Anyone can choose to fill a shot glass or load up a needle. People all around the country — and all around the world, in fact — do so every day. That’s why researchers often say that addictions don’t discriminate. Anyone can develop a problem when exposed to the right mix of pressure and opportunity.
But there are some groups of people that have unique triggers that lead to substance abuse. Research suggests that those within the gay, lesbian, bisexual, transsexual, queer, and questioning (LBGTQ) community are among those with enhanced addiction risks.
Sadly, research also suggests that people in the LGBTQ community are among the least likely to ask for help and get appropriate services when they’re needed.
Many cities and states, including both Philadelphia and Florida, are working to change that. And all states have professionals who are willing to help people learn to move past addictions and into a healthier future. But you might need to do a little digging to find the spot that’s right for you.
Addiction’s Impact on the LGBTQ Community
The term LGBTQ refers to several different types of people, all with their own unique stories to tell. For decades, those stories were hidden from view, as researchers rarely asked questions about identity or preference when conducting studies. But now, many published studies do contain data about the LGBTQ experience, and some of the statistics are worrisome.
According to the National Survey on Drug Use and Health, conducted in 2015, LGTBQ people are twice as likely as heterosexual adults to use illicit drugs. Substances cited in the study include:
- Marijuana, used by 30.7 percent of LGBTQ adults, compared to 12.9 percent of heterosexual people.
- Prescription painkillers, used by 10.4 percent of LGBTQ adults, compared to 4.5 percent of heterosexual people.
- Binge drinking (five or more drinks in one sitting), which was performed more often by LGBTQ adults than heterosexual adult.
Addictions tend to form when drug use starts early. Brain cells are vulnerable to damage as they grow, and the earlier they’re touched by drugs, the more likely they are to change in ways that make use compulsive rather than voluntary.
Researchers say that drug use tends to begin earlier in LGBTQ communities, and when it does, it can lead to suicidal thoughts. The National Alliance on Mental Illness (NAMI) reports that suicide is one of the leading causes of death in those ages 10 to 24 in this community. Those who don’t complete suicide can emerge into adults with entrenched addictions that seem difficult to address.
How Does Addiction Begin?
An addiction in any person begins with a choice. There’s a moment at which you put the glass to your lips, light the flame on the cigarette, or push the plunger of the syringe into your arm. LGBTQ people come to addictions in the same way, but their stressors can push them into addictions in a way that heterosexual people might not understand.
Consider stress. We’ve long known that stress can push us into substance abuse. When we’re feeling pressure from family members, friends, coworkers, or the world around us, we look for relief in any place that will have us. Often, that’s at the bottom of a pill bottle or alcoholic drink.
People in the LGBTQ community experience what researchers call minority stress. They live with the spark of worry caused by feeling alone in a community that neither understands nor accepts them. They internalize this stress, and it manifests as health conditions, including the following:
- Heart disease
- Chronic health disorders
Their stress is also transformed into substance abuse. They use substances early in life to numb pain, and they continue that use into adulthood to make their lives feel easier to tolerate.
Even opening a magazine or listening to the news could make that sense of stress so much worse.
For example, the Center for American Progress reports on a young man kicked, beaten, and slapped on a school bus for his sexual preference. The next day at school, he was punched even more.
Sharing these stories means exposing the heterosexual world to the indignities and injustices that come with the LGBTQ label. But if you’re already part of that community, those stories can traumatize you. Are you safe walking to work? Will someone hit you while you’re in a movie theater?
To you, these stories are personal. And they could be warnings of what will happen to you if you live openly.
Stress like this can result in other mental health issues, including post-traumatic stress disorder (PTSD). NAMI reports that people in the LGBTQ community are three times more likely than others to have a major mental health concern, including anxiety or depression.
The link between mental illnesses and addictions is both clear and strong. You may begin to abuse substances to help you deal with the symptoms of mental illness, but the brain changes caused by substance abuse can make mental illness worse.
When addictions and mental illnesses combine, you need a treatment program that can address both problems at the same time. Leaving one in place can allow the other to strengthen or worsen. Many addiction treatment facilities offer this kind of care for co-occurring conditions.
How Are Communities Helping?
Discrimination is real and very present. But some communities are looking for ways to ease the misery and help when they can. In two representative areas, Florida and Philadelphia, officials are looking for ways to help.
Philadelphia could be considered the epicenter of the prescription painkiller epidemic. On some streets in the city, people both buy and use drugs out in the open. Walk down these streets, and you’ll be surrounded by the very real consequences of addiction at all times.
While the problem is touching both heterosexual and LGBTQ communities equally, officials in Philadelphia are looking for ways to help the minority community heal. The city has created a resource for residents that contains information about:
- Housing opportunities.
- Healthcare centers.
- Advocacy groups.
- Hate crime reporting.
All of the groups mentioned here focus specifically on the LGBTQ community, and none of the resources come with an entrance fee. People in the community would likely appreciate more entries on this page, but it does represent a good-faith beginning on behalf of officials.
In Florida, officials are focused on gathering data about both abuse and public perception. In one report, officials suggest that 80 percent of Florida residents agree that people in the LGBTQ community face discrimination within the state when it comes to:
- Health care
Florida officials don’t have the same type of focused web presence that directs people in the community to resources that can help. Florida is a big state with many residents, and it’s possible the state just doesn’t have the funds to either create or maintain a page of this size and breadth.
But quick searches can bring results that showcase just how much Florida knows that people in this community need help.
For example, in Orlando, a nonprofit organization called Two Spirit Health offers care for people in the LGBTQ community, provided by people who are also part of this community. Addiction treatment, as well as some general health care, is provided, and services are offered regardless of the ability to pay for them.
These are a few small examples of how communities are looking for ways to both support and encourage members of the LGBTQ community to get the help they need. But if you’re part of this group, you will need to make the final decision about where you should get care. And making the right choice can be complicated.
Principles of Effective Treatment
People in the LGBTQ community are people first. You have blood, bones, tendons, organs, nerves, and feelings — just like everyone else. And you deserve to have care that’s respectful of where you come from and what you’ve been through. That’s especially important when you’re looking for help with addiction.
An addiction is an illness of chemistry. Your brain cells and body are changed due to drug abuse, and they no longer function properly without those agents of change. As part of your healing, you’ll need to help your chemistry return to a new normal, so your cravings will lessen.
But you’ll also need to come to terms with what has happened to you and how your addiction started. That could mean dealing with:
- Were you subjected to teasing from classmates or family members? Was the torment physical?
- Self-hatred. Did you internalize homophobia? Does your inner voice attack you?
- Were you abused at some point in your life? Did you abuse someone else?
- Sad conversations. How did your coming out conversation go? Do parts of those talks haunt you?
Your treatment should take your preferences into account, and it should be sensitive to your trauma and your pain. There are differences of opinion among professionals about what a program like that might look like.
What to Look for in Treatment
Should you get care in a facility that’s made just for people in the LGBTQ community, or can you find care in a mixed setting? The answer to that question is very personal, and it’s one officials are debating.
According to the Center on Addiction, in 2007, some 854 treatment programs in the United States claimed to offer LGBTQ services, but only 62 actually had them when confronted by researchers. This means many places that say they provide unique care actually don’t do so.
But does it matter? Some researchers don’t think so. They say seeking out the few facilities that offer this care can mean stigmatizing yourself yet more, as well as isolating you from some solutions that might be both affordable and accessible. The key, these researchers say, is to investigate any option carefully.
You can do that, says Social Work Today, by looking for inclusive spaces. Does the facility you’re considering:
- Include open terminology on forms?
- Include images of LGBTQ people and symbols in posters and brochures?
- Come with good reviews from those in your community?
- Employ LGBTQ people?
- Let you use any pronoun you prefer?
As you interview people to care for you, says NAMI, you can:
- Ask about their experience working with LGBTQ people.
- Disclose your sexual orientation, and see if you feel safe doing so.
- Ask about votes of confidence from national LGBTQ organizations, such as the Association of Gay and Lesbian Psychiatrists.
- Ask about how your past might be worked into your treatment plan.
You should always choose the facility and the provider that makes you feel both valued and safe. If you find that provider within a facility that’s made for LGBTQ people, that’s great. But if you find the support and compassionate care you need in the community, that’s great too.
When it comes to your healing, you know where you feel at home. You can make the right choice and move toward a healthier future.