Substance Abuse in the LGBTQ Community
–25 % of the LGBTQ population abuse alcohol, while only 5-10% of the heterosexual population abuse alcohol.
–73% of lesbians have used alcohol in the last 30 days and 81% have used alcohol in the last year.
–80% of gay men have used alcohol in the last 30 days and 89% have used alcohol in the last year.
Addictions and Recovery Support for the LGBTQ Community
Drug abuse and addiction present major challenges for the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community. Already high within the general population, rates of substance abuse increase substantially within the LGBTQ community alone.
Unfortunately, little research is available to confirm actual rates of drug abuse among those who identify as LGBTQ, so it is difficult to ascertain the exact extent of the problem. However, a study conducted by Australia’s Queensland Association for Healthy Communities presents a grim picture. In this 2005 survey, 44.8 percent of respondents claimed to smoke daily, with most using between 11 and 20 cigarettes per day.
Alcohol abuse was also rampant, with 41.4 percent of respondents drinking more than eight alcoholic beverages per week. Perhaps most alarming of all, half of respondents had used recreational drugs at some point or were still using them at the time of the survey. The top five recreational drugs mentioned in the survey included marijuana, Ecstasy, amyl nitrite (poppers), crystal meth and speed.
Preliminary research suggests that rates of drug abuse are also high in the United States. A study published in the Journal of Substance Abuse Treatment found that LGBTQ youth were far more likely to develop crippling addictions than their heterosexual counterparts. Furthermore, once they did fall victim to addiction, these individuals were less likely to seek rehab and recovery treatment.
Why are LGBTQ addiction rates so high? It is clear that drug addiction is the cause of much suffering among members of the LGBTQ population, but why exactly is this community afflicted by such high rates of substance abuse? A number of factors can contribute to LGBTQ drug abuse, including the following:
–Higher rates of depression among LGBTQ individuals
–A need to escape from the constant presence of social stigma and homophobia
–Efforts to either numb or enhance sexual feelings
–Ease shame and guilt related to LGBTQ identity
–Drug use among peers leads to pressure on non-users
Unfortunately, many of the factors contributing to the development of addiction in LGBTQ individuals can also prevent these sufferers from seeking treatment. Addiction, as well as mental illness in general, carries a heavy social stigma with it, but an LGBTQ identity compounds that stigma even more. Additionally, many members of the LGBTQ community worry that they will not be able to find LGBTQ recovery centers suited to meeting their unique needs. They may be unwilling to enter traditional addiction recovery programs instead of gay drug recovery facilities, mostly due to their fear of being targeted by heterosexuals taking part in these recovery programs. These worries are not necessary, however, because a number of excellent LGBT rehab facilities are available.
Michael Boticelli: TED Talk
Michael Botticelli is a drug policy expert. He also happens to be gay. As Director of National Drug Control Policy, Michael Botticelli led the Obama Administration’s drug policy efforts to diminish the consequences of substance use through evidence-based prevention, treatment and recovery support services. His TED Talk lecture (April 2017) is worth viewing.
He says that addiction is a disease and that we should treat it that way. Only one in nine people in the United States gets the care and treatment they need for addiction and substance abuse. A former Director of National Drug Control Policy, Michael Botticelli is working to end this epidemic and treat people with addictions with kindness, compassion and fairness. In a personal, thoughtful talk, he encourages the millions of Americans in recovery today to make their voices heard and confront the stigma associated with substance use disorders.
As Director of National Drug Control Policy, Botticelli led the Obama Administration’s drug policy efforts, which are based on a balanced public health and public safety approach. The Administration advanced historic drug policy reforms and innovations in prevention, criminal justice, treatment and recovery.
In response to the national opioid epidemic, Botticelli coordinated actions across the Federal government to reduce prescription drug abuse, heroin use and related overdoses. These include supporting community-based prevention efforts; educating prescribers and the public about preventing prescription drug abuse; expanding use of the life-saving overdose-reversal drug naloxone by law enforcement and other first responders; and increasing access to medication-assisted treatment and recovery support services to help individuals sustain their recovery from opioid use disorders.
According to Pride Institute, “In the LGBTQ community, research suggests that alcohol abuse and dependence occurs at even higher rates than in the mainstream population. Independent studies collectively support the estimate that alcohol abuse occurs in the LGBTQ community as rates up to three times that in the mainstream population. Said another way, alcohol abuse is estimated to occur in up to 45% of those in the LGBTQ community.”
Ann Leible is an LPC with Pride Institute. She offers this critical information about drug and alcohol abuse among LGBTQ persons:
It is generally held among researchers that LGBTQ persons are more likely to use alcohol and drugs than the general population and more likely to abuse alcohol and drugs, as cited in the Center for Substance Abuse Treatments A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, Transgender, and Queer Individuals. Twenty to twenty-five percent of gay men and lesbians are heavy alcohol users, compared to 3-10% of the heterosexual population.
Why is this? What factors contribute to the prevalence of chemical abuse among gays and lesbians, bisexual, transgender, and queer individuals? And, finally, what can be done about it? Attitudes and assumptions regarding homosexuality and chemical abuse have evolved throughout the years. Until 1973, homosexuality was defined as a mental illness by the American Psychiatric Association.
Alcoholism and chemical abuse issues, once treated solely as legal problems, now are seen as illnesses of the mind, body, and spirit. At one time it was believed that there was a causal relationship between homosexuality and alcoholism with the idea that suppressed homosexual tendencies actually triggered chemical abuse and dependency.
Today this myth has been dispelled by research. Instead, scientists believe that societal factors affect the relationship between chemical abuse and the experiences of members of the LGBTQ community. The society in which we live marginalizes the LGBTQ community. In fact, there is an ever-presentness of possible oppression in LGBTQ people’s lives. Under such conditions, LGBTQ folk can experience varying degrees of heterosexism.
Why Are There More LGBTQ Addicts?
Ann Leible (LPC with Pride Institute) offers an explanation as to why substance abuse may be higher among LGBTQ people. She sites these factors:
Heterosexism – Heterosexism is defined as the stigmatization of non-heterosexual forms of emotional and affectional expression, sexual behavior or community. Negative covert and overt messages about the gay and lesbian lifestyle as well as incidents of hate in the form of threats, acts of humiliation, emotional abuse, and even murder occur frequently. Other common examples of heterosexism include: rejection by family, friends, and peers; loss of employment or lack of promotion; and observing/hearing people make heterosexist jokes. Heterosexism can contribute to internalized homophobia, shame, and a negative self-concept.
Self-Medication – Some LGBTQ individuals self-medicate with drugs and alcohol as a way to cope with or numb negative feelings associated with heterosexism, such as isolation, fear, depression, anxiety, anger, and mistrust. Others in the gay community may use mind altering substances as a way to cope with stressors caused by the tensions of living under the stigma of marginalization. In fact, substance use is a large part of the social life of many in the LGBTQ community. The gay bar scene is regarded as a risk factor for substance abuse among the gay community. But these bars have often been the only places where LGBTQ folks can socialize and feel free from the prevailing oppression that is experienced every day in a strongly heterosexist society. The LGBTQ individual who has experienced rejection from his or her biological family may find in the gay bar that one opportunity for identity affirmation and acceptance.
Heterosexism also causes many LGBTQ folks to compartmentalize their lives. On the outside, they may follow the rules of the dominant society and behave in ways that are accepted as the norm in order to fit in and succeed. Kimeron N. Hardin, in The Gay and Lesbian Self-Esteem Book: A Guide to Loving Ourselves (1999), defines this identity as the public self. The secret self, on the other hand, is that part of self that is honest and consistent with how one truly feels and what one desires. It remains hidden and is often perceived by the LGBTQ identified individual as shameful, evil, or unworthy. Engaging in such actions of secret keeping, compartmentalizing, and self-degradation can take a huge emotional toll on an individual. As every 12 Step member knows, secrets keep us sick.
Substance use can provide an avenue of relief that is easily accessible and immediate in its effects. It can also mirror the coping mechanisms of self-compartmentalizing. The user can experience a chemically promoted dissociation, which the LGBTQ individual may find both familiar and comforting. Therefore, the compelling allure of alcohol and drugs manifest, and the user becomes vulnerable to the cycle of chemical addiction.
Barriers in Treatment Services – Heterosexism plays a part in the chemically dependent LGBTQ individual’s inability to access effective treatment services. Substance abuse treatment facilities are often not able to meet the needs of this special population. The treatment staff of such facilities may have varying heterosexist assumptions regarding the LGBTQ clients who access their services. They may be uninformed about LGBTQ issues, insensitive to or antagonistic toward LGBTQ clients or believe that homosexuality causes substance abuse or can be changed by therapy. Other clients may have negative attitudes toward the LGBTQ client.
These issues become barriers in successful treatment experiences for the LGBTQ individual seeking those services. Treatment components designed to promote successful treatment experiences for the LGBTQ client include cultural sensitivity, an awareness of the impact of cultural victimization, and addressing issues of internalized shame and negative self-acceptance. The integrated biological-psychological social model of chemical addiction treatment takes into account the effects of society on the individual and his or her relation to the use of chemicals.
Cognitive behavioral counseling techniques challenge internalized negative beliefs and promote emotional regulation. Such counseling helps the LGBTQ client reach for internal acceptance instead of the nearest bottle or drug.
The inclusive and accepting spirit promoted by Alcoholics Anonymous and other support groups provides an appropriate alternative to the gay bar. LGBTQ folks can find a way to transcend the in-authenticity promoted by cultural oppression through the affirming acceptance of others. As a result, they may find themselves living more integrated and expressive lives. Who needs alcohol or drugs when one’s life is so full?