Substance use is common in LGBTQ+ individuals, who are at higher risk for developing substance use disorders and mental health conditions. More treatment centers are providing specialized and affirming care for LGBTQ+ populations, who may benefit from tailored interventions to address specific risk factors.
- LGBTQ+ individuals struggle with higher rates of mental illness and substance use disorders.
- Addiction treatment providers are becoming increasingly skilled at providing affirming treatment to individuals who identify as LGBTQ+.
- A number of effective treatments exist, including inpatient, residential, and outpatient rehabs that can support individuals with different treatment needs.
Understanding substance use in LGBTQ+ populations
Substance use is common in LGBTQ+ communities, and individuals within this community are more likely to use substances and develop addictions. According to data from the largest survey on drug use in the U.S., individuals who are gay, lesbian, or bisexual are two to three times more likely than heterosexuals to be diagnosed with a substance use disorder. [1][2]
Individuals within the LGBTQ+ community are more likely to abuse a variety of substances, including cannabis, hallucinogens, stimulants, sedatives, and inhalants. Adolescents and young adults are more likely to abuse illicit drugs, while older LGBTQ+ individuals are more likely to abuse alcohol. [2]
Why substance use is more common in LGBTQ+ communities
Research has found that people who identify as LGBTQ+ are at higher risk for substance use and are more likely to develop a substance use disorder. There are a number of factors that are likely to increase the risk for addiction within the LGBTQ+ community, including stress and social stigma. [2][3][4]
According to the Minority Stress Theory, LGBTQ+ individuals face stigma and social stress related to their identity as sexual minorities, which increases their risk for problem substance use. [4] For example, LGBTQ+ individuals may abuse substances to self-medicate symptoms of an underlying mental illness, which is also more prevalent in this community.
Substance use is especially common among adolescents and young adults in the LGBTQ+ community, which could also be linked to a number of factors. At this age, individuals are working with key aspects of identity development, which can be a more complicated process for individuals who are LGBTQ+. [2][4]
Substance use is also common in LGBTQ+ spaces and subcultures, which could increase social pressures to use drugs to fit in or connect with others. For example, gay bars are often hotspots for illicit drug use and excessive drinking, which also increases the likelihood of other types of risky behavior. [2][3][4]
Addiction treatment options for LGBTQ+ individuals
There are a number of effective treatment options for those struggling with substance use disorders, including individuals within the LGBTQ+ community. Because of the prevalence of addictive disorders in this population, most programs are accustomed to providing treatment to individuals who identify as LGBTQ+.
Individuals within the LGBTQ+ community have access to the same addiction treatment options as those who do not identify as a sexual minority. Addiction treatment can be provided in a number of different settings, including inpatient, residential, intensive outpatient, and regular outpatient settings. People may be recommended for a specific level of care, depending on the severity of their addiction and their treatment needs.
All forms of addiction treatment involve behavioral therapy, which may be provided in individual, group, or family therapy sessions. In some treatment centers, case management services are provided to help individuals who need help accessing resources for basic needs like housing, food, or employment. Others will provide access to medications to treat co-occurring mental health disorders or to reduce cravings or withdrawal symptoms. [5]
Inpatient rehab and medically monitored detox
Inpatient rehab and medically monitored detox programs offer the highest level of support for those in early recovery from a substance use disorder. Many people utilize these programs on a short-term basis in order to safely withdraw from a substance and stabilize themselves. In inpatient settings, a higher level of medical monitoring, intervention, and support is available than in other settings. [5]
Individuals with complex or high-risk substance use patterns may benefit most from a short-term inpatient stay. After 1-4 weeks, most people are discharged from inpatient settings and are recommended to step down and transition to a lower level of care.
Residential rehab
Residential rehab is another treatment option for LGBTQ+ individuals and provides therapeutic support in a residential environment. Most residential rehab programs offer structured schedules that involve individual and group therapy, psychoeducation, and other therapeutic activities. Residential rehab can be utilized for several weeks or months, depending on the structure of the program and the individual needs of each person. [5]
Intensive outpatient rehab
Intensive outpatient (IOP) rehab is another treatment option that is sometimes recommended for LGBTQ+ individuals in recovery from a substance use disorder. In an IOP program, individuals will come 3-5 times per week for group and individual addiction treatment. Many IOP programs also offer case management and medication management to those in need of these services. The length of IOP programs varies, but many last between 3-6 months. [5]
Medication-assisted treatment (MAT)
Medication-assisted treatment (MAT) is another treatment option for LGBTQ+ individuals who are in recovery from an opioid use disorder. MAT programs provide access to FDA-approved medications like methadone and Suboxone, which reduce opioid cravings and withdrawal symptoms. Many MAT programs also require that individuals participate in individual and/or group therapy, which may be offered at the same facility or by outside agencies and providers. [5]
Outpatient therapy
Outpatient therapy for addiction is a good option for those who are stable in their recovery and need less support to prevent relapse. There are many individuals, couples, and family therapists who specialize in working with individuals in recovery from an addiction. At this level of care, one-hour therapy sessions are offered 1-2 times per week in an outpatient facility. Some people may combine outpatient therapy with other forms of support, like 12-step groups or psychiatric medication management services. [5]
LGBTQ+ affirming treatment
While almost all addiction treatment centers are able to provide treatment for individuals in the LGBTQ+ community, some people may want treatment options that are specifically marketed as LGBTQ+ affirming. Affirming treatment may highlight its inclusivity through welcoming language, visible symbols of support, diverse staff, and policies that help maintain a safe environment. [3]
Discrimination against LGBTQ+ individuals still exists, but it is less pervasive than in the past. State and federal laws, in addition to ethical and professional codes, help prevent discrimination against an individual because of their race, class, or sexual identity. Increasingly, the standard of care in addiction and mental health treatment is to provide compassionate, inclusive treatment to people from all backgrounds.
Barriers to treatment and how to overcome them
LGBTQ+ individuals may have unique treatment needs and challenges that can complicate addiction recovery. Identifying and addressing these needs and challenges early in the process is crucial to helping ensure a successful treatment experience.
Here are some of the barriers and ways to overcome them: [3][4]
- Lack of social support: LGBTQ+ individuals may have less family and natural support, and may need to work on developing an active support system in recovery. Individuals with strained family relationships may benefit from family therapy during addiction recovery.
- Substance use norms in LGBTQ+ cultures: Individuals in recovery may need to find alternatives to nightclubs or other places where substance use is common. They often need to find ways to develop sober connections with other LGBTQ individuals.
- Hostile group environments: While most treatment providers are trained to provide multiculturally sensitive services, hostility or prejudice from other group members may make LGBTQ+ individuals feel unsafe or unwelcome. It may take more than one try to find a group environment that feels comfortable.
- Co-occurring mental health conditions: Individuals who identify as LGBTQ+ are more likely to suffer from co-occurring mental health conditions that can complicate addiction recovery and treatment. Best practice guidelines for co-occurring addiction and mental health issues involve finding treatments that can address both issues simultaneously, often with therapies and medications.
- High levels of stress: LGBTQ+ individuals often report high levels of stress related to social stigma or other unique aspects of their life experience. Developing healthy routines, habits, and self-care practices is an essential aspect of recovery that can help prevent relapse.
When to seek help
Substance use disorders can develop when individuals begin using substances in ways that are compulsive, problematic, or interfere with other important priorities. Most of the time, people who develop a substance use disorder begin by abusing drugs or alcohol occasionally, socially, and recreationally. Over time, their use will often become more frequent and heavy, and they will have more difficulty moderating or controlling it. [6]
Here are some of the signs and symptoms that licensed professionals look for when diagnosing substance use disorders: [6]
- Using drugs or alcohol in higher doses or more often than intended.
- Excessive time spent trying to obtain, use, or recover from effects of drugs or alcohol.
- Unsuccessful attempts to cut back or stop using drugs or alcohol.
- Strong urges or cravings to use drugs or alcohol.
- Neglecting basic responsibilities at work or home because of drugs or alcohol.
- Using drugs or alcohol in situations where it is risky or unsafe.
- Giving up important social or recreational activities to use drugs or alcohol more.
- Negative impacts on important relationships because of drugs or alcohol.
- Negative impacts on physical or mental health because of drugs or alcohol.
- Developing a tolerance, needing to use more drugs or alcohol for the same effects.
- Physical or psychological withdrawal symptoms when stopping or cutting back on use.
According to the DSM 5, a person who displays 2-3 of the symptoms above has a mild substance use disorder. Someone with 4-5 symptoms has a moderate substance use disorder, and 6 or more symptoms indicate a severe substance use disorder. [6] Without treatment, most substance use disorders worsen over time, becoming more severe. By seeking treatment, it is possible to interrupt the cycle of problem drug use and overcome an addiction to drugs or alcohol.
