Among lesbians, gays, bisexuals, transgenders, and queer/questioning (LGBTQ) persons, substance abuse is a significant problem. In the sexual minority, there is a high rate of alcohol abuse and binge drinking as well as the use of harder drugs like methamphetamines, heroin, and opioids.
In fact, the likelihood of LGBTQ adults using illicit drugs and suffering from substance abuse disorders is almost twice as high as that of heterosexual adults.
In the LGBTQ community, why do substance abusers have such a high rate? LGBTQ people face a variety of triggering issues, and some of them are listed below.
Social stigma and discrimination.
The United States is a country where homophobia and discrimination are on the rise, despite a growing acceptance of LGBTQ individuals. It could come from a stranger or an acquaintance, or even a friend or family member. Additionally, they are subject to workplace harassment, bullying, and hate crimes on a regular basis.
Support for LGBTQ people is lacking.
The LGBTQ community often hides their sexual identity to avoid discrimination, remaining "in the closet." However, this dual lifestyle can cause anxiety and loneliness.
When people choose to come out, they often face rejection from family and friends, and in order to cope with the pain, they turn to substance abuse.
Homophobia that is internalized.
Members of the LGBTQ community often suffer from internalized homophobia, regardless of whether their families and friends accept them. As a result of self-identifying with anti-gay stigmas, they might experience this. Often, one feels self-loathing and is uncomfortable in their own skin as a result.
Drugs and alcohol can serve as an effective mechanism for silencing the thoughts of those suffering from internalized homophobia. It is possible for LGBTQ individuals to temporarily live their true selves when they are drunk or high.
Disorders that co-occur.
Among LGBTQ people, depression, stress, and anxiety disorders are very common. Additionally, they are prone to mood disorders, eating disorders, and other mental illnesses.
Others may suffer from serious health issues such as hepatitis, HIV, and AIDS. Having to deal with these medical issues can make it more difficult for someone to seek substance abuse treatment and interfere with their ability to do so.
As a result of coping with high-stress environments on a daily basis, LGBTQ members turn to opioid drugs for relief, believing they will improve their situation by taking painkillers.
Opioid use and minority stress.
Based on data from the 2020 National Survey on Drug Use and Health (NSDUH), substance use patterns reported by sexual minorities differ from those reported by heterosexuals. Sexual minority adults are those who describe themselves as lesbians, gays, or bisexuals. In 2020, approximately 41.3% of sexual minority adults 18 and older reported using marijuana in the past year, compared with 18.7% of the general population. The incidence of opioid misuse in sexual minority adults was 6.7% in 2020, compared to 3.6% in the general adult population.
Based on the NSDUH survey, approximately 21.8% of sexual minority adults reported an alcohol use disorder in the past year, compared to 11.0% overall.
In particular, LGBTQ youth may use opioids as a coping mechanism for stigma-related stress. As compared to their sexual majority peers, sexual minority youth are more likely to begin using opioids early in life. According to other studies, stress has been associated with an increase in opioid use among young men with sex with men (MSM), especially Black MSMs. According to a survey of transgender Americans, 35% said they used substances to cope with bullying or assault in school.
The use of medical opioids by LGBTQ populations.
LGBTQ people are also disproportionately exposed to opioids in medical settings. Behavioral Risk Factor Surveillance System (BRFSS) data shows that 58% of sexual and gender minority respondents between 35 and 44 years of age have been prescribed an opiate by a medical professional, compared to just 35% of their majority counterparts.
In some clinical situations, LGBTQ individuals are at an increased risk of opioid exposure. According to the American Society of Plastic Surgeons, gender affirmation surgery is on the rise, despite not all transgender people seeking it. Transgender patients are at an increased risk of developing opioid dependence following these procedures, since opioid therapy is the most commonly used post-surgical pain management.
There is also an increased prevalence of chronic pain among transgender people and HIV-positive older people, and up to one-fifth of these people use opioid-based pain medicines. As a result of these clinical situations, certain subpopulations within the LGBTQ community are at greater risk of developing an opioid addiction, which signals the need for special care when prescribing opioids.
The dangers of opioid drugs.
Dopamine is released in the brain's pleasure centers when opioids are taken. As a result of dopamine's euphoric effects on the body, a user feels relaxed and happy.
There are, however, also harmful effects associated with opioid drugs, including:
As a result of opioid abuse, breathing can become slower, resulting in a reduced amount of oxygen reaching the brain. Lack of oxygen in the brain can cause short- or long-term damage, even resulting in death or coma.
Further, substance use has been found to mediate the relationship between life stress and sexual risk, and opioid use in particular is associated with an increased HIV risk.
What can you do about opioid abuse?
There are treatment options available for LGBTQ people with opioid use disorders, including medication-assisted therapy, behavioral health interventions, and counseling.
To ensure that the treatment does not interfere with other forms of therapy the patient may be receiving, certain considerations should be addressed during the course of the treatment given the complex medical needs of the LGBTQ community.
People suffering from trauma-related stress disorders have also benefited from cognitive behavioral therapy.
There is a need for specialized treatment options.
At the same time, despite their addiction problems, many sexual minorities are reluctant to seek help from traditional treatment centers. Homophobic behaviors and inappropriate remarks may be displayed by therapy participants and counselors alike. In order for rehabilitation to be successful, recovering addicts cannot let down their guard because of this.
Moreover, most traditional therapies do not address the specific needs of LGBTQ people. Learning how to cope with social isolation, family problems, homophobia, and violence is part of this process.
The good news is that rehabilitation centers are beginning to offer addiction treatment programs specifically tailored to the needs of LBGTQ individuals. It is important for those who need assistance to know that they have viable options. In order to achieve recovery, it takes courage and strength to ask for support.