LGBTQ+ Resource Guide for Substance Use Disorders

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:

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:

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:

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 is much easier.