"I am a transgender man who had to leave my rehab early because of bullying. I have now been in two sober living houses and have struggled so much because of my trans identity. ... Sometimes I don't know how much more I can take of the personal attacks. ... I am trying to educate people that I am just another human needing help with my addiction. Not everyone understands or even agrees with that, and it's made recovery that much harder!" - Comments posted by a man from Portland, Maine, in response to an online article on addiction.
While the open discussion of identity and being LGBT has become more customary, those who identify as LGBT often exist silently - in the closet, in fear, ashamed, and sometimes suffering with addiction. Members of the LGBT community face a two-edged sword when it comes to addiction. The emotional stress that lesbian, gay, bisexual and transgender individuals often feel - including rejection, isolation and low self-esteem - as well as the threats of physical violence, prejudice and discrimination, make them vulnerable to addiction. At the same time, these factors decrease the likelihood that they will receive effective treatment. Too often, members of the LGBT community face internalized stigma and homophobia. These internal struggles with themselves can make it more difficult to seek out or achieve long-term recovery.
Studies have demonstrated that members of the LGBT community suffer a significantly higher incidence of drug addiction. According to the Center for American Progress, an independent, nonpartisan policy institute, an estimated 20 to 30 percent of gay and transgender people abuse substances, compared to about nine percent of the general population.
We know that providing specialty groups can offer people the safety of a treatment community that addresses their specific lifestyles and needs. The LBGT client can benefit from groups. When compared with their heterosexuals peers, LGBT individuals have been found to suffer significantly higher incidences of stressful childhood experiences, school victimization, neighborhood-level hate crimes and family conflict - stressors that correlate with increased substance abuse. Recently, we have all seen the trauma experienced by the LGBT community with the recent shooting at the Pulse nightclub in Orlando. The tragedy reminds LGBT individuals of the homophobia and hate that continues to shadow their progress. This kind of trauma and other factors play a role in this higher rate of addiction, including peer pressure in a social culture dominated by bars and clubs - where doing drugs and drinking is par for the course.
The nature of addiction is different, too. Gay and bisexual men have a higher propensity to abuse methamphetamines than heterosexual men, while lesbians and bisexual women are more likely to engage in hazardous drinking than heterosexual women. Members of the LGBT community are also more likely to suffer from mental illness. A 2014 study at the Hazelden Betty Ford Foundation found that 92 percent of LGBT patients had co-occurring mental disorders, compared to 78 percent of non-LGBT patients. Other studies have found that LGBT patients are two to three times more likely to report suicidal thoughts or attempts.
The good news is that members of the LGBT community seek treatment at a significantly higher rate than their heterosexual counterparts. The fact that they are more willing to seek treatment opens the door to improved outcomes through the development of addiction treatment plans that address the unique challenges they face. This is true even though LGBT individuals are likely to encounter the same prejudices in treatment that they do in the wider world and often end up at treatment centers that fail to address their needs and lifestyle. Treatment programs can do a better job by accepting their client's "family of choice," not one determined by blood or law, effectively restricting the patient's support system to the biological family who may have refused to accept their lifestyle - a key stress factor and potential driver of addiction. This can adversely affect their chances of success in recovery.
As we come to the end of LGBT Pride Month this June, it's important to turn our attention to the problem of addiction in the LGBT community and in particular to the demand for specialized treatment programs. There is a great need for safe and supportive treatment, with counselors who are affirming of LGBT individuals, and for treatment therapies that integrate mental health treatment, HIV and other medical conditions.
It's clear - both from the stories seen on the news and the stories of the people we treat - that addiction does not discriminate. Addiction can truly happen to anyone. We treat people of all lifestyles, demographics and socioeconomic statuses, all of whom have learned how similar their struggles are to each other's, and that they have more in common than they may have originally thought.
In his online post, the writer from Maine said: "I want to do what I can to make it so other trans people have a safe place to go in recovery." The LGBT community has been very effective at fighting for equality. Now it's time for us in the medical community to treat each person with the best chance for recovery, by providing better outcomes to the high rate of addiction by offering recovery programs that are sensitive to each individual's needs and lifestyle.
For more information on an addiction treatment program for those in the LGBT community, visit sunspirehealth.com.
Need help with substance abuse or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.