Substance Abuse Treatment with LGBTQ Individuals

Today, we see more awareness and a greater acceptance of diversity in gender and sexual orientation. However, we still have a long way to go. Marginalization of the LGBTQ community does still exist which contributes to higher rates of substance abuse. Some estimates suggest that 30% of those in the LGBTQ community struggle with some form of addiction. While working with LGBTQ in the substance abuse community involves the same general approaches as with those who are heterosexual, it is important for a therapist to be culturally sensitive. Gay affirmative therapy is a model of treatment used when working with the LGBTQ community. Asking about a client's sexual orientation and understanding sexuality is important. A gay-friendly substance abuse treatment program and one that is culturally sensitive is essential for clients identifying as LGBTQ.

Sexual Fluidity

Many clients will identify as having one sexual orientation, and others may be more sexually fluid, meaning that it can change over time. After all, sexual orientation exists on a continuum that ranges from exclusive homosexuality to exclusive heterosexuality and includes different forms of bisexuality.

Therapists need to be educated and culturally sensitive

For therapists, if you do not understand different aspects of sexuality and sexual orientation, then do some reading, attend workshops, and learn! We can also gain knowledge from our clients. Each will have a different experience, so just ask! For clients, do share what the coming out process was like for you. It is important for a therapist to hear this to understand you more fully, your beliefs, past experiences, and process.

Factors contributing to the increase in use in individuals who identify as LGBTQ

Many factors might contribute to increased substance abuse in the LGBTQ community. These include, but not limited to:

• Trauma in childhood - and after
• Internalized homophobia
• Discrimination
• Experience with the coming out process - including emotions involved which can range from fear to shame to isolation
• Reactions to coming out by loved ones and others in one's life
• Negative feelings about the self
• Daily stressors
• Bullying
• Social prejudice
• Pressure to fit in with the gay community, and more.

It is important for all individuals to feel safe and supported during their recovery process!     

Dr. Rachel Needle has specialized training in the area of substance abuse. She is a professional consultant to substance abuse facilities and assists them in expanding and enhancing clinical programming. Dr. Needle also does expert training for staff members at residential and outpatient facilities that specialize in alcohol and substance abuse.

| Twitter: @DrRachelNeedle