By The Recovery Village | By Megan Hull | Medically Reviewed By EricPatterson, LPC

Several surveys indicate a clear link between people who identify as LGBTQ+ and increased substance misuse risk.

People in the LGBTQ+ community are more likely to experience social stigma, discrimination, rejection, abuse and ostracism from society and even their families. People who identify as anything, but heterosexual often face more challenges in their life, in addition to daily stressors, and as a result are at a higher risk of developing mental health and substance use disorders.

While great strides have been made in the LGBTQ+ community towards equality, most LGBTQ+ individuals still experience prejudice and harassment. Discriminatory laws, practices in employment, housing, relationship recognition, health care, and challenges with family and friends still exist and can cause higher levels of anxiety, fear, isolation, depression, anger and mistrust for people in the LGBTQ+ community.

Why is the LGBTQ+ Community at a Higher Risk for Addiction?

A number of surveys indicate a clear link between people who identify as LGBTQ+  and increased substance misuse risk. National studies conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) show that patterns of drug, alcohol and tobacco use tend to be significantly higher in the LGBTQ+ community compared to the general population.

Statistics also show that LGBTQ+ drug and alcohol misuse begins at an early age. The University of Southern California’s School of Social Work found that substance misuse is twice as prevalent among LGBTQ+ youth as compared to their heterosexual peers. Almost 30 percent of gay and transgender individuals considered attempting suicide in their adolescent years. Substance abuse usually exacerbates the underlying fear, loneliness and isolation many LGBTQ+ people can feel in ever-changing political and social climates.

Identifying as anything other than heterosexual can mean losing relationships with family and friends, experiencing bullying in school, or experiencing underlying prejudice in the workplace and in society in general. Internally, LGBTQ+ individuals can struggle with feelings of isolation, mental illnesses like depression and anxiety, and even fear for their own safety due to permeating social stigmas. These are just a few of the major contributing factors to the high rates of LGBTQ+ substance abuse. However, there are ways to help someone dealing with these challenges and it begins with understanding. Knowing why LGBTQ+ individuals are more likely to struggle with drug and alcohol abuse can be key in supporting a friend or loved one.

LGBTQ+ Discrimination and Societal Stigma

Many LGBTQ+ individuals experience heterosexism (bigotry against the LGBTQ+ community) and discrimination from society in the form of social prejudice and exclusive laws. This often results in a great deal of stress in various areas of life, including work, in relationships and going through the healthcare system. To cope with this high level of stress and the pressure to conform, many LGBTQ+ individuals turn to drugs and alcohol.

Transgender Identity

The transgender community is one that faces a great deal of stigma, which can result in depression and anxiety. Transgender individuals are assigned a biological gender at birth that does not correspond with their gender identity. There has been some progress in recent years for the transgender community, but lack of familial and societal support still persists in most countries. In fact, according to a national study in the American Journal of Public Health, social stigma toward transgender individuals correlates with psychological distress.

This psychological distress is known as minority stress. Minority stress is defined as a theory that health disparities exist within minority communities (ethnic, cultural, sexual) as a result of the larger, more dominant culture causing stress on the smaller minority. Both mental health disorders and gender nonconformity remains stigmatized in society, leaving transgender people to struggle with both.

According to the Center for American Progress, the rates of addiction for people who identify as transgender are “disproportionately higher” compared to the rates of substance misuse among people who identify as heterosexual.

Lack of Familial Support

For LGBTQ+ individuals, embracing their true identities and coming out to family and friends can be extremely difficult and painful. More often than not, their news is met with judgment, hostility and even disownment by their own families. According to the Centers for Disease Control, LGBTQ+ young adults who experience family rejection are three times more likely to use illicit drugs than those from supportive families. Sadly, lack of acceptance among family members has led to a rise in gay and transgender men and women’s substance abuse levels, as they attempt to ease the ostracism they feel and numb the pain of rejection.

Help Is Here: The Trevor Projectis an organization dedicated to crisis intervention and preventing suicide for young LGBTQ+ adults. If you or a loved one is in crisis, you can call, text orlive chat with a caring person who can help.

• Lifeline: 866-488-7386
• TrevorChat
• TrevorText: Text “Trevor” to 1-202-304-1200.

Mental illness and LGBTQ+ Counseling

According to a 2015SAMHSA report, people in the LGBTQ+ Community are more than twice as likely as heterosexual individuals to experience mental illness in their lifetime. Self-loathing, pressure to fit in and feelings of isolation can lead to struggling with a mental health disorder and even suicidal thoughts. LGBTQ+ individuals are almost three times more likely than others to experience major depression or generalized anxiety disorder. When concurrent with substance use disorders, mental health disorders are considered co-occurring disorders and should be addressed simultaneously through counseling and therapy. For people struggling with their mental health, counseling resources exist in the form of helplines, crisis lines and addiction treatment:

• The National Mental     Health Association answers questions about mental health conditions  and helps connect people to the care they need. Call 800-969-6642 during  business hours to talk with a compassionate mental health professional.
• The National Alliance on Mental     Health offers a free helpline for anyone struggling  with mental health issues. Call 800-950-6264 to speak with a crisis  counselor. You can also text NAMI to 741-741 to receive support via text  message.
• The National Suicide     Prevention Lifeline connects suicidal individuals with  free and confidential emotional support. Call 800-273-TALK (8255) for  24-hour support.

Some reasons that LGBTQ+ individuals typically misuse drugs someone more likely to abuse drugs; it’s the pressures inherent in surrounding society that marginalize people who are different from the status quo. Evening out the disproportionately high rates of substance misuse in the LGBTQ+ community will take time, effort and understanding from treatment specialists, lawmakers and society. But most importantly, decreasing LGBT substance abuse requires a greater societal shift in perspective from apathy to empathy as America strides toward equality forall.

How DoesSubstance Abuse Affect the LGBTQ+ Community?

Because of the added daily challenges that LGBTQ+individuals face, the effects are often magnified and the entire LGBTQ+population can be affected. Some ways that drug use and addiction impacts thegreater LGBTQ+ community can include:

1. Homelessness

Drug abuse and addiction have the potential to interfere with relationships and jobs, potentially leading to a life of homelessness. Homelessness doesn’t just affect adults with addictions, many LGBTQ+ youth are left homeless if their families reject them. In the LGBTQ+ community, rejection and ostracization from family members leave teens out on the streets. Unfortunately, being an LGBTQ+ homeless youth opens the door to dangers including mental disorders, violent victimization, suicidal tendencies, unsafe sexual practices and HIV risk.

2. Mental Health Issues

Substance use disorders are often associated with mental health disorders, either as a cause, effect or co-occurring disorder. The LGBTQ+ population is at a greater risk for such conditions. In fact, according to the National Alliance on Mental Illness (NAMI), LGBTQ+ individuals are nearly three times more likely than heterosexuals to experience a mental condition. If these conditions exist before drug misuse begins, they can be exacerbated or lead to other disorders. Some of the common mental health disorders associated with drug abuse include:

• Paranoia: an  exaggerated distrust of others, which may include delusions
• Delusions: very strong and irrational beliefs in something untrue
• Psychosis: extensive  changes in personality, impaired functioning and a warped or imagined  sense of objective reality
• Depression: an intense feeling of sadness and hopelessness that negatively affects  day-to-day life
• Anxiety: unusual,  distressing and overpowering feelings of fear and apprehension that are  often characterized by physical signs
• Panic attacks: sudden incidents of intense distress or tension that may occur for no apparent reason or in response to a known trigger

3. Increased Risk for Suicide

According to SAMHSA,one of the biggest risk factors for suicide is substance abuse. There are also many studies that indicate a greater risk of suicide for LGBTQ+ individuals (including those who don’t misuse drugs), especially for youth and transgender adults. Some LGBTQ+ statistics on the link between the LGBTQ+ community and the risk for suicide are:

• Lesbian, gay and bisexual (LGB) youth:

 
• Suicide attempts by LGB youth and questioning youth  are 4 to 6 times more likely to result in injury, poisoning or overdose  that requires treatment from a physician, compared to their straight      peers, according to a CDC      report.
 
• LGB youth who come from highly rejecting families are 8.4 times as likely to have attempted suicide as LGB peers who reported no or low levels of family rejection.

• Transgender adults:

 
• Based on the results of a national study in The Report of the 2015 U.S. Transgender Survey, 40 percent of transgender adults  admit to having attempted suicide. Ninety-two percent of these  individuals reported having attempted suicide before the age of 25.
 
• The prevalence of suicide attempts among respondents  to the National Transgender Discrimination Survey (NTDS) is 41 percent. This exceeds the 4.6 percent of the overall U.S. population who report a lifetime suicide attempt.

Which Substances Do LGBTQ+ Individuals Struggle With?

While anyone can become dependent on any addictive substance, members of the LGBTQ+ community most commonly struggle with tobacco, alcohol, amphetamine and heroin addiction.

Tobacco

Members of the LGBTQ+ community are significantly more likely to use tobacco products than the rest of the population. According toa 2015report by the CDC, nearly 1 in 4 individuals who are gay, bisexual or transgender smoke cigarettes, compared to approximately 1 in 6 heterosexual individuals.

While this widespread tobacco use is often attributed to the stress and anguish caused by LGBTQ+ stigmatization, there are other, more sinister factors at play. In the last 25 years, several major tobacco companies have launched aggressive ad campaigns targeting the LGBTQ+ community. The most famous example of this emerged in 2000, when a document labeled “Project SCUM” from Camel and Pall Mall was leaked to the press. This document outlined plans for a campaign that targeted young gay men and the homeless in the city of San Francisco. Ironically, while many of these companies position themselves as allies to the queer community, they donate money to support politicians opposed to gay rights.  

High tobacco use among members of the LGBTQ+ community leaves them vulnerable to addiction and the countless negative health effects associated with smoking. This includes the development of cancers, diseases and other health complications. Sadly, these consequences can sometimes be fatal, and more than 30,000 LGBTQ+ people die each year of tobacco-related diseases.

Alcohol

Between 20 and 25 percent of gay and transgender individuals abuse alcohol, compared to 5 to 10 percent of the general population. This is likely due to a combination of factors. The safety, support and sense of community that gay bars offer can make heavy drinking among gay and transgender individuals more likely. Many in the LGBTQ+ community also use alcohol to cope with the high stress levels that societal stigma can cause.

Whatever the reason, alcohol dependence can quickly become dangerous or even deadly if left unaddressed. Regular, excessive use may even lead to alcoholism, a condition in which a person is psychologically and physically dependent on alcohol. Side effects of long-term alcohol use and alcoholism include:

• Depression
• Liver damage
• Cancer
• Decreased immune system function
• Reduced sexual performance

If you suspect that you or someone you love may bedependent on alcohol, it’s important to seek help if you observe any of thefollowing signs:

• Drinking that interferes with work, school or other activities
• Frequent blackouts
• Inability to control the amount of alcohol consumed
• Spending a great deal of time drinking or recovering from drinking
• Drinking early in the day, staying drunk for long periods of time or     drinking alone
• Experiencing withdrawal symptoms when alcohol consumption stops,     like feeling shaky sweaty, sick and anxious

Amphetamines

Amphetamines belongto a class of drugs called stimulants thatproduce intense feelings of euphoria. Amphetamines can be medicallymanufactured or occur in dangerous street forms like meth. While thesesubstances bring short-term, good feelings, regular use can quickly lead todependence and addiction. Amphetamines are another type of drug widely abusedby the LGBTQ+ community. Recent studies show that gay men are 12.2 times morelikely to use these drugs than their heterosexual peers.

This high frequency of misuse likely occurs for a varietyof reasons. LGBTQ+ Individuals may use the stimulating, energizing effects ofthe drug to perform well at work or participate in the late-night gay clubscene. But while amphetamines might seem like harmless party or productivitydrugs, they can cause psychosis, malnutrition, cardiac problems or evenconvulsions if used frequently. Because of this, it’s important to be honestwith yourself if you are misusing amphetamines, or talk to friends or familymembers who you suspect may be addicted to them.

Signs of amphetamine abuse or addiction can include:

• Withdrawing from friends and family
• Emotional disturbances, including depression and psychosis
• Physical health problems
• Withdrawal symptoms when consumption stops, including intense     cravings, anxiety, depression, fatigue and hunger

Heroin

Heroin is oneof the most dangerous street drugs available. Produced from morphine, heroinproduces an intense rush of euphoria when ingested, injected or snorted.Lifelong experiences with homophobia, discrimination or abuse can leave membersof the LGBTQ+ community more likely to try this dangerous drug as a way to numbthe pain of their experiences. Because of this, gay men are 9.5 times morelikely to use heroin than heterosexual men.

Frequent heroin use can lead to a broad range of dangeroushealth effects, including:

• Collapsed veins (from intravenous use)
• Constipation and stomach cramping
• Infection of cardiac tissue
• Kidney or liver disease
• Lung complications

But the most dangerous potential health effects of heroinuse are addiction and death. Misusung this drug regularly causes a tolerance todevelop, meaning that someone with a heroin addiction need more of the drug toproduce similar effects. Once a person develops a tolerance, the possibility ofa fatal overdose becomes increasingly likely. Signs of heroin addictioninclude:

• Withdrawing from friends or family
• Visible needle marks or bruises
• Emotional disturbances, like sudden bursts of anger or depression
• Withdrawal symptoms when consumption stops, including vomiting,     nausea, diarrhea and paranoia

How Loved Ones Can Help

Whether you’re a friend, family member, ally or member of the LGBTQ+ community, there are a number of  ways to help support those affected by drug or alcohol abuse. Instead of perpetuating an environment(whether it be at home, school, work or public) that is hostile or exclusive,creating a judgement-free and inclusive space is critical.

For parents, this could mean having open conversationsabout unconditional love. At work and school, it means presenting equal opportunities, amenities and rights and in public, it means providing equalservices without discrimination.

Reinforcing self-worth is an important, if not the mostimportant factor in preventing substance use in the LGBTQ+ community. It isequally important that individuals who suffer from addiction or mental healthconditions are not ostracized further. Despite the fact that addiction affectspeople of all races, genders, incomes and sexual orientations, there is still anegative stigma associated with it.

People whostruggle with substance use are human beings, just like anyone else, who needhelp and encouragement to overcome their struggles. Addiction, like sexuality,does not need to be kept a secret. As society slowly accepts this concept, moreLGBTQ+ people may seek the help they need.

EncourageLGBTQ+ Substance Abuse Treatment

For those affected by addiction, it can be difficult torealize when outside resources and help should be sought. For the LGBTQ+community, it can be even harder; addiction and sexuality can both seem likeisolating, enveloping issues. Neither of these is something to be ashamed of.Friends and family members play a vital role in encouraging others to betterthemselves by accepting their sexuality and seeking treatment for addiction and mental illness.

How Can a Rehab Center Treat LGBTQ+ Substance Abuse Disorders?

There are hundreds of rehabilitation facilities in the country that offer substance abuse treatment options and are welcoming to the LGBTQ+ community. Recovery centers help individuals with substance addiction and co-occurring disorders and can help transform lives.

Traditional Rehabilitation Centers

Although the LGBTQ+ community can be affected by substance use disorders more than the general population, they are more likely than heterosexuals to seek treatment. Based on the results of a national survey recorded in the Journal of Substance Abuse Treatment. In addition, 15.3percent of LGBTQ+ adults who needed substance misuse treatment received it at a specialty facility in 2015, according to a report from SAMHSA report. Only10.6 percent of heterosexual adults received treatment.

Many traditional rehab centers include LGBTQ+ addictiontreatment and LGBTQ+ substance abuse treatment programs, with drug or alcohol detox asthe first phase. Other care options may include:

• Residential     (inpatient) treatment: Around-the-clock care,     including therapy.
• Partial     hospitalization programs: Around-the-clock care, but with     less monitoring than residential care.
• Intensive     outpatient programs: Can take place at the     patient’s home or at one of the center’s housing locations.
• Outpatient     programs: Intended to help patients move from treatment to recovery,     while providing access to recovery specialists.
• Aftercare     services: Ongoing care that may include LGBTQ+ counseling or therapy to     prevent relapse.

Many of these programs areindividualized to meet the specific needs of each patient, with regard to the specificsubstance being used. However, not all rehabilitation centers operate equallywhen it comes to the needs of the LGBTQ+ community. Some facilities have asignificantly larger population of heterosexual patients, some of whom may notbe accepting of LGBTQ+ patients. Some centers may also not offer anygender-specific programs.

To help combat this problem and make more traditional rehabcenters LGBTQ+ friendly, SAMHSA established nine principles of care fortreatment providers. These principles are intended to enable substance abusetreatment providers to better accommodate LGBTQ+ individuals, helping them to:

1.   Be understanding and flexible
2.   Provide a comprehensive approach
3.   Be consistent with cultural needs
4.   Promote self-respect
5.   Promote healthy behaviors
6.   Support collective decision making
7.   Reduce barriers to treatment
8.   Provide evidence-based treatment
9.   Create a recovery community

LGBTQ+ Rehab Centers

Fortunately, LGBTQ+ individuals have more options beyond traditional drug rehab facilities, including those that are designed specifically for the lesbian, gay, bisexual, transgender and queer community. Just knowing that these options exist may be all it takes to remove barriers for those who would otherwise be hesitant to seek treatment.

Many of these centers offer the same substance misuse treatment programs as traditional facilities while also focusing on issues thatare specific to the LGBTQ+ population. An emphasis on research-based therapy aswell as individual and group meetings are common aspects of many of theseprograms. Similar to standard rehab centers, the primary phase in treatment ata LGBTQ+ rehab center is detoxification.This first step is critical to recovery for any patient at a rehab facility.

One of the other benefits of various LGBTQ-oriented rehabcenters is that staff members are specially trained to meet the needs of theLGBTQ+ community. In many cases, some of the staff members are part of thequeer community themselves. Some centers were even founded by LGBTQ+professionals. The same is true of the creation of the various gender-specificprograms.

However, just as with standard drug rehab facilities, notwo LGBTQ+ rehab facilities are exactly alike. Treatment programs may bedifferent, in terms of the approach, length and intensity. Some are categorizedby sexual orientation while others have a wider range of gender identities. Thefollowing are some of the treatment options that you can expect at variousLGBTQ+ rehab centers:

• Residential treatment
• Intensive outpatient programs
• Partial hospitalization programs
• Sexual health programs

Many centers may also help patients cope with variousstressors that are associated with substance misuse. These includediscrimination, rejection, depression, coming out and homophobia.

Depending on the specific needs of the LGBTQ+ individual, atraditional rehab center like TheRecovery Village may be best, while for other individuals, they mayfeel more comfortable at a LGBTQ+ specific rehab center. Fortunately, there areresources available to help everyone in the queer community make the rightdecision for their unique needs.

At The Recovery Village, we welcome our LGBTQ+ friends andfamily. If you or someone you love is struggling with substance use andco-occurring disorder, you’re not alone. Whether you are lesbian, gay,bisexual, transgender or questioning, you are worthy of the highest level ofcare in overcoming a substance use disorder.

The Recovery Village offers a continuum of care for alltypes of substance use and co-occurring disorders from medical professionalswho have years of experience in the field. In our judgment-free environment,you’ll be surrounded by people who care about your unique situation and want tohelp you overcome addiction for good. At The Recovery Village, you can find relieffrom addiction and pursue healing — no matter who you love. Call and speak with a representative tolearn more about what treatment program can work for you.

[Sidebar] At a Glance: LGBTQ+ Substance Abuse

·        20–30 percent of LGBTQ+people misuse substances, as compared to about 9 percent of the generalpopulation

·        39.1 percent of lesbian,gay and bisexual adults used illicit drugs in 2015, compared to 17.1 percent ofheterosexual adults

·        25 percent of LGBTQ+people abuse alcohol, as compared to 5–10 percent of heterosexual individuals

·        Transgender and gayindividuals use tobacco up to 200 percent more than their heterosexual peers

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