. It can lead to anxiety, depression, and other mental health issues.
There are a lot of anti-gay and anti-transgender social prejudices out there. Sometimes, these prejudices are expressed in obvious and exaggerated ways. Other times, they’re expressed more subtly. For example, a receptionist may ask a couple who the “real” parent is. They may mean no harm. In fact, they may not even realize that they were being discriminatory.
8. Relationship Recognition Discrimination
Whether LGBT individuals have a right to get married has long been debated. It’s a huge issue. In conventional families, both partners can easily access the health care policies of the other.
Same-sex couples are not only barred from getting married in some states, but they also do not have the same access to certain programs. For example, they may not be able to access public policies. Since they do not qualify as being legally married, they may miss out on a lot of programs that can improve the family’s economic security. For example, same-sex couples may miss out on child care tax credits, Social Security survivor benefits, and more.
Other Factors That Affect LGBTQ Drug Use
Much like with every other group are demographic, the LGBTQ+ community is just as likely to abuse every type of drug. Those who identify as a sexual minority may abuse anything from depressants, like alcohol, to stimulants, like cocaine, to prescription drugs, like opioids and anti-anxiety medications.
The type of drug that is most commonly abused by individuals in the LGBTQ+ community will depend on several factors. Some of the sociocultural factors that are involved include:
- Affiliation with gay culture
- HIV status
- Sexual minority stress and outness
Depending on these factors, an adult who identifies as a sexual minority may be more at risk of substance abuse. He or she may also be more at risk of developing a mental health disorder, and, thus, a co-occurring disorder.
Understanding how these factors influence and affect an individual is key. It’s important in understanding how addiction affects the LGBTQ+ community. It’s also a crucial part of finding out what type of addiction treatment will be the most effective.
Affiliation with Gay Culture
Another interesting study has shown that affiliation with gay culture may be linked to elevated substance use. This is because gay bars are one of the main social outlets in the LGBTQ+ community. Many of those looking to belong will often rely on drugs and alcohol when placed in these settings.
Many of the individuals who are heavily involved in the LGBTQ+ community will also frequent house parties and circuits. Drugs and alcohol are often readily and easily available in these places.
Interestingly enough, extremely low affiliation with gay culture can also increase heavy drinking and illicit drug use. This is because these individuals do not receive the social and emotional support that they need. Substance abuse becomes one of their main outlets for venting out their frustrations.
Studies have shown that those who frequent bars, clubs, and lounges are more likely to engage in drug use. Also, those who have a higher number of sexual partners are more likely to use drugs as well. Research also shows that MDMA use is usually linked with a higher level of gay community affiliation.
Age is generally considered to be a protective factor against substance abuse. Alcohol abuse rates generally tend to decrease with age. This appears to be the case in the LGBTQ+ community as well.
Similar to heterosexual adults, young homosexual adults tend to exhibit heavier alcohol use and drug use. Among the LGBTQ+ community, homosexual women appear to abuse alcohol more often than other sexual minorities. They are more likely to:
- Drink more frequently
- Drink more heavily per occasion
- Be more likely to binge drink
In this demographic, age does not seem to play a protective role against substance abuse. Both young lesbian and bisexual women are just as likely to continue the alcohol abuse or drug abuse even as they age. This shows that age is not as robust as a protective factor in this area.
A person’s sexual orientation may also come into play. Recent research indicates that bisexuality appears to have a stronger correlation and link to substance abuse. Those who identify as bisexual are more likely to report drug or alcohol use. It doesn’t matter what gender they are.
This could be because those who are bisexual are more likely to face discrimination. Not only do these individuals face discrimination from the general population, they may also face discrimination from the homosexual community. Studies have also shown that bisexual individuals receive less social support.
Once again, further research is needed in this area.
One’s gender can also affect the type of substances that they choose to abuse. Studies have shown that homosexual and bisexual women are usually more likely to abuse alcohol and get addicted to it than homosexual or bisexual men. On the other hand, bisexual and homosexual men are more likely to abuse drugs.
There still isn’t a lot of research in this area. As a result, some studies do conflict with one another. Fortunately, a lot of research in this area is currently underway.
Substance use is considered to lead to an increased risk for HIV. This is because HIV is a blood-borne disease. Those who share needles have an increased risk of contracting the disease.
With that said, it has also been suggested that one’s HIV status may influence substance use patterns as well. Those who are HIV positive are more likely to engage in polydrug use. They are more likely to rely on drugs like:
- Crystal methamphetamine
The reason why HIV-positive individuals are more likely to engage in substance abuse is that they tend to struggle with mental health disorders as well. They often feel isolated, depressed, anxious, shameful or guilty.
Sexual Minority Stress and Outness
The social pressures of being a sexual minority can lead to many issues. Those who identify as a sexual minority may be ostracized from their peers, family, and colleagues once they come ‘out’.
Studies have shown that those who are out to more than half of their social network will be more likely to use drugs or alcohol. Those who disclose their sexual orientation to their family members are also more likely to use club drugs. Whether a person is supported or not by their family and friends will make a huge difference.
Effective Drug Treatment Methods
Addiction affects everyone in similar ways. Drug treatment methods that are effective in the general population will also be effective for the LGBTQ+ community. Patients can still enjoy the same types and levels of care, like:
- Inpatient treatment programs, or residential treatment
- Partial hospitalization programs (PHPs)
- Outpatient treatment programs
The type of treatment options offered at the rehab facility will also be fairly similar. Patients will still receive medical detox to ease withdrawal symptoms, counseling, and behavioral therapy. Sexual minorities will usually want to look for treatment programs that focus heavily on behavioral therapy and counseling. They may want to try Cognitive Behavioral Therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR) or Dialectical Behavioral Therapy (DBT).
As long as patients choose evidence-based treatment programs, they’ll have a better shot at recovery. Sexual minorities, however, may want to look for rehab programs that specialize in LGBTQ+ programs.
Specialized Drug Rehab Centers Focused on LGBTQ
LGBTQ-oriented rehab centers offer treatment programs for queer patients. These patients receive a higher quality of care that is geared towards their sexual orientation. Staff members at these rehab facilities receive special training, so they understand the needs of their patients better.
Those who identify as a sexual minority should really consider seeking addiction treatment from a LGBTQ+ rehab center. These alcohol and drug treatment centers can help patients cope with:
- Coming out to loved ones
- Mental health disorders, like depression and anxiety
- Being rejected and ostracized by family and friends
These individuals will learn how to handle and deal with problems that are specific to the LGBTQ+ community. These drug rehabs and alcohol rehabs also help patients learn how to accept their sexual or orientation or gender identity. They learn how to love themselves.
These treatment centers can also help patients learn how to deal with other issues. Most patients leave the facility feeling a lot more confident in themselves.
How to Choose an Effective LGBTQ+ Rehab Center
If you or a loved one is looking for an LGBTQ+ rehab center, it’s important to understand how to choose the right rehab.
When looking for the right rehab program, there are many factors that need to be taken into consideration. To make sure that you choose the right program, do your own research. This may include looking at what each rehab center specializes in by getting a tour of the facility. When trying to make a decision, here are some factors that you should really consider:
- The aspects of the LGBT community that are represented. Some alcohol rehabs and drug rehabs will reach out to all members of this community. However, others will only reach out to specific segments. For example, some alcohol and drug treatment centers may only reach out to lesbians or gay men.
- The amount of training that staff members receive. Not only should staff members be accepting of all sexual orientations, they should also have experience in dealing with these problems. The staff should be experienced in dealing with LGBTQ+ problems.
- How successful the treatment programs are. It’s important to note that different rehab centers considered different things as success. The requirements can vary significantly. Some alcohol and drug treatment facilities may require absolute abstinence while others may be happy with better management.
- The overall cost of the program. It’s always better to get details about the costs upfront. If you have private insurance, your health care insurance may cover some, if not most, of the costs. Have our admissions team verify your insurance information and provide you with more details on the type of insurances accepted.
With some patience, you can easily find the drug or alcohol treatment you’re looking for. Do your own research to make sure you choose the right rehab.
Why Is It Important to Have Specialized LGBTQ+ Services and Programs?
Understanding the correlation between rates of substance abuse and a person’s identifying sexual minority is crucial to improving overall healthcare for this marginalized group. It’s allowed health officials to recognize that these individuals have unique addiction treatment needs and to better understand what they are.
Case Studies have shown that LGBTQ-specific programs can treat addiction more effectively. These treatment programs address unique issues that are often overlooked and standard programs. Interviews with LGBTQ patients have also come for aren’t these results. Pass patients have preferred LGBTQ-specific programs. They find that these programs are able to better address their needs and their situation.
Aftercare programs should be the same but different in the sense that they cater to LGBTQ+ specific issues. Those who are involved with LGBT drug abuse will easily relapse if they don’t have the right aftercare support program in place. Before you leave the rehab facility, you must have an aftercare treatment plan in place.
There are many different types of post-rehab programs that prevent substance use and abuse. They include:
- Sober living homes
- Outpatient treatment programs
- Recovery meetings
Have an addiction specialist walk you through the different programs, so you have a better idea of what to expect.
Sober Living Homes
After completing addiction treatment, not every patient is ready to tackle the world on their own. One of the most popular aftercare programs is sober living homes. These living arrangements allow recovering addicts to live in a drug-free and alcohol-free environment. It’s as if they’re renting and a room in an apartment building or in someone else’s home.
With sober living homes, residents are expected to pay rent and all of their own living expenses. They are not allowed to do drugs or alcohol on the property. Also, they’re expected to do some household chores.
Residents are also expected to attend meetings on a daily, weekly, and monthly basis. Daily meetings tend to be reflections. They keep recovering addicts on the right track. Weekly meetings white touch-up on certain skills that can prevent relapse is what monthly meetings look at the group health.
Gays, lesbians, transgenders, and others in the LGBTQ+ community should look for sober living homes that cater to their sexual orientation. It’s easier to live with others that understand your situation.
Outpatient Treatment Programs
Those who struggle with a mild addiction will often opt for an outpatient treatment program. An outpatient program is also an excellent choice for an aftercare program. This type of treatment touches up on fundamental skills.
Sexual minorities will want to look for an outpatient treatment program that offers behavioral therapy and counseling specific to their sexual orientation. Much like standard outpatient programs, patients can choose between standard programs and intensive outpatient programs (IOPs). The former does not come with any sort of time commitment. The latter requires 3 hours of therapy 3 times a week.
The most important post-rehab care that LGBT individuals need is access to a strong social and emotional support network. Fortunately, there are many support groups and recovery meetings that help lesbians, gays, bisexuals, and transgenders that struggle with substance use and abuse.
These recovery meetings come in many different forms and types. Some follow the same structure as 12-step programs, like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). Both of these 12-step programs follow twelve faith-based principles. Other programs follow scientific principles. The most popular science-based support group is the SMART (Self-Management and Recovery Training) program.
For Loved-Ones: Helping an LGBTQ+ Person Cope With Drug Addiction
It doesn’t matter whether the individual is lesbian, gay, bisexual, or transgender. If he or she struggles with addiction, he or she needs help immediately. Don’t let the situation worsen and fester. Reach out to them to see what you can do.
To help an LGBTQ+ individual cope with drug or alcohol addiction, consider the following:
- Provide a judgment-free environment. Try to have an open conversation about unconditional love. Help the affected individual feel as if they can open up to you about their problems and struggles. Be careful not to perpetuate a hostile or exclusive space.
- Bolster self-esteem and self-confidence. Many LGBTQ+ individuals feel self-conscious. They may even fall victim to feelings like self-loathing, shame, and guilt. Help sexual minorities feel more confident in their own skin, especially if they are youth.
- Encourage them to seek substance abuse treatment. You can make their job even easier by giving them a list of LGBTQ-friendly options. This way, all they have to do is make a phone call.
- Get them counseling and therapy. Mental health disorders and substance use disorders often come hand in hand. LGBTQ+ individuals often struggle with issues that are serious enough to warrant counseling.
- Look for alternative coping strategies for stress. This may include changing up their sleeping patterns and habits, taking up art therapy, or even exercising more often.
Addiction can easily affect anyone. It can affect people of all ages, sexual orientations, and incomes. It affects both genders equally although each gender may be more prone to abusing a certain type of drug.
To help a loved one struggling with addiction, you must first understand it yourself. Addiction is a disease. You can treat it, but you can’t cure it.
Substance Abuse Resources for the LGBT Community
If you are looking for recovery resources for yourself or for a loved one, you’re in luck. There are many different programs and organizations available in this day and age. It’s easy for homosexual, bisexual, and transgender LGBT individuals to get the type of help that they need.
Take a look at some of the recovery resources below that offer help to gay, bisexual, and transgender individuals.
This membership organization dates back to 1979. The organization is dedicated to preventing and treating substance abuse and alcoholism in lesbian, gay, bisexual, and transgender communities. This organization plans to confront all types and forms of discrimination and oppression. Its primary purpose is to affirm equality between all genders and sexual orientations.
The main goal of NALGAP is to provide training, networking opportunities, and medical information to recovering addicts. The programs help recovering addicts make a better choice on the type of treatment plan to try.
Help Is Here
This program is run by the National Mental Health Association. Call the hotline, or 800-969-6642, during business hours. You can talk about different issues related to your mental health with a professional.
National Alliance on Mental Illness
This free helpline can help anyone who is struggling with a mental health issue. You can speak with a crisis counselor by calling 800-950-6264. If you’re more comfortable with texting, text NAMI to 741-731.
National Suicide Prevention Lifeline
Having to deal with your addiction alone can already feel very tough. Now, imagine having to deal with it even though other people don’t agree with your sexual orientation. If you’re ever feeling depressed, speak with a crisis counselor by calling 800-273-TALK (8255) for 24-hour support.