What You Need to Know About Substance Abuse in the LGBTQ Community

Drug abuse, especially opioids, is a culture-wide problem. It is estimated that about 130 people die daily in the US due to opioid overdose. While this statistic alone doesn’t capture the totality of of all substances use, it demonstrates the depths of the substance abuse crisis around the country. Sexual minorities, such as LGBTQ people, are often at higher risk for substance abuse issues, making these groups particularly vulnerable.

Why Are LGBTQ People Impacted More Frequently?

This is a hard, and complex, question to answer. The truth is that there hasn’t been a great deal of research on queer people and substance use. There is a significant knowledge gap for people who live at the intersections of being active drug abusers and sexual minorities. Transgender people are often left out of current research as well (which is why you’ll see the acronym LGBQ throughout this piece at times). We still have a lot to learn about how substance use issues show up in these communities.
We do, however, know that many LGBQ people regularly face discrimination and societal isolation. The lived experiences of queer people may account for increased, and more severe, substance abuse among these groups.
In many states, it is still legal to discriminate on the basis of sexual orientation and gender identity for employment, housing, and healthcare. Currently, more than half of the United States does not offer explicit prohibitions on discrimination in these areas for LGBTQ people. Current local and federal cases are addressing these issues as we speak. However, this means that many queer folks are facing (or at risk of facing) horrendous life circumstances on a daily basis. Major life stressors, such as discrimination, increase the use of substances.

What Do the Stats Say?

The stats around substance abuse in LGBQ populations reveal some staggering truths about the mental health of queer people in the United States. According to the 2015 National Survey of Drug Use and Health:

• Sexual minority adults, in a given year, are more likely to use illicit substances (such as heroin, cocaine, prescription pills, etc.) at much higher rates than their straight counterparts.
• Young queer adults (ages 18-25) demonstrate greater use of marijuana, LSD, hallucinogens and other substances such as methamphetamines than older queer folks.
• LGBQ adults were more than twice as likely as straight counterparts to misuse prescription drugs in the past year.
• While LGBQ people are more likely to be active smokers than their straight counterparts, they tend to smoke fewer cigarettes on any given day.
• Sexual minority adults tend to be more active binge drinkers.
• LGBQ adults experience substance use disorders at over twice the rate of straight adults.
• While most people with substance abuse disorders that require treatment do not get that treatment, LGBQ folks accessed treatment at substance treatment facilities at higher rates than their straight counterparts.

Addressing Substance Abuse Issues in Queer Communities

There’s a lot of work to be done in order for queer-affirming spaces to address substance abuse issues. It is simply not enough to say that services are provided to LGBTQ people. Creating competent and affirming spaces means addressing the nuances that LGBTQ people face in their use of substances. This means that, in order to provide more effective treatment, providers and treatment clinics have to better educate themselves about the lived experiences of LGBTQ people who abuse substances. This may often mean looking at the social and sexual lives of LGBTQ people and the role that substances may play in fostering, and challenging, connections and wellness.
Many treatment centers claim to provide substance abuse treatment to LGBQ folks, but in reality, these services may not be accessible at all. A study completed in published in 2007 found that, out of the many treatment centers who advertised their services as LGBTQ friendly, only about 7% had queer specific services on site.
It is the responsibility of individual providers, agencies, and treatment centers to ensure that they are working hard to understand and meet the needs of LGBQ folks who are active substance abusers. Without competent care, we are not helping those who seek out support. At worst, we are actively harming their recoveries by providing incompetent services.
Providers can also start being intentional about creating warm and welcoming environments to LGBTQ people. Providers can adopt gender neutral language on forms and brochures, feature queer folks in their advertisements, and ensure gender neutral bathrooms are accessible to all.

Find A Match That Works Best For You

There are many factors to consider when seeking professional support for substance abuse issues. While there is no onesizefitsall approach, if you are a queer person looking for support in reducing your use (or abstaining altogether), you will be best served by a queer affirming provider who specializes in treating substance abuse and misuse. An affirming therapist can help you openly explore all the ways your use impacts your life without judgment. You might consider finding a therapist with a similar cultural background, as having that kind of safety in therapy can make all the difference.