If you are a member of the LGBT (lesbian/gay/bisexual/transgender) community or are a loved one of someone who is, then you know the numerous issues facing this population. Related to these issues are the statistics that reveal that the LGBT community has a significant rate of substance use disorders (SUDs) – much higher than the heterosexual/cisgender population.
A 2015 National Survey on Drug Use and Health (age 18 and older), indicated that for the LGB community, any illicit drug use was 39.1% vs. 17.1 % for heterosexual individuals; 30.7 % for LGB and 12.9% for heterosexuals regarding marijuana use; as well as specific high numbers in all the categories of illicit use including the misuse of prescription pain medications, tranquilizers, stimulants, and sedatives; cocaine; hallucinogens; inhalants; methamphetamines, and heroin. Also, alcohol use was higher with the LGB population with 63.6% vs. 56.2 % of heterosexual use. Likewise, the National Institute on Drug Abuse reported on a study regarding LGB adolescents revealing that they were 90% more likely to use substances than their straight counterparts. In one study of transgender individuals, in the Journal of Addictions & Offender Counseling (2017), it’s shown that the SUDS rate is quite high – approximately between 25-28% for this population.
Why is there a high rate of substance use disorders in the LGBT Community?
- Prejudice and discrimination: The LGBT community continues to struggle with acceptance and copes with such issues as being denied housing, work, being kicked out of the family, and homophobia/bi-phobia, transphobia, and sometimes, outright hate with harassment and violence.
- Internalized homophobia/transphobia where the LGBT person takes on the negatives of a majority culture and struggles with acceptance of self.
- Heterosexism and cisgenderism: We live in a world where most everything revolves around being heterosexual and of male or female gender. From the time we are born until death, we are bombarded with a straight/cisgender culture that is seen as the most natural and “normal” – to be different is to be feared, pitied, hated, and at best, tolerated. The media constantly influences this as do political/religious/educational/social systems that also push their beliefs.
- Some people may not want to out themselves for a variety of reasons and are fearful that they may be outed by someone else.
- While this is more accurate for the older community, the gay bar has been the historical meeting place for this population as it offered a safer place to meet others, have fun, and be their true self.
- There is stress regarding “coming out” – heterosexual/cisgender people do not have to do so.
- There may be even more prejudice and hate if you are a minority of another group such as a racial minority.
- There is a significant lack of legal protection for the LGBT community – local/state/national/worldwide.
- There may be fear of getting substance abuse treatment help due to prejudice (or perceived prejudice) of caregivers or other clients in treatment.
- A lack of family/ friends/sponsors who are supportive leading to trying to do recovery alone.
- Prejudice by educational communities.
- Prejudice by spiritual communities.
- Prejudice by social systems.
- Prejudice by legal systems.
- Lack of counselor training and acceptance may be an issue for the therapist/treatment provider and makes treatment ineffective.
- There are often no policies or procedures in an agency to help guide the process.
- There are few SUDS programs that specialize in the population making treatment difficult for you may feel you have to lie about your status, therefore, negating the entire premise of getting clean and sober. There also may be fear of confidentiality violations for those who are not out. Another problem is housing considerations in treatment especially for the transgender person.
- There is often a lack of a continuum of care after treatment especially in small communities.
While these are not excuses for substance use, they are leading factors in why an LGBT person – either yourself or a loved one - may turn to using substances, both illicit and legal, and/or not seeking help. Please know that there are many providers who are either LGBT themselves or are LGBT friendly who can offer services not only for the SUDS, but for the unique situation of being LGBT and helping one to embrace this in themselves. For in the end, we all need to be accepted.