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Substance Abuse and the LGBT Community: What We Know

Members of the LGBT community often face a greater risk for substance abuse. Despite an overwhelming consensus on this fact,1 most research in the areas of addiction and recovery does not include sexual orientation.

For example, in the journal Drug and Alcohol Dependence2 the authors searched two major databases for articles on the subject of substance abuse and sexual orientation. 200 papers were randomly selected and scanned for references to sexual orientation and/or gender identity. The results led to no useful information on these subjects.

Among the voices bringing attention to the relationship between substance abuse and the LGBT community is the Substance Abuse and Mental Health Services Administration (SAMHSA). Included in its efforts is a 230-page handbook designed to serve as both a reference tool and program guide for clinicians and administrators.3

Over the last few decades that have followed suggests little has improved. The journal Addiction published an article that estimated lesbian, gay and bisexual adolescents were, on average, 190 percent more likely to engage in substance abuse than their heterosexual counterparts. Picking apart the data further, the researchers determined this number jumped to 340 percent for bisexual youth, and 400 percent for LGB females.4

Gay couple hugging

What’s the Connection?

SAMSHA study on the relationship between substance abuse and the LGBT community5 and institutionalized homophobia.6 These individuals also face frequent stigmatization at home, work and elsewhere. It is not surprising to find that many LGBT individuals in therapy report feeling isolated, fearful, depressed, anxious and angry and have difficulty trusting others.7 When this happens, mind-altering and mood-altering substances can become a way to escape.
The other issue to consider is homelessness. In the general public, LGBT youth are believed to account for 7 percent of the youth population. Among the homeless, this number jumps to 40 percent.8 What is the reason for this massive disparity? According to one survey with nearly 400 homeless LGBT youth, nearly half had left home due to their family’s rejection of their sexual orientation or gender identity. These individuals were forced out of their homes.9
Once on the streets, LGBT youth face the challenges of living on the street.The lack of acceptance of the LGBT youth often leads to stress. As a response, these youths may use more substances and use them more frequently than do heterosexual youths.11

Getting Help

The LGBT community has a troubled history with the world of psychotherapy. Sadly, this strained relationship can make problems worse. It wasn’t until 1973 that the American Psychiatric Association voted to no longer classify homosexuality as a mental disorder. Meanwhile, the legacy of gay conversion therapy lives on, with only a handful of states having banned the practice which is tied to depression, drug use and suicide.12 Given all this, SAMHSA warns that some within the LGBT community may find it difficult or uncomfortable to access treatment services.13

Bryan Cochran, a professor at The University of Montana, has built a career around understanding the health challenges confronting LGBT individuals. Cochran states that there has been an increase in interest his workas well as an uptick in the number of LGBT-specific treatment centers. Still, Cochran says, ambiguity remains when it comes to what it means for an agency to be LGBT-inclusive.

It is important to remind you that support and treatment for substance abuse are available to everyone regardless of gender, ethnicity, religion or sexual orientation. We at Michael’s House are here to help. If you have any questions, please reach out. Don’t delay. Admissions coordinators are available to answer all of your questions. Take this important step forward today.


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Written by Tamarra Kemsley