Substance abuse and addiction have been a widespread issue in the U.S. for decades. Still, these problems seem to affect some demographics more than others. For instance, the LGBTQIA community is significantly more prone to substance abuse and addiction than the general population.

In fact, substance abuse rates are more prominent within the LGBTQIA community than in any other demographic. Several studies support this, including ones from both Psychology of Addictive Behaviors and The American Journal of Public Health. The research shared in the latter journal shows that LGBTQIA individuals are four times more likely to develop a substance use disorder (SUD) after facing discrimination from others.

Overall, between 20 and 30 percent of the LGBTQIA population have reported problems with drugs or alcohol at some point in their lifetime. And, according to the Substance Abuse and Mental Health Services Administration (SAMHSA), only 8.4 percent of the general population reported the same issues.

About the LGBTQIA Community

Although the LGBTQIA community is vastly considered a minority, it is a lot larger than most people think. National surveys spanning over several years have suggested that as much as 11 percent of Americans identify as LGBTQIA. So, what exactly does it mean to identify as LGBTQIA?

LGBT

Lesbian: (n.) a homosexual woman

Gay: (n.) a homosexual man, or (adj.) sexual desire toward others of the same sex

Bisexual: (adj.) sexual attraction to both men and women

Transgender: (adj.) relating to a person whose gender identity is different from (and usually the opposite of) the sex the person was identified as having at birth

Queer: (adj.) sexual or romantic attraction that is not limited to any one person of particular gender identity or sexual orientation

Intersex: (n.) a person who has genital tissue that is characterized as both male and female or is ambiguous

Asexual: (adj.) not having sexual desire or attraction toward others, or (adj.) not having or showing a particular sexual identity; neither male nor female

Although society as a whole has demonstrated more acceptance of the LGBTQIA community in recent years, people who identify as any of the orientations listed above unfortunately still experience social stigma, discrimination, and other challenges that cisgendered heterosexual individuals would usually never face.

As a result, LGBTQIA individuals have a statistically higher-than-average risk of developing various mental and behavioral health issues, including substance abuse and addiction.

Drug and Alcohol Addiction Among the LGBTQIA Community

As mentioned earlier, LGBTQIA individuals are statistically more likely to experience addiction at some point in their lifetime as compared to cisgendered heterosexual individuals.

In fact, according to one study published in The American Journal of Public Health in 2010, the prevalence of any past-year SUD among gay men was 31.4 percent, more than twice the recorded percentage for heterosexual men (15.6 percent).

The statistical difference among women of varying sexualities was even more staggering. The same study revealed that the prevalence of any past-year SUD among lesbians was 25.8 percent— five times more than their heterosexual counterparts (5.8 percent).

The prevalence of addiction among bisexual men and women in 2010 was 27.6 percent and 24.3 percent, respectively.

Overall, the study highlighted that addiction rates in 2010 were more than twice as high among LBGTQIA adults (27.6 percent) as compared to cisgendered heterosexual adults (10.5 percent).

These statistics have not changed much in recent years.

LGBTQIA Alcoholism

Alcoholism is one of the most common forms of addiction because alcohol is legal, widely accessible, and relatively inexpensive.

This particular substance use disorder is also one that is frequently seen in the LGBTQIA community. In fact, SAMHSA revealed that LGBTQIA individuals statistically consume more alcohol than heterosexuals (63.6 percent versus 56.2 percent).

One study from SAMHSA highlighted that, in 2015, 10.8 percent of LGBTQIA individuals (or 1 in 10) had an alcohol use disorder. Meanwhile, only 6.1 percent of cisgendered heterosexual adults (or 1 in 16) had an alcohol use disorder.

Overall, LGBTQIA individuals in the U.S. are about twice as likely to struggle with moderate to severe alcoholism than their cisgendered heterosexual counterparts.

LGBTQIA Drug Abuse

According to data collected by the National Survey on Drug Use and Health (NSDUH) in 2015, the LGBTQIA population is more than twice as likely to have used an illicit drug in the past year as compared to the cisgendered heterosexual population.

This report found that 39.1 percent of adults who identified as gay, lesbian, or bisexual had used illicit drugs in the past year, while only 17.1 percent of cisgendered heterosexual adults did the same. Moreover, roughly 15.1 percent of the gay and bisexual individuals who participated in the 2015 NSDUH survey reported struggling with a substance use disorder in the past year.

Other studies that examine the prevalence of substance use and addiction among “sexual minorities” have found that LGBTQIA individuals are about 3.5 times more likely to use marijuana, 9.5 times more likely to use heroin, and 12.2 times more likely to abuse amphetamines than their cisgendered heterosexual counterparts.

Contributing Factors for Addiction Among LGBTQIA Individuals

“Substance use disorders [are] more prevalent among [LGBTQIA] adults than among heterosexual adults in the United States… Many studies have posited that [these] differences… are related to social stressors such as discrimination…”

—excerpt from The Relationship Between Discrimination and Substance Use Disorders Among Lesbian, Gay, and Bisexual Adults in the United States

Because of their gender identity or sexual orientation, LGBTQIA individuals often face bias, social stigma, discrimination, and other challenges. Even today, some find themselves on the receiving end of violent behaviors such as bullying, harassment, verbal or emotional abuse, and physical assault.

These issues, of course, can have an overwhelmingly negative impact on the overall health and wellness of LGBTQIA individuals. Moreover, these issues may drive some LGBTQIA individuals to abuse substances as a means of self-medication, escape, or possibly both.

In other words, addiction rates among the LGBTQIA community are most likely the result of drug or alcohol use as a coping mechanism for personal, public, and even professional discrimination. After all, an LGBTQIA person struggling with substance abuse and addiction is likely to have experienced multiple incidences of discrimination or other similar challenges.

According to the Centers for Disease Control and Prevention (CDC), LGBTQIA teens and young adults who are disowned by their families are three times more likely to use illegal drugs than those who have familial support.

Mental Health Disorders Among the LGBTQIA Community

Human sexuality is a spectrum. However, the world of medicine once labeled all forms of non-heterosexuality as mental illness.

It’s understandable, then, that many LGBTQIA individuals still feel rejected by society at large even when they have love and support from family and friends.

After all, the stigma attached to “sexual deviance” can lead to some intense feelings of fear and isolation— feelings that frequently drive people to substance use and, consequently, addiction.

The most common mental health issues that influence the likelihood of substance abuse and addiction among LGBTQIA individuals include:

  • Stress
  • Anxiety
  • Depression
  • Eating disorders
  • Suicidal ideations

LGBTQIA Stress

The LGBTQIA community as a whole is especially prone to stress. The American Psychological Association (APA) refers to this as minority stress, which “[stems] from stigma and prejudice experienced by [LGBTQIA] individuals and that place [them] at risk for adverse mental and physical health outcomes.”

Many studies have determined that minority stress can have lasting adverse effects on the mental health of LGBTQIA people. In fact, unaddressed minority stress can lead to extreme levels of anxiety, depression, anger, and other psychological and behavioral disorders within the LGBTQIA community.

These mental health issues, of course, increase the risk of substance abuse as a coping mechanism. And, where substance abuse exists, addiction soon follows.

LGBTQIA Anxiety

LGBTQIA people reportedly experience more frequent instances of anxiety than their cisgendered heterosexual peers. This is especially true for homosexual and bisexual men and women.

According to the Anxiety and Depression Association of America (ADAA), between 30 and 60 percent of LGBTQIA people deal with chronic anxiety, which is between 1.5 to 2.5 times more than their cisgendered heterosexual counterparts.

LGBTQIA Depression

In addition to facing higher levels of chronic stress and anxiety, LGBTQIA individuals are also three times more likely than others to experience depression.

In fact, discrimination against LGBTQIA people contributes to higher rates of clinical depression, post-traumatic stress disorder (PTSD), suicidal ideation, and substance abuse among that demographic.

LGBTQIA Eating Disorders

In addition to the increased likelihood of developing a substance use problem, many LGBTQIA people face a greater-than-average risk of developing an eating disorder.

In fact, research suggests that homosexual and bisexual adolescents aged 12 and older are more likely to engage in binge eating and purging (forced vomiting) than heterosexual adolescents in the same age group.

According to the National Eating Disorders Association (NEDA), one study that examined eating disorders among the LGBTQIA community found that gay and bisexual boys were significantly more likely to have purged, fasted, taken laxatives, or used diet pills to control their weight in the past month.

LGBTQIA Suicidal Ideations

The LGBTQIA community regularly suffers from severe cases of suicidal ideation and, even worse, suicide attempts.   

According to the National Alliance on Mental Illness (NAMI), LGBTQIA people— especially children and teens— are four times more likely than the general population to engage in self-harming behavior, think about suicide, or attempt suicide.

And, unfortunately, suicide remains one of the leading causes of death for LGBTQIA people between 10 and 24 years of age.

The LGBTQIA Community and Co-Occurring Disorders (Dual Diagnosis)

“People who suffer from depression and substance use disorders often fall into two categories. Either they assume that substances are their primary problem and perceive that all their misery stems from using [or they] only accept mental illness as their true, core underlying problem and dismiss substance use as only the consequence of depression, anxiety or PTSD. More often than not, neither of them are correct.”

—Dr. Petros Levounis, Dept. of Psychiatry at Rutgers New Jersey Medical School

According to SAMHSA, LGBTQIA adults not only face a higher risk of substance use disorder than cisgendered heterosexual adults but also a higher risk of co-occurring disorders, or dual diagnosis.

Most LGBTQIA individuals who have a dual diagnosis are struggling with a disorder— like the ones listed above— that either perpetuates active substance use or contributed to the development of the substance abuse problem in the first place. For example, transgender teens with substance use disorders are likely to also suffer from depression, an eating disorder, or possibly both.

Overall, LGBTQIA people who struggle with addiction are more likely than the general population to have one or more co-occurring disorders.

Because of this, it is imperative that addiction treatment professionals take extra time to screen LGBTQIA patients to identify any other mental, physical, or emotional problems that should be concurrently addressed during rehab.

Increasing Demand for Drug and Alcohol Rehab for the LGBTQIA Community

“Substance abuse treatment programs that are LGBT sensitive are more likely to have more successful outcomes with LGBT clients.”

—excerpt from A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals

Several studies from various sources have established that the LGBTQIA community is more prone to addiction and co-occurring disorders than most other demographics. However, unlike most others, LGBTQIA people are not shy about reaching out for help.

A report from SAMHSA found that, while LGBTQIA adults are more likely to develop addictions, mental health issues, or dual diagnosis, they are also more likely than their cisgendered heterosexual peers to seek treatment.

Still, the same issues that pushed them toward substance abuse may also be keeping them from finding the best possible help. Right now, only 7.4 percent of rehab programs have specialized treatment services for LGBTQIA patients.

Thankfully, more and more rehab facilities are starting to implement specialized options for members of the LGBTQIA community who come forward for treatment.

Drug and Alcohol Treatment Options for the LGBTQIA Community

While LGBTQIA-centric treatment options are still expanding, anyone struggling with addiction or dual diagnosis would benefit from:

These, plus aftercare services, make up the full spectrum of care in rehab and addiction recovery. Each of these treatment options offers different benefits that can help LGBTQIA patients get and stay sober.

LGBT

Group meetings like Alcoholics Anonymous (A.A.) and Narcotics Anonymous (N.A.) are also helpful during the recovery process. Most rehab facilities hold their own group meetings, but A.A. and N.A. meetings can be found virtually anywhere in the U.S.

Outcomes for LGBTQIA Individuals in Recovery

“With [the] advancement of societal acceptance of [LGBTQIA] orientations, and the new generations internalizing less homophobic beliefs, we should see a decrease in the rates of substance use.”

—Dr. Petros Levounis, Dept. of Psychiatry at Rutgers New Jersey Medical School

Respect, compassion, and understanding are critical components of addiction recovery. For the LGBTQIA community, finding the right treatment program for a substance use disorder, a mental health disorder, or both can be challenging.

Thankfully, more and more rehabs are creating more inclusive options for LGBTQIA patients.

For more information about addiction treatment options for members of the LGBTQIA community, contact us here or call us at (833) 369-6443.

References:

Brenner, B., & The Anxiety and Depression Association of America (ADAA). (n.d.). Understanding Anxiety and Depression for LGBTQ People. Retrieved from https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/understanding-anxiety-and-depression-lgbtq

Centers for Disease Control and Prevention (CDC). (n.d.). Stigma and Discrimination Affects Gay and Bisexual Men’s Health. Retrieved from https://www.cdc.gov/msmhealth/stigma-and-discrimination.htm

Laumann, E. O., Gangon, J. H., Michael, R. T., & Michaels, S. (2000). The Social organization of sexuality: Sexual practices in the United States. Chicago: University of Chicago.

Linhares, D. (2016, June 21). Commentary: Substance Abuse in the LGBT Community. Retrieved from https://www.nbcnews.com/feature/nbc-out/substance-use-problems-lgbt-communities-n595641

McCabe, S. E., Bostwick, W. B., Hughes, T. L., West, B. T., & Boyd, C. J. (2010, October). The relationship between discrimination and substance use disorders among lesbian, gay, and bisexual adults in the United States. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2937001/

Medley, G., Lipari, R. N., & Bose, J. (2016, October). Sexual Orientation and Estimates of Adult Substance Use and Mental Health: Results from the 2015 National Survey on Drug Use and Health. Retrieved from https://www.samhsa.gov/data/report/sexual-orientation-and-estimates-adult-substance-use-and-mental-health-results-2015-national

Meyer, I. H. (2015). Individual versus community resilience in minority stress of lesbians, gay men, and bisexuals. Psychology of Sexual Orientation and Gender Diversity. Retrieved from https://www.apa.org/pubs/journals/special/6190205

National Alliance on Mental Illness (NAMI). (n.d.). LGBTQ. Retrieved from https://www.nami.org/Find-Support/LGBTQ

National Eating Disorders Association (NEDA). (2018, February 21). Eating Disorders in LGBTQ Populations. Retrieved from https://www.nationaleatingdisorders.org/learn/general-information/lgbtq

National Institute on Drug Abuse (NIDA). (2017, September 05). Substance Use and SUDs in LGBT Populations. Retrieved from https://www.drugabuse.gov/related-topics/substance-use-suds-in-lgbt-populations

SAMHSA Report Shows Higher Rates of Substance Use & Mental Illness Among Sexual Minority Adults. (n.d.). Retrieved from https://www.ncadd.org/index.php/blogs/in-the-news/samhsa-report-shows-higher-rates-of-substance-use-mental-illness-among-sexual-minority-adults

Substance Abuse and Mental Health Services Administration (SAMHSA). (n.d.). A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals (HHS Publication No. (SMA) 12–4104). Retrieved from https://store.samhsa.gov/system/files/sma12-4104.pdf

Wolitski, R. J., Stall, R., & Valdiserri, R. O. (2008). Unequal Opportunity: Health Disparities Affecting Gay and Bisexual Men in the United States (Alcohol, tobacco, and drug use among gay and bisexual men). New York: Oxford University Press. Retrieved from https://books.google.com/books?id=3_j212m0HNwC&printsec=frontcover&dq=unequal+opportunity&hl=en&sa=X&ved=0ahUKEwjdv-SghLLiAhUNyFkKHY6_DqAQ6AEIKDAA#v=onepage&q=unequal%20opportunity&f=false