ARTICLE OVERVIEW: A look at barriers to treatment in the LGBT community and the unique need for clinicians to adapt treatment styles accordingly.
ESTIMATED READING TIME: 7 minutes
TABLE OF CONTENTS:
- Alarming Amounts of Discrimination
- The Sobering Statistics
- Coping with Trauma
- Seeking Sobriety
- Finding Qualified Help
- How You Can Help
Alarming Amounts of Discrimination
Members of the LGBT+ community face public scorn, discrimination, and even violence at levels only imagined by their heterosexual peers. Some face additional ostracism from those who should support them the most, their families.
Indeed, even though LGBT+ youth represent only 7 percent of the overall population, they comprise 40 percent of the homeless population, often because of being kicked out of their homes by close-minded parents.Additionally, hate crimes have risen at record rates over the past two years. In 2017 alone, trans-phobic criminals murdered 29 people identifying as transgender.
With the terrifying realities members of the LBGT+ community face, it should come as no surprise that they suffer from higher rates of substance addiction. Many people identifying as anything but cis or hetero often turn to drugs and alcohol to cope with the bias and hatred they face on a daily basis.
The Sobering Statistics
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, defines substance abuse disorder as the recurrent use of alcohol or drugs to the point where usage causes health problems and an inability to meet major work and personal responsibilities. Treating substance abuse disorders costs millions annually, but the heaviest price gets paid in human suffering, both by the addict and those who love them.
Members of the LGBT+ community face a two to three-time higher risk of suicide than their hetero and cis peers. Younger members of the LGBT+ community experience higher risks of homelessness, sexually transmitted diseases such as HIV and mental health disorders, including substance abuse. Older members of the community often face isolation, untreated health issues and loneliness, as even quality care facilities often lack knowledge in helping members of this population.
Further frustrating matters, discrimination prevents many LGBT+ individuals from obtaining equal housing opportunities, job opportunities, and access to health insurance and critical social services.
Coping with Emotional Pain and Trauma
Members of the LGBT+ community can experience trauma simply from the process of coming out to friends and family. Research shows that LGBT+ children whose families reject them after coming out are four times more likely to become involved with drug addiction. Indeed, when traditional avenues of self-help provide little relief, frustrated members of the LGBT+ community increasingly turn to the bottle or illicit drugs as a survival mechanism.
Numbing the pain, even for only a little while, seems preferable to facing the hatred they encounter daily, even if that relief comes with the high price tag of broken relationships, careers and dreams.
According to the U.S. Census Bureau, LGBT+ individuals between the ages of 18 – 64 report higher levels of binge drinking than their cis and hetero peers. The National Center for Disease Control and Prevention defines binge drinking as the downing of more than five drinks for men or more than four drinks for women over a two-hour period, raising their blood alcohol to levels in excess of .08 percent.
In addition, members of the LGBT+ community try illicit drugs at twice the rate of members of the hetero and cis-gendered community. As many illegal substances such as crystal meth and crack cocaine cause near-instant addiction in many individuals, the rate of drug abuse by members of the LGBT+ community has climbed sharply.
Finally, members of the LGBT+ community use tobacco at a rate 200 times higher than the general population. An irrefutable link exists between rates of tobacco usage and the risk of developing lung cancer as well as other forms of cancer. When coupled with the lower levels of health insurance coverage, if any, that many members of the community possess, it’s easy to see why countless lives are lost for no reason.
Seeking Sobriety
One silver lining to the dark cloud of the rate of substance abuse by LGBT+ community members is the fact that members remain more likely to seek professional help.
However, even when they do reach out for aid, they encounter additional difficulties.
Historically, treatment for substance abuse disorders made few allowances for the unique pressures faced by members of the LGBT+ community. A one-size-fits-all treatment approach neglects realities such as socioeconomic pressures and hate crimes experienced by individuals not conforming to traditional sexual orientation or gender roles.
Another issue members of the LGBT+ community face involves the lack of adequate research studies directed toward discovering additional reasons why so many people who don’t identify with sexual and gender norms turn to substance abuse at higher rates than heterosexuals. In addition, to date, no studies have focused on the reasons why bisexual women often struggle with substance abuse issues.
Finding Qualified Help
People identifying as members of a sexual minority may find themselves struggling to find qualified help for their disorders. While attitudes have progressed for the most part, unfortunately, some mental health professionals still regard members of the LGBT+ community as having made a lifestyle choice instead of following a biological imperative. They exhibit less empathy, making it more difficult for patients to truly connect at a therapeutic level.
So, even when members of the community do access services, they’re often met with counselors, doctors and social workers who fail to recognize their unique needs.
Negative past experiences with mental health professionals who sought to change their individual identity may give some members of the LGBT+ pause when it comes to reaching out for assistance. As they base their fears on life experience, overcoming their previous conditioning to avoid certain people and situations can be difficult to overcome.
Proper therapeutic care can ease the stress of disclosing one’s identity, but only if the therapist exhibits genuine empathy and supportive care.
Some research points to the fact that treatment programs specifically designed for members of the LGBT+ community can help alleviate substance abuse disorders more effectively than traditional approaches. In addition, support groups targeted specifically to those identifying as sexual minorities can help members of this population form a strong, positive support system as they go through recovery.
Clinicians Require Sensitivity Training
Therapy geared toward treating members of the LGBT+ community requires a safe, nonjudgmental atmosphere. Fortunately, treatment facilities specially designed to treat LBGT+ individuals now exist. Many programs support inpatient and outpatient programs exclusively geared toward sexual minorities to aid in the addiction recovery process.
Therapists working with this population must receive training on the unique challenges presented by this treatment group.
Drug treatment often begins in the emergency room following an overdose. As such, all hospitals should implement comprehensive training programs intended to educate medical professionals as to cultural sensitivities unique to the LGBT+ community.
What are some other training requirements for clinicians?
Because substance abuse disorder frequently involves co-morbid conditions such as anxiety and depression, addressing these underlying issues should go hand in hand with treatment for the addiction itself. Both anxiety and depression can be alleviated with the help of appropriate medications and cognitive behavioral therapy.
Due to the increased risk of suicide among LGBT+ individuals, all hospitals and doctors’ offices should administer regular suicide screenings to all patients. By identifying those most at risk of suicidal ideation, we can save many lives.
Schools, too, can do much to support their students who identify as LGBT+. Few anti-bullying laws currently exist, but learning institutions should implement comprehensive anti-bullying programs on campus. In addition, all school counselors should receive training on exhibiting sensitivity toward this cultural group.
How You Can Help
While few of us can claim mental health professional status, all of us can make a difference in supporting LGBT individuals as they get clean. Here’s how you can get involved to support those in recovery.
1. Become an ally.First, identify yourself as an ally. You never know when a co-worker may feel discriminated against at work, for example, but refusing to participate in homophobic jokes or banter and especially speaking out against it may show a closeted individual that you care. Report blatant acts of discrimination to your human resources department.
2. Educate yourself about the warning signs of addiction. These include behavioral changes, struggles at home or work, increased isolation so that substance abuse can take place in private, and increased irritability or explosive behavior. Physically, look for red, bloodshot eyes, changes in body weight without corresponding changes in diet and exercise, and poor attention to personal hygiene.
3. Be recovery oriented.If you personally know someone struggling with addiction, avoid triggering them. Instead of suggesting getting together at the local pub, suggest alcohol-free activities such as going bowling or playing miniature golf.
4. Listen without judgment. We all need people we feel safe confiding in, and allowing your loved ones to vent without criticizing them or even interrupting them goes a long way toward making isolated individuals feel less alone.
5. Get politically active. Contact your elected representatives and urge them to pass the Employment Non-Discrimination Act, which would prohibit discrimination based on sexual orientation and sexual identity to all government employees as well as all private employers with more than 15 workers. Urge them to also support the Housing Opportunities Made Equal Act, which would prohibit discrimination on the basis of real or perceived sexual orientation or identity reasons in residential real estate transactions. In addition, the Health Equity and Accountability Act addresses disparity in health care access.
Overcoming addiction takes time, work, and love. The increased societal pressures members of the LGBT+ community face provide tougher roadblocks on the road back to health. However, recovery is possible! With the aid of a strong support network and quality trained medical intervention, members of sexual minority groups can tackle their addictions and live their best lives free from drugs and alcohol.
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