Drug and alcohol use in the LGBT community is higher than in the general population. Exactly how much higher is difficult to say, since the exact size of the LGBT community is unknown and studies on substance use rarely ask about sexual identity or orientation. Despite great strides in LGBT rights in recent years, widespread discrimination still exists and many people remain reluctant to come out. According to some estimates, about 30 percent of lesbians have an alcohol use issue and about 20 to 25 percent of gay men are heavy drinkers compared to about three to 10 percent of heterosexuals. Marijuana and cocaine use have been found to be higher among lesbians than among heterosexual women and gay men are more likely to have used a variety of drugs, including party drugs like MDMA and ketamine. The higher rates of substance use in the LGBT community is likely the result of being a marginalized group. Many LGBT people internalize homophobic attitudes, leading to feelings of shame. Substance use is often a way to cope with these feelings. Therefore, substance use isn’t directly related to sexual orientation, but is rather a response to discrimination based on sexual orientation. LGBT people often feel socially isolated, fearful, anxious, depressed, and angry. All of these feelings can lead to excessive substance use. It is often assumed that addiction treatment for LGBT people is pretty much the same as it is for anyone else. In fact, LGBT people have special needs in addiction treatment and if these aren’t met, their chances of successful recovery are much lower. Here are some of the most important issues to consider for LGBT people seeking addiction treatment.
Perhaps the most important aspect of treatment is whether the staff is experienced in treating issues common among LGBT patients. These often include internalized homophobia or shame, depression, anxiety, and anger. LGBT individuals are also more likely to be the victims of social ostracization, bullying, abuse, and violence.
While we’ve made a lot of progress in recent years in protecting LGBT individuals from discrimination, not every state provides equal protection and even if they do, prejudice is still strong in certain areas. Anyone seeking treatment for addiction or any other kind of therapy has a right to confidentiality, and that is especially important for people who may face discrimination. LGBT people may have good reason to be concerned that if their sexual orientation were made public, they might face career setbacks, lose custody of children, or discrimination in terms of housing or social services. Since confidentiality breaches can be especially severe for LGBT people, staff should be aware of regulations affecting LGBT patients and they should be aware that a patient’s sexual orientation is protected information. Patients should be aware of their own legal liabilities and be careful how much they discuss, even in treatment.
Individual therapy is typically the safest place to discuss sexual orientation and sexual identity. A good therapist familiar with LGBT issues will keep a patient’s confidence and help her or him work through specific issues related to sexuality. How this translates to a group setting is more complex. Some members of the group may be homophobic and create a hostile group environment. Even if that’s not the case, many LGBT individuals will likely be hesitant to discuss issues related to their sexuality or identity in an unfamiliar group unless it’s explicitly LGBT or LGBT friendly. A good group leader will make sure that the group is a supportive and civil environment by immediately putting a stop to any homophobic speech or behavior. Still, it’s understandable that people who are used to ostracism might not be forthcoming in a group environment.
Family and social support
Family support is crucial for a successful recovery. When a patient leaves treatment, she will have a much better chance of succeeding if her family supports her. This ideally begins early in treatment, with family therapy. Often, dysfunctional family dynamics contribute to addiction. Addressing these issues and helping family members understand how to support their loved one’s recovery is a tremendous help. However, family situations can be complicated for LGBT individuals. They are often rejected by their families for their sexual orientation or identity. Sometimes these wounds can be healed, but often, having to engage with one’s family is just another source of stress. LGBT individuals often rely more on families of their own choosing, such as allies or friends from the LGBT community. Although they may not be related, they may be closer to these people than they are to their biological families and they may play a significant role in addiction recovery. Treatment providers should be aware of this and open to flexible arrangements. They should also be aware of any biases they may have about working with same-sex partners of patients. Another complicating social factor is that substance use is generally higher in LGBT culture. It’s important to have supportive friends in recovery but if those supportive friends also use a lot of drugs and alcohol, the patient may face a conflict. Gay men, in particular might find their social lives severely restricted by sobriety and it’s important to address that possibility in treatment and in aftercare.
Trans people, who don’t identify their biological sex often face more discrimination than gays and lesbians because their difference is often more apparent. This has been a hotly debated issue regarding public bathrooms. In residential treatment, it may be an issue in housing. Trans people who are considering entering residential treatment should ask whether they can be housed with the gender they identify as. Being forced to room with the opposite gender may be uncomfortable and intimidating. Flexibility in housing trans patients may be a good indication of how prepared a facility is to treat LGBT patients in general.
If you or someone you love is struggling with addiction or mental illness, we can help. Recovery Ways is a premier drug and alcohol addiction treatment facility located in Salt Lake City, Utah. We have the resources to effectively treat a dual diagnosis. Our mission is to provide the most cost-effective, accessible substance abuse treatment to as many people as possible. Request information online or call us today at 1-888-986-7848