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There are all manners of people on this planet, however, not every person is fortunate enough to experience the same treatment and measures of acceptance from everyone they meet. The Substance Abuse and Mental Health Services Administration reported in October of 2016, that their National Survey on Drug Use and Health (NSDUH) found that within the United States adult population, 4.3 percent consider themselves to be either gay, lesbian, or bisexual.

The report did not examine transgender individuals, thus this number was not included in that statistic. However, looking at information published in early summer of 2016, The Williams Institute reports on information sourced from the 2014 Behavioral Risk Factor Surveillance System, citing that roughly 0.06 percent of U.S. adults, or 1.4 million Americans identify as transgender.

In a world where they are the minority, LGBT persons come from all different backgrounds, walks of life, races, ethnicities, socioeconomic status, spiritual beliefs, and are located all over the world. While confronting challenges that heterosexual individuals do not face, the LGBT person has a whole new set of internal struggles they often deal with. While frequently facing feelings of displacement or rejection, many LGBT individuals are striving to find where they belong, and commonly face many hurdles, hurts, and challenges along the way. It is these struggles that often push an LGBT individual towards drug or alcohol abuse.

A Unique Set Of Concerns

Due in large part to the vast uncertainty, instability, and myriad of challenges that many LGBT individuals face on a daily basis, they often struggle with emotional and mental health challenges. Even though public support and acceptance has dramatically increased in recent years, many individuals still face a discrepancy in the way they are treated in their day-to-day life experiences, in comparison to heterosexuals. Here we explain some pertinent areas of concern that may influence substance abuse risk, and thusly must be considered as a person seeks and encounters treatment.

In Youth

LGBT youth are at a greater risk of experiencing emotional and mental duress. One U.S. National Library of Medicine publication, “Mental Health in Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth,” wrote that these youth experience “elevated rates of emotional distress, symptoms related to mood and anxiety disorders, self-harm, suicidal ideation, and suicidal behavior.” This paper cited a specific study from Australia that found that these youth “experienced more major depression, generalized anxiety disorders, substance abuse/dependence, and comorbid diagnoses.” Mental health disorders and emotional dysregulation are often linked to substance abuse.

Minority Stress Theory

This term refers to the often constant and long-term stressors that LGBT individuals encounter, starting even at young ages; it is also at times termed “LGBT-related stress.” Confronting what is still too widespread, in terms of stigma, prejudice, homophobia, victimization, bullying, and discrimination, LGBT individuals of all ages may experience lives that are impeded and negatively influenced by these things, in a manner that alters their life for the worse. On top of this, the expectation of these things happening creates yet more fear, set against stress of either hiding or coming out with their orientation.

Many of these individuals begin to manifest serious mental health disorders, which may lead them to other harmful scenarios, including suicidal ideation, homelessness, and ultimately for some, substance abuse or addiction.

Mental Illness

This community witnesses higher instances of certain mental illnesses as certain issues and stressors are more present within the LGBT population. The National Alliance on Mental Illness (NAMI) reports that “LGBTQ individuals are almost 3 times more likely than others to experience a mental health condition such as major depression or generalized anxiety disorder.” Mental health concerns go beyond these, including, as the CDC notes, a higher risk of bipolar disorder occurring in gay and bisexual men. “Building Bridges: LGBT Populations: A Dialogue on Advancing Opportunities for Recovery from Addictions and Mental Health Problems,” writes that lesbian women suffer from “simple phobias, and posttraumatic stress disorder,” more than the general public. Other disorders may also exist.

Trauma

Instances of experienced trauma are altogether too high within this population. LGBT individuals may have been the victim of a domestic violent crime or hate crime, events that may drastically influence their mental and emotional state, and treatment.

In addition, for those that struggled during childhood or within their youth, they may have experienced these acts, and even sexual, physical, emotional, or mental abuse. This abuse may also occur as an adult within this population, which may push a person towards drugs or alcohol, however, studies show that childhood abuse increases a person’s risk towards developing substance abuse or addiction.

Lesbian women are shown to experience a specific risk, as elaborated by “A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals.” It informs us that research has found “that adverse, punitive, and traumatic reactions from parents and caregivers in response to their children’s sexual orientation were closely correlated with poor mental health and an increase in substance use.”

It is reported that transgender individuals may experience trauma in a greater capacity than other individuals within this population, which may, as noted in the aforementioned provider’s guide, “influence a transgender client’s ability to complete and maintain successful recovery from substance abuse.” The “Building Bridges” report offered specifics on this travesty, citing “that more than 50% have experienced some type of harassment or violence, or both, during their lives, and 25% reported experiencing a physically violent incident.”

Suicide

Suicide attempts are a deep concern with LGBT youth. The U.S. National Library of Medicine paper’s authors went on to chronicle the extent of the suicide risk within this age group, referencing an American study that found in comparison to national rates at 4.1 percent, 31 percent of LGBT youth reported having had suicidal behaviors within the course of their life.

Another high-risk population are transgender individuals of any age. A second Williams Institute publication found that respondents of the National Transgender Discrimination Survey had a 41 percent rate of suicide attempts, which is nearly ten times higher than the national average of 4.6 percent (over the course of a person’s lifetime). Their publication also noted that lesbian, gay, and bisexual individuals had a 10 percent to 20 percent chance.

Homelessness

Homelessness in LGBT youth is far too prevalent. Many who are heterosexual don’t face these great obstacles in their young life. Compared to heterosexual youth, LGBT persons who have faced homelessness have a far higher percentage of abuse with mental and substance use disorders. The National LGBTQ Task Force tells us that in youth, this number is especially disproportional, as up to 40% of runaway or homeless youth identify as LGBT. Though faced with these challenges, many of these youth are still very creative and strong individuals.

Adults are not immune from this concern. The Task Force continues, reporting that homelessness has been a concern to almost one in five transgendered individuals. The National Coalition for the Homeless writes that “43% of clients served by drop-in centers…30% of street outreach clients…and 30% of clients utilizing housing programs identified as LGBT.” This aspect of LGBT need creates another facet of care—individuals in rehab often require assistance finding safe and stable housing options.

Each of the above concerns puts a person at a greater risk of developing a substance use disorder. People that start drinking alcohol as youth have a higher risk of developing an alcohol addiction later in life, and people who use drugs at this age also experience an increased danger of having issues of abuse and addiction as adults. Suicidal ideation often creates these issues, and use of these substances can also perpetuate these thoughts. Homelessness is a known factor in contributing to substance abuse, as well as also being caused from it in certain cases.

LGBT Drug And Alcohol Abuse

Beneath these struggles, and often due in part to them, LGBT persons are known to have higher rates of alcohol consumption and substance abuse. The Substance Abuse and Mental Health Services Administration’s NSDUH Data Review did not entail findings on transgender individuals. To supplement this, we cite findings of another report specific to transgender needs, that asserts “26% use or have used alcohol and drugs to cope with the impacts of discrimination.”

The SAMHSA report found that adults who are lesbian, gay, or bisexual (referred to as sexual minority adults) had a much higher rate of substance use and mental illness than the heterosexual adult. Specifically, it found that “Sexual minority adults were also more likely than sexual majority adults to have substance use disorders in the past year, including disorders related to their use of alcohol, illicit drugs, marijuana, or misuse of pain relievers.”

In terms of percentage, this report found that this group had nearly double the occurrence of past year instances of substance use disorders, with 15.1 percent versus the 7.8 percent that sexual majority adults witnessed. Other sources cite these rates as even more discrepant, and even higher, with NAMI reporting that LGBTQ individuals may see what is estimated to be as high as 20 percent to 30 percent, versus nine percent for heterosexuals.

Within the NSDUH findings, SAMHSA reported on the following:

Tobacco

Despite the fact that sexual minority adults reported higher past month use (32.2 percent in comparison to 20.6 percent for heterosexuals), their daily use was lower than their heterosexual counterparts, by 8 percent. However, the daily rate was still high, with 51.6 percent of sexual minority adults smoking. Countering this, however, other reports show smoking rates for LGBT individuals to be almost double the amount of heterosexuals.

Alcohol

The SAMHSA report cites that sexual minority adults cite higher rates of past month drinking, of a 7.5 percent difference (63.6 percent compared to 56.2 percent). They elaborated, noting that sexual minority females saw higher risks, exhibiting increased rates of current, binge, and heavy drinking, whereas, sexual minority males were actually similar to the heterosexual statistics. In terms of alcohol abuse as a whole within this population, NAMI cites that a quarter of LGBTQ individuals struggle, in comparison to only five percent to ten percent of the general population.

Illicit Drug Use

This is the highest percentage difference among the categories surveyed, with SAMHSA reporting that 39.1 percent of sexual minority individuals were found to have used illicit drugs in the past year, in comparison to 17.1 percent of the heterosexual population surveyed. Certain drugs of abuse ranked higher within this population, with marijuana use ranking highest, at nearly a third (30.7 percent). The top ten illicit drugs used within the past year as reported by SAMHSA include:

Keep in mind, these numbers reflect past year use, not necessarily patterns of abuse, however, use and misuse of illicit drugs, in any capacity has a strong likelihood of leading to a greater form of drug abuse, and an increased risk of developing an addiction.

What Is Needed For The LGBT Community?

In order to decrease instances of substance abuse and addiction within this community, stronger preventative measures need to be put in place alongside of greater education, resources, and treatment. Fortunately, momentum in these aspects has been great, and today a variety of options exist. In order to better understand the direction this care needs to take, we will speak of specific concerns that individuals, their loved ones, and providers need to be mindful of when seeking and implementing treatment.

As we’ve witnessed, LGBT individuals within this age are already faced with extensive measures of mental and emotional strife, including increased risks of substance abuse. Again, individuals within this age bracket that begin using drugs or alcohol experience a greater likelihood of a problem during adulthood. In order to counter the various risk factors that these youth face, we must be conscientious about providing them with preventative measures.

Getting information on sexual orientation and gender identity to parents and caregivers, within early childhood development, can help the overall health of these LGBT children and adolescents. Helping parents and caregivers to support their LGBT children will give further clarity and insight, increasing the overall health and protection of these individuals before they reach out to substances. Rejection from family creates grave health concerns with LGBT children and adolescents, including increased risks of substance abuse.

Transgender Individuals

Individuals within this group have certain needs that need to be addressed both within individual counseling sessions and treatment as a whole, in order to ensure that treatment is effective and sensitive with lasting results. These individuals may have trauma in their life, as many others within the LGBT community, however certain concerns may be higher. For instance, the provider’s resource we spoke of earlier notes that transgender individuals may “have been prostitutes or sex workers, resulting in clinical issues that can also block recovery if they are not adequately addressed.”

Within their treatment, a transgender person may require that certain needs be addressed. Some of these individuals may be transitioning, and they may be taking hormone therapies; this warrants greater medical support and attention, and also increased mental support during this time. Staff needs to be mindful of sleeping or bathroom arrangements, as these individuals may desire certain care or access that is not present in every facility. Lastly, transgender persons may desire a certain pronoun to be used, thus providers need to be conscientious and open to this. All of these issues must be brought to light, in order to help a transgender person towards feeling the comfort, acceptance, and attention that is needed for positive transformation within treatment.

Consideration Of Co-Occurring Disorders

As we’ve outlined, mental illness within LGBT groups is of significant concern and prevalence. Whether it be depression, anxiety, PTSD, trauma, or other concerns, care needs to be specific to each within the spectrum of substance abuse treatment. Trauma is of immense concern, as the specific history and nature of the event(s) may alter and even impede treatment for some. Due to this, providers within a good program will thoroughly assess this and any other mental health disorders, in order to fully embrace each client and adapt to their unique needs.

To reiterate, mental health disorders put any person at greater risk of developing a substance use disorder. Paired with the variety of other daunting concerns this population may face, this risk is even more worrisome. Substance abuse and addiction may also aggravate an existing mental health condition, or in some cases, precipitate one, giving even more urgency to the importance of accessible dual diagnosis care that takes into account this population’s unique needs, perspectives, and varied histories.

Embodying Sensitivity

A treatment program should be sensitive to the sexual orientation and/or gender identity of the individual. Every staff member that encounters these individuals will need to understand the background of the client’s feelings about his or her sexual identity and/or gender preference paired with LGBT issues. In order to increase the inclusive and welcoming nature of treatment, a good program should also employ LGBT individuals to offer greater empathy and shared experiences, both of which can make a vast difference within treatment.

The LGBT client may hold deep feelings and negative attitudes, such as feelings of fear, confusion, doubt, or sadness from the rejection, insensitivity, and discrimination they’ve faced within their life. Due in part to this, they may distrust or feel uncomfortable with health care professionals. To balance this, treatment may require even greater sensitivity, patience, and individualized care from the substance abuse treatment provider, versus what is typical within general treatment.

Breaking Down Barriers

Effective and compassionate care must be made even more accessible. To break down the barriers between client and counselor, the issues we’ve discussed must be addressed for the individual to firstly gain help, and secondly glean the full benefit of treatment. Allowing for groups to be inclusive, so that the LGBT client will feel safe in openly discussing his or her needs, is of utmost concern.

Rehab may occur within a facility that is LGBT only, or in a program that has designed a specific treatment approach for this population. In optimal cases, through guidance of a trained and educated staff, LGBT clients may have a powerful encounter of gaining love, support, and acceptance from both their LGBT and non-LGBT peers alike.

All questions and interactions geared toward the LGBT client should be met with sensitivity and compassion. A snide, insensitive, or careless remark toward a LGBT person can have devastating repercussions. A counselor must carefully uncover the specific needs of each of their clients, or they may miss a key factor that is essential in creating a positive and safe atmosphere. All of these issues need to be brought into light to help bring sobriety and recovery goals closer.

Family Support And Therapy

Access to this care is essential in both youth and adult populations. Due to the varied, and at times complicated history that is associated with this lifestyle, especially situations that may have surrounded coming out, LGBT people can greatly benefit from the additional support of integrated family therapy and counseling, should they choose. In addition to helping them learn better coping and interpersonal skills that may be useful with their family, these programs will strengthen their family in better supporting them during their recovery journey.

Acknowledging and understanding what could be many potential and multifaceted differences within family relations are key to helping a LGBT individual recover. Integrating the external concerns and unique challenges same-sex couples face is also needed. Many of these clients will have children, either through a previous heterosexual marriage, or with their current partner through adoption, a sperm donor, or other means. This also provides certain challenges that impact an individual, thus, some individuals may require help with their parenting issues as well.

Consideration Of Health Issues

Due to the perceived stigma and discrimination of LGBT individuals, many clients may have long avoided treatment and neglected their health. Since some of the mental and physical health concerns are sensitive to a LGBT person, they may shy away from a typical health care provider. Thus, these individuals may neglect their needs, resulting in a late diagnosis and incomplete treatment. Good treatment should help a person in learning how to reinvest in their self-care and address any issues that are specific to their lifestyle choices.

When entering into treatment, a LGBT person may face a variety of health issues. As with any substance abuse treatment, these individuals need to be screened for other health problems. Like many clients in recovery from substance abuse, a LGBT person may face a co-occurring mental health disorder that impacts their physical health as well, such as an eating disorder or instances of self-harm. Treatment that is adept at addressing both the physical aspects and mental ramifications of these concerns is essential.

Abusing substances can lead to other health risks. Due to the lifestyle of some within the LGBT community, HIV/AIDS and hepatitis B and C may be more prevalent, these concerns are further compounded by various drugs of abuse which also increase these risks. Substance abuse may lead to, or aggravate existing health conditions, including malnourishment, a weakened immune system, and a variety of illness and disease. For all of these reasons, a good treatment facility should be able to concurrently address these issues as well.

Aftercare Support And Relapse Prevention

These aspects of treatment and continued support are crucial for any person, however, they may be even more critical for an LGBT individual. Aftercare support and relapse prevention help to further strengthen a person within their recovery and prepare them for the life they face after treatment. To protect these individuals from relapsing, a prevention plan, coping skills, and thorough understanding of the varied life of a LGBT person after rehab should be addressed.

For a heterosexual individual, many of the concerns that aggravated substance abuse or addiction may have been treated prior to, or during treatment, however, due to the nature of an LGBT lifestyle, these individuals may yet encounter an excess of struggles, challenges, and stressors after treatment that a heterosexual person does not. Aftercare support can offer priceless outreach and connect a person to various support groups that may help them during this time.

Support Groups

Support groups are very commonly referred to both within treatment, and after, during recovery. Their necessity may be of even greater import for the LGBT community. In addition to providing drug and alcohol support, these groups may support individuals in the unique concerns and journeys that face LGBT persons on a day-to-day basis. Increasing access to support groups that offer substance abuse support paired with an inclusive LGBT focus can make this care even more effective. These groups may be either 12 step or non 12 step, and follow any number of faith-based or secular perspectives.

And Compassionate Treatment

As we’ve illustrated, the treatment needs for the LGBT community are as diverse and varied as the individuals within it. Due to these numerous, and many times intense needs, effective and compassionate evidence-based treatment is necessary, to the extent that the NSDUH review tells us that the sexual minority population had a greater need of treatment overall than did heterosexuals.

The numbers speak for themselves—the review continues, telling us that 1.7 million sexual minority adults needed treatment, and that only 340,000 individuals received it. Keep in mind, this number doesn’t include transgender individuals, so the number for the community as a whole would be even larger. It is important to note, that even within the heterosexual population, there is a huge discrepancy within these numbers. The good news is that the review wrote that sexual minority persons were more inclined than the heterosexual adult to get the needed treatment for mental illness and/or substance use disorders.

Depending on the scope of abuse, and presence of any co-occurring disorders or other health and medical concerns, a person may need either outpatient or inpatient drug rehab. Oftentimes, in more severe cases, either in terms of abuse and/or these dual diagnosis concerns, a residential inpatient program is the best option to deliver more thorough and intensive treatment and support. This allows a person to spend ample time having their co-occurring disorders treated as well.

Another positive to inpatient treatment, is that it allows a person to step away from the demands and challenges of their life—of which for LGBT individuals there may be many—to focus entirely on their treatment. Some programs even allow you to travel out of state to unique locations, to provide you with even greater distance and privacy.

Again, a person may seek an LGBT-only program, or another program that is well-versed towards offering compassionate, inclusive LGBT-friendly care. The choice is dependent on a person’s life circumstances, notably including the variety of concerns and struggles we’ve noted here. The spectrum of options vary from luxury rehabs to executive programs that offer people the benefit of being able to stay in touch with the demands of their career.

What Treatment Entails

Within these programs, a person will have access to individual, group, or family therapies as well as a variety of other modalities and therapeutic methods that vary facility to facility. Firstly, a person may have to undergo a medical detox. Common therapies include, but are not limited to:

Motivational Interviewing (MI)

This progressive and intuitive method allows caregivers and staff to thoughtfully assess a person’s situation, while allowing for a non-confrontational approach that is based on empathetic and reflective listening. This method acknowledges that a person has the internal directive and ability to change, and will help direct a person towards finding, and embracing this power for positive transformation.

Cognitive Behavioral Therapy (CBT)

A type of psychotherapy, or talk therapy, this approach has been shown by countless studies to be highly effective in treating a variety of addictions as well as co-occurring disorders. Within these sessions, a person will learn to identify negative and harmful thought patterns as a way to empower themselves towards making positive changes to their behavior, while reacting in a more healthy way to the challenges of their life.

Dialectical Behavioral Therapy (DBT)

Originally created as a way to treat borderline personality disorder, this treatment is yet highly effective for this, as well as treating substance abuse with or without co-occurring disorders. This therapy helps a person towards both accepting their circumstances and creating the motivation for change. Through your sessions, you will learn to work through your thoughts, emotions, and behaviors in way that helps you towards isolating and changing maladaptive patterns. You will then learn coping skills and constructive ways which allow you to more effectively handle the challenges that rehab and recovery present.

Medication-Assisted Therapies

Originally created as a way to treat borderline personality disorder, this treatment is yet highly effective for this, as well as treating substance abuse with or without co-occurring disorders. This therapy helps a person towards both accepting their circumstances and creating the motivation for change. Through your sessions, you will learn to work through your thoughts, emotions, and behaviors in way that helps you towards isolating and changing maladaptive patterns. You will then learn coping skills and constructive ways which allow you to more effectively handle the challenges that rehab and recovery present.

Begin Anew, Find Solace, And Seek Help

If you or a loved one is a LGBT person suffering from a drug or alcohol addiction, please contact us now for more information. Today, many more opportunities exist to provide you with treatment that suits your unique desires. Our caring staff understands that you have a complexity of needs and circumstances that warrant individualized care. We can help you to find treatment options and discuss any other concerns you may have about the process, including financial considerations. RehabCenter.net is committed towards helping you find better balance, health, wellness, acceptance, and sobriety.

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