LGBTQ+ Resource Guide for Substance Use Disorders

In 2015, the National Survey on Drug Use and Health found that adult members of the lesbian, gay, bisexual, transgendered, and questioning (LGBTQ) community were over two times more likely to have used an illicit drug that year than heterosexual adults. The survey found that 30.7 percent of the LGBTQ individuals involved in the survey had used marijuana and 10.4 percent misused prescription pain medication. Conversely, only 12.9 percent of heterosexuals used marijuana and 4.5 percent misused prescription pain pills. Additionally, in 2013 the United States Census Bureau reported that heterosexuals began drinking alcohol later in life and tended to binge drink less frequently than non-heterosexuals.


This trend of substance use and abuse isn’t exclusive to adults, however. In fact, one analysis conducted by the National Institute on Drug Abuse found that LGBTQ adolescents were as much as 90 percent more likely to use substances than their heterosexual counterparts.


These numbers are significant, as they show that LGBTQ individuals are at a particularly high risk of substance use and abuse. Substance use disorders develop after the consistent use of potentially dangerous substances, such as alcohol, tobacco, and other drugs. A diagnosis is generally appropriate once use of the substance or substances begins to negatively impact the patient’s social life, academics, professional career, and/or health.


In order to successfully address this condition in LGBTQ patients of all ages, it’s important that counselors have a clear and thorough understanding of the issues individuals within this community often face, as well as the best methods of treatment. Working with LGBTQ clients can be challenging and success hinges on professionals learning how to:


  • Recognize and understand emotional and sexual lives of their LGBTQ patients

  • Educate other staff members about adopting more inclusive language and behaviors

  • Appropriately address intolerance and harassment from non-LGBTQ peers receiving treatment

  • Develop and establish relevant training requirements and programs for personnel

  • Institute policies that specifically acknowledge the unique needs of LGBTQ patients


The information and resources provided below are meant to offer assistance for substance abuse counselors working with clients from the LGBTQ community.


Substance Use Disorder in LGBTQ+ Population


Research indicates that members of the LGBTQ community are at a significantly higher risk of using and abusing various substances. As a result, these individuals are more likely to develop one or more substance use disorders throughout their lifetime than heterosexuals. LGBTQ patients also tend to begin treatment programs with more severe substance use disorders than their counterparts.


While everyone has their own individual reasons for substance use, research does indicate that these trends may be a result of several important factors. LGBTQ individuals experience a substantial amount of social stigma and discrimination, so much so, in fact, that their civil and human rights are often questioned and/or blatantly denied. They are also frequently the targets of violent acts and face many emotional hardships resulting from family and friends refusing to accept their sexual orientations and gender identities. Feelings of shame and self-doubt are prevalent as well. Exposure to this kind of emotional and physical stress and victimization, even limitedly, can have long-lasting, negative effects that may leave the individual more susceptible to the development of substance use and abuse, psychiatric disorders, and even suicide.


Research has also found that some orientations may be prone to overuse of certain substances. While it’s possible for LGBTQ patients to abuse any substance, lesbians and bisexual women, for example, have proven to be at higher risk for alcohol use disorders. Gay and bisexual men, on the other hand, seem to be at a higher risk for illicit drug use disorders; these individuals are significantly more likely to use marijuana, psychedelics, hallucinogens, stimulants, sedatives, cocaine, and barbiturates.


It’s also important to realize that some patients will keep their sexual orientations and gender identities private while receiving treatment for their substance use disorder(s). This means that it’s completely possible that the staff will never know whether individual clients are part of the LGBTQ community or not, which can slow down the recovery process. While a person should never feel pressured to disclose this type of information, maintaining an approachable and accepting atmosphere will make it much easier.


Co-Occurring Disorders in the LGBTQ+ Community


Research shows that LGBTQ community members are likely to have co-occurring disorders. They are reportedly at a higher risk for substance use and abuse, as well as many common emotional and mental disorders. As a result, it’s not uncommon for these patients to suffer from a substance use disorder and a psychiatric disorder at the same time. Common co-occurring disorders include:


  • Substance Use Disorders

  • Major Depression

  • Eating Disorders

  • Phobias

  • Post-Traumatic Stress Disorders

  • Panic Attacks

  • Anxiety Disorders

  • Bipolar Disorders


Specifically, studies indicate that gay and bisexual men are more likely to experience mental distress, major depression, anxiety, and symptoms associated with bipolar disorder than heterosexual men. These patients may also have various health complications, such as HIV/AIDS, which can result in or further exacerbate current psychiatric disorders. This demographic has also been found to be at higher risk for suicide. Lesbians and bisexual women are also more likely to experience mental distress, major depression, phobias, post-traumatic stress syndrome, and generalized anxiety disorder than their heterosexual counterparts. This is combined with a higher likelihood of hazardous drinking habits and sexual abuse. Transgender children and young adults also demonstrate a greater predisposition for depression, eating disorders, self-harm, and suicide than peers within the sexual majority.


There is evidence that these disparities are linked to the fact that many LGBTQ individuals are exposed to various levels of harassment, life stressors, maltreatment, stigmas, discrimination, childhood adversity, family rejection, victimization, and a lack of available resources. It’s also been proven that reducing these factors, especially discrimination, can help reduce the risk of substance use and abuse in LGBTQ youth.


Because the LGBTQ community is at such high risk for substance abuse and other psychological disorders, it’s absolutely imperative that treatment providers screen patients thoroughly. If one disorder is present, it’s quite possible that other problems exist as well. In situations such as this, recovery is considerably more likely when the conditions are treated concurrently. When mental and emotional disorders are ignored, substance abuse relapse becomes significantly more probable over time.


Many government rich studies have just lately started to ask relating to sexual orientation as well as additionally gender identification in their data collections.1 Studies so far have actually found that sex-related minorities have higher costs crucial misuse as well as material use issues (SUDs) than people that identify as heterosexual. For that reason, it is not yet possible to develop lasting patterns regarding compound usage and also SUD events in LGBTQ populaces.


Together with going to danger to the development of mental and likewise mental illness, LGBTQ individuals are also at a greater danger of self-destruction. This is particularly appropriate for LGBT teenagers, who are supposedly 2 to 7 times more than likely to attempt suicide than heterosexuals. Self-destruction is the 3rd most common cause of death for people between 15 and likewise 25 years of age and additionally LGBTQ young adults are a lot more likely to try it than their equivalents.


On the other hand, simply 9.9 percent to 13.2 percent of heterosexual pupils thought worrying trying self-destruction in addition to just 3.8 percent to 9.6 percent really tried it. Different various other researches program that about one in 3 self-identified transgender individuals attempt self-destruction at the minimum as quickly as. It is important to recognize, it is not belonging of the LGBTQ community that causes suicide.


Various other usual threat variables contain compound misuse, harassment, bullying, social seclusion, clinical depression, and other psychological health and wellness and wellness troubles. Security elements, on the other hand, contain household authorization, developing favorable social connections, as well as experience safe and secure. Experts functioning with LGBTQ people of any age can aid reduce the possibility of self-destruction by creating a setup that is protected as well as comprehensive.


When establishing a treatment environment that rates and also affirming for LGBTQ people, take into account the adhering to important criteria. Team ought to: While there are specific methods to tailor compound abuse treatment programs for LGBTQ customers, it's fairly unusual to find recuperation facilities that do. Despite evidence that these programs produce better end results, a number of LGBTQ individuals at some point obtain solutions from facilities that fit the majority of people.


Gay and likewise bisexual guys, on the various other hand, appear to be at a higher threat for illegal drug usage problems; these individuals are substantially more potential to utilize marijuana, psychedelics, hallucinogens, energizers, sedatives, cocaine, as well as barbiturates. It's furthermore important to recognize that some individuals will certainly keep their sexual placements in addition to sex identifications individual while getting therapy for their compound use problem( s).


There's a huge difference between a gay and lesbian substance abuse problem versus a transgendered addiction. In this piece I will discuss some of the unique challenges that gay and lesbian substance abusers face when it comes to receiving the proper treatment for their condition.


First of all, you really need to understand that the term "substance use disorder" is not commonly used for people who engage in same sex activities. That's the way most substance abuse programs work. Because of this, you really need to look into any program which is run by an organization that advocates on behalf of gay and lesbian individuals and find out what kinds of resources are available for them.


If you don't know specifically what your needs and desires are, then you will likely not receive a personalized treatment which may only be applicable to your specific types of sexual behavior. For example, if you have been out for many years and you're just beginning to come to terms with your sexual identity, you may want to consider looking into a program that specializes in this. The same can be said if you've been out for a while and you feel that there's a problem with you as a person. Look into programs that work with transgendered people as well so that you can have personalized treatment that can work for your specific needs.


In addition to your specific type of sexual or gender orientation, there are plenty of other things that can cause help in the fight against your addictions. For example, if you are a drug addict then you really want to make sure that you are receiving treatment so that you can get clean. This means that you need to make sure that you are getting information about which substance abuse programs are going to be able to help you in your particular situation.


When it comes to gay and lesbian addiction, there is a certain number of rules and regulations which govern when you can seek treatment. If you are unsure how the process works, then you want to look into a program that has specific guidelines which must be followed.


Another thing that you want to make sure of is that you have access to the proper resources which will give you advice on everything from where to go for therapy to how to get the help you need on your own. This is a critical part of being able to recover.


When you are trying to deal with a gay substance abuser, you also want to make sure that you are getting a good idea of what the best programs are for people like you. Because they are not as commonly advertised and because they are not often included in the "mainstream," there are plenty of resources out there which offer support to the specific groups that you might be interested in.


So, the next time you think about coming across a support group, look into getting the right programs for your particular situation. It's possible that your loved one is experiencing substance abuse and the right programs might be able to help you make a complete recovery in no time at all.


The last thing you need to know about these resource guides for substance use disorders is that they don't really do anything to help you. They do not provide any help to those who are struggling to overcome their addictions.


Instead, these programs focus on encouraging you and helping you deal with the emotional aspects of substance abuse. This is a good thing to do and you want to make sure that you are making the right decision when you are looking into these types of programs.


It's important to understand that your loved one's struggles with alcohol or drugs are very personal to them. And this means that they are likely going to have different needs and concerns that they need to hear and get answers to.


Suicide Prevention and Resources


In addition to being susceptible to the development of mental and emotional disorders, LGBTQ individuals are also at a higher risk of suicide. This is particularly relevant for LGBT adolescents, who are reportedly two to seven times more likely to attempt suicide than heterosexuals. Suicide is the third most common cause of death for individuals between 15 and 25 years of age and LGBTQ adolescents are more likely to attempt it than their counterparts. In fact, the 2009 Youth Risk Behavior Surveillance System reported that 18.8 percent to 43.4 percent of lesbian and gay students considered attempting suicide and 15.1 percent to 34.3 percent actually attempted suicide at least once during the 12-month survey period. Conversely, only 9.9 percent to 13.2 percent of heterosexual students thought about attempting suicide and only 3.8 percent to 9.6 percent actually attempted it. Other studies show that up to one in three self-identified transgender individuals attempt suicide at least once.


It is important to realize, it is not being a part of the LGBTQ community that leads to suicide. Instead, the higher rate of suicide stems from to the bias, discrimination, family rejection, and emotional stressors often associated with being LGBTQ. Other common risk factors include substance abuse, harassment, bullying, social isolation, depression, and other mental health issues. Protective factors, on the other hand, include family acceptance, establishing positive social connections, and feeling safe.


Professionals working with LGBTQ individuals of all ages can help decrease the potential of suicide by creating an environment that is safe and inclusive. The following preventative strategies may also be helpful:


  • Train all staff to effectively interact with and serve LGBTQ patients, as well as identify potential suicidal risk factors and behaviors

  • Address new clients with the understanding that they may be any sexual orientation or gender identity

  • Provide up-to-date and accurate information regarding LGBTQ issues

  • Ensure all services and providers are inclusive and affirming

  • Provide peer-based programs that cover stress management, life skills, and discrimination

  • Establish appropriate protocols to be administered once a client is identified as at-risk

  • Understanding the Concerns of LGBTQ Clients


While LGBTQ substance abuse clients often share many similarities with heterosexuals who have the same diagnosis, they must often learn to cope with additional issues throughout the treatment process. It’s not uncommon for these patients to simultaneously be dealing with coming out, social stigmas, medical issues, and discrimination. LGBTQ community members also tend to associate with friend groups that actively participate in social drinking, drug use and partying that make it difficult to avoid potential substance abuse triggers. These factors can negatively impact recovery and must be taken into consideration during treatment


Additionally, LGBTQ individuals are at a higher risk of contracting HIV and AIDS, especially in the case of gay and bisexual men. While substance abuse treatment can help patients avoid spreading these diseases, the resulting physical, mental, and emotional effects must be taken into consideration at all times.


Other common concerns for lesbians, gay men, and bisexuals include:


  • Heart disease due to inactivity, obesity, and smoking

  • Certain cancers

  • Harassment and/or physical violence

  • Suicidal ideation and/or attempts

  • Emotional stress that may develop into depression

  • Other sexually transmitted diseases

  • Recommendations and Policies for Developing Affirmative Therapeutic Environments


Unfortunately, many substance abuse treatment centers insufficiently meet the needs of their LGBTQ patients. Recovery programs are often ill-equipped to address the unique situations often associated with individuals within this community and, as a result, the treatment becomes less effective. Group therapy, for example, may not be the best solution if other patients demonstrate bias or homophobia. If the group is not inclusive, it can result in a sense of alienation and counteract progress.


Studies show that specialized programs which address factors like homophobia, discrimination, harassment, violence, family unacceptance, and social isolation, resulted in better recovery outcomes. Substance abuse counselors should incorporate a variety of modalities, including social support therapy, cognitive-behavioral therapy, motivational interviewing, and contingency management. Patients have also proven to respond well to social skills training.


When developing a treatment environment that is welcoming and affirming for LGBTQ patients, consider the following important guidelines. Staff must:


  • Work to understand how social stigmas, discrimination, and violence impact LGBTQ patients

  • Acknowledge that having a different sexual orientation doesn’t mean the patient is mentally ill

  • Understand that same-sex relationships are normal and that attempting to change a person’s sexual orientation is ineffective and unsafe

  • Identify, address, and strive to understand the unique experiences of LGBTQ community members, as well as their potential problems and risks

  • Accept that LGBTQ patient families may not be legally or biologically related

  • Recognize that an LGBTQ client’s sexual orientation may impact family and occupational relationships

  • Realize there may be additional challenges outside of sexual orientation, such as racial, ethnic, and religious values and beliefs

  • Understand how health factors, such as HIV/AIDS, will impact an LGBTQ client

  • Program Models for LGBTQ Clients


While there are definite ways to tailor substance abuse treatment programs for LGBTQ patients, it’s relatively rare to find recovery centers that do. Despite evidence that these programs produce better results, many LGBTQ patients ultimately receive services from facilities that cater to the majority population. There are, however, some organizations that can serve as successful models for future improvement.


While everyone has their own individual reasons for substance use, research does indicate that these trends may be a result of several important factors. LGBTQ individuals experience a substantial amount of social stigma and discrimination, so much so, in fact, that their civil and human rights are often questioned and/or blatantly denied. They are also frequently the targets of violent acts and face many emotional hardships resulting from family and friends refusing to accept their sexual orientations and gender identities. Feelings of shame and self-doubt are prevalent as well. Exposure to this kind of emotional and physical stress and victimization, even limitedly, can have long-lasting, negative effects that may leave the individual more susceptible to the development of substance use and abuse, psychiatric disorders, and even suicide.


Research has also found that some orientations may be prone to overuse of certain substances. While it’s possible for LGBTQ patients to abuse any substance, lesbians and bisexual women, for example, have proven to be at higher risk for alcohol use disorders. Gay and bisexual men, on the other hand, seem to be at a higher risk for illicit drug use disorders; these individuals are significantly more likely to use marijuana, psychedelics, hallucinogens, stimulants, sedatives, cocaine, and barbiturates.


It’s also important to realize that some patients will keep their sexual orientations and gender identities private while receiving treatment for their substance use disorder(s). This means that it’s completely possible that the staff will never know whether individual clients are part of the LGBTQ community or not, which can slow down the recovery process. While a person should never feel pressured to disclose this type of information, maintaining an approachable and accepting atmosphere will make it much easier.


General Resources on Serious Mental Illness


Studies show that tens of millions of people suffer from mental illness in the United States alone. According to the 2015 National Survey on Drug Use and Health, there were significantly more LGBTQ adults suffering from mental illness than sexual majority adults. Approximately 3.9 million (37.4 percent) of LGBTQ adults over 18 years of age had a mental illness. About 1.4 million (13.1 percent) of those individuals had what is considered a serious mental illness. These numbers vary drastically from those reported for sexual majority adults. Only 17.1 percent of sexual majority adults had a mental illness, 3.6 percent of which was classified as serious.


Because many LGBTQ substance abuse disorder patients are also diagnosed with mental illnesses, it’s important that counselors become familiar with conditions that are prevalent among this demographic. It’s also vital that professionals have a clear understanding of how serious mental conditions should be treated. While anxiety disorders, eating disorders, and post-traumatic stress disorders are all common, the most serious mental illnesses include:


  • Schizophrenia

  • Severe, Major Depression

  • Severe Bipolar Disorder