Even as the years pass and people become more aware and understanding of the true issues associated with addiction, there is still a significant stigma surrounding the subject of substance use disorders as well as those who suffer from them. Much the same can be said for mental health disorders, and those with them, which can make struggling with addiction even more difficult as mental health disorders will often co-occur with addiction.
However, it is perhaps most difficult for individuals who identify as LGBTQ. While the last few decades have brought about a shift in attitudes, perceptions, and acceptance that is helping to break down the prejudice, discrimination, and violence that sexual minorities have historically faced, we as a society still have so much further to go.
The difficulties and challenges those in LGBTQ community face just for their sexual and gender identity put them at a significantly higher risk of both mental health and substance use disorders. With the heavy social stigma that is still attached to differing sexual and gender identities, issues concerning mental health, and substance abuse as well, it is no wonder that many people who identify as LGBTQ and struggle with either just addiction or a co-occurring disorder besides are unable to receive the treatment they need.
Luckily, even if these issues are not changing as quickly as they ought to be, they are still changing for the better as more and more recovery facilities are making it a point to offer LGBTQ-specific recovery services and provide an overall friendlier space for successful addiction recovery.
It has now been widely acknowledged in the field of addiction science and research that within the demographic of the LGBTQ spectrum there is a much higher incidence of both substance abuse and addiction than among those who identify as heterosexual or cis-gendered.
In fact, according to the 2015 National Survey on Drug Use and Health (NSDUH), adults identifying as LGBTQ were twice as likely to have used an illicit drug within the past year when compared to heterosexual adults. In that same year, while 1 in 25 heterosexual adults reported misusing prescription painkillers, the rate of LGBTQ prescription opioid misuse was 1 in 10 adults.
These statistics do indicate that LGBTQ people are more prone to substance abuse, but not in the sense that a person’s sexual or gender identity in any way makes them more predisposed to misusing drugs or alcohol. Instead, it is in many cases a vicious cycle rooted in the discrimination, stigma, and violence that those who identify as LGBTQ face on a daily basis. If someone publicly identifies as LGBTQ, especially if they are under the age of 18, they are likely to experience a wide array of extensive discrimination and trauma, including:
According to research conducted by the American Journal of Public Health, people who identify as LGBTQ who have experienced multiple forms of discrimination are four times more likely to develop a substance use disorder.
People on the LGBTQ spectrum are at a higher risk of abuse, aggression from strangers, and also more likely to be assaulted and even murdered. Even if they are not public with their identity, it can still be a significant source of intense psychological stress as they struggle to hide their identity and remain “closeted.” All of this can, and often does lead to depression, contemplations of suicide, as well as anxiety and other panic disorders, including PTSD.
Compounding this with the challenges that many people in the LGBTQ community had encountered in getting proper healthcare, it is unfortunately not surprising that they instead turn to drugs and alcohol as a means to cope with both the difficulties they encounter in their day-to-day lives and the mental health disorders that can manifest as a result of those difficulties. Self-medicating with drugs and alcohol soon leads to dependency and addiction issues.
There is also the fact that for many young people who identify as LGBTQ, their introduction to the community happens in places that, while a safe space for LGBTQ individuals, often involve addictive substances, like gay bars or clubs. Unfortunately, due to the fact that there are often far more safe zones available that either serve alcohol or overlook drug use compared to sober places where someone within the LGBTQ community can find support, it can create an association that links safety and community to drinking and drug use, making it even more difficult for someone to be motivated to seek out treatment.
While every person’s addiction and experience is unique to them and therefore requires their own unique treatment, there are still many aspects of LGBTQ addiction treatment that require it to be separate from what would be considered a “typical” addiction rehabilitation program. As well as specific considerations that must be taken in order for someone who identifies as LGBTQ to be able to have the highest chance of a successful recovery.
Many addiction recovery treatment centers may refer to themselves as LGBTQ friendly but have not given their clinicians or staff the proper training required to overcome underlying biases and provide truly effective treatment without judgment or prejudice. An LGBTQ individual seeking treatment is extremely likely to have deep feelings of fear, doubt, and distrust based on discrimination and other traumatic experiences they may have dealt with previously.
A treatment facility that employs LGBTQ individuals is a good way to mitigate those feelings and provide feelings of welcome and inclusivity. Often, when an LGBTQ client knows that the health care professional they are working with understands what they have gone through and may even have similar experiences, it can make a significant difference in their overall addiction treatment.
Transgender individuals, in particular, have certain needs that must be addressed within their treatment to ensure its effectiveness, including ensuring that their identities are respected with proper pronoun usage, making accommodations towards sleeping or bathroom arrangements as necessary, and providing proper and informed medical support, as an individual may be transitioning and therefore on hormone therapies while they are in treatment.
If instead of receiving comfort and acceptance, a transgender individual continues to have their identity invalidated in a space that is meant for recovery and positive change, they are unlikely to see any level of real success in their addiction treatment.
While LGBTQ addiction treatment requires the same basic elements of detoxification, varying therapies, workshops, and relapse prevention planning to be effective, it is also necessary that an LGBTQ addiction treatment program offers support in overcoming issues specific to the LGBTQ experience. Some examples of this include:
Speaking specifically of mental health disorders such as depression or anxiety, because these are so much more likely to occur in an LGBTQ individual suffering from a substance use disorder, dual diagnosis treatment is an essential element of an effective LGBTQ treatment program. If only the addiction is dealt with, the individual is almost guaranteed to relapse back into using drugs or drinking as a means of coping with mental health issues.
Also important is considering both mental health and overall physical health. Just as discrimination and social stigma can keep LGBTQ individuals from seeking addiction treatment, they can also cause people who identify as LGBTQ to avoid healthcare providers in general, neglecting their personal health as a result. As with any good addiction rehabilitation treatment, they should be screened for other health problems that may also be present.
Finally, there is the matter of relapse prevention planning and proper aftercare support. While these two treatment elements are critical for anyone in addiction recovery, in LGBTQ addiction treatment they are even more so. Once an LGBTQ individual has completed their treatment, they will have to return to a daily life that is still rife with difficulties that can present a significant challenge to being able to effectively manage their addiction and maintain their sobriety.
LGBTQ addiction treatment should help clients gain the tools and skills needed to more effectively cope with these difficulties in a healthy and positive manner. But, without ongoing support, sometimes what they have in their addiction management toolbox is not going to be enough. Aftercare in the form of outpatient sessions, alumni networks, LGBTQ friendly support groups, and other forms of post-treatment outreach can make all the difference when it comes to avoiding relapse.
According to the National Institute on Drug Abuse (NIDA), having specific subsets of LGBTQ addiction rehabilitation treatment programs is the best way to meet the needs of LGBTQ clients and give them the highest chance of success in recovery by ensuring that they are more likely to stay in treatment for the recommended 90-day minimum.
These are the necessary elements that are essential in order for a recovery treatment center to go beyond just being LGBTQ friendly and offer truly effective treatment for those who identify as LGBTQ that gives them the best chance of being able to manage their addiction and remain sober in the long-term.
When searching for recovery treatment centers that are LGBTQ friendly, there are many factors that you need to keep in mind beyond just a treatment center that claims to specialize in LGBTQ addiction recovery services or otherwise offer treatment programs geared toward LGBTQ individuals.
While you want to find a treatment center that can meet your needs as an LGBTQ individual, it is also important to make sure it is a professional, accredited, results-driven facility. Some questions you will want to make sure to ask when choosing the right LGBTQ addiction treatment center include:
Struggling with a substance use disorder is difficult enough already, but doing so while also facing the added difficulties and discriminations that are often inherent for those who identify as a sexual minority can feel overwhelming.
If you identify as LGBTQ and are battling an addiction, it can often feel hopeless and as though you are all alone. But this is not the case. There is always hope and there is always help. You deserve addiction recovery treatment that meets your needs, whatever that may be, and as more and more facilities assert their ability to provide this treatment, issues with both stigma and accessibility will hopefully begin to diminish in turn.
It is never too late to seek out treatment for drug or alcohol addiction, but the sooner you do, the better your chances will be for making a successful recovery and maintaining long-term sobriety long after you have completed your treatment program.
Green, K. E., & Feinstein, B. A. (2012). Substance Use in Lesbian, Gay, and Bisexual Populations: An Update on Empirical Research and Implications for Treatment. Retrieved May 29, 2018 from http://psycnet.apa.org/record/2011-25205-001
Lynch, A. (2010). Creating Lesbian, Gay, Bisexual, Transgender, and Queer Treatment-Sensitive Substance Abuse Counselors: The Importance of Cultural Competency. Retrieved May 29, 2018 from https://www.drugabuse.gov/international/abstracts/creating-lesbian-gay-bisexual-transgender-queer-treatment-sensitive-substance-abuse-counselors
McCabe, S. E., Bostwick, W. B., Hughes, T. L., West, B. T., & Boyd, C. J. (2010, October). The Relationship Between Discrimination and Substance Use Disorders Among Lesbian, Gay, and Bisexual Adults in the United States. Retrieved May 29, 2018 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2937001/
National Institute on Drug Abuse. (2017, September). Substance Use and SUDs in LGBT Populations. Retrieved May 29, 2018 from https://www.drugabuse.gov/related-topics/substance-use-suds-in-lgbt-populations