Rates of tobacco, alcohol, and drug abuse are all higher in the LGBTQ+ community than among heterosexual-identifying individuals. Members of these minority groups often experience hardship related to their sexual orientation and gender identity, in addition to the difficulties of everyday life that we all face. The lack of representation in the medical field leaves members of the minority at a further disadvantage. Without specialized treatment options, LGBTQ+ youth and adults are less inclined to seek treatment for substance use disorders (SUD) and any comorbid disorders, and those who do pursue treatment may not receive proper care, leading them to relapse. Until members of this community have access to treatment programs dedicated to promoting positive mental health and sobriety among LGBTQ+ individuals, rates of SUD and its comorbidities will continue to climb.
Rates of Substance Abuse Among LGBTQ+ Individuals
The 2018 National Survey on Drug Use and Health (NSDUH) records higher rates of marijuana, opioid, and alcohol abuse in LGBTQ+ adults than their heterosexual counterparts. Approximately 16.2% of heterosexual-identifying adults reported marijuana use in the past year as compared to more than 37.6% of LBGTQ+ adults. Approximately 9% of LGBTQ+ individuals report opioid abuse, including the use of heroin and non-prescription opioids, within the past year, whereas only 3.8% of heterosexual adults struggled with opioid abuse.
The Addiction Center finds that alcohol dependency affects between 20 and 25 percent of the LGBTQ+ community. Tobacco use is 200 times more prevalent in the sexual minority. Abuse of amphetamines is over 12 times more likely in the queer population than the heterosexual populations. Individuals who identify as LGBTQ+ battle drug and alcohol abuse at higher rates than the heterosexual majority, yet their specific treatment needs are still unmet in most circumstances.
Unique Tribulations That Face the LGBTQ+ Community
Sally Stevens, a professor in the Department of Gender and Women’s Studies at the University of Arizona, explores treatment options for lesbian and transgender women in a 2012 research project. In her abstract, she notes that “substance abuse prevention, early intervention, and clinical treatment programs were designed to meet the needs of the sexual majority population with relatively few programs designed to incorporate the specific needs of sexual minorities.” In short, treatment programs are rarely equipped to address the unique issues that members of the LGBTQ+ experience.
Rates of anxiety, depression, and suicidal thoughts or planning are higher in LGBTQ+ youth and adult populations. The NSDUH shows that 31.3% of LGB (lesbian, gay, bisexual) adults over the age of 18 who were diagnosed with SUD experienced suicidal thoughts, and 14.1% of this group made plans to enact suicide. The National Institute of Drug Abuse finds that “sexual minorities with SUDs are more likely to have additional (comorbid or co-occurring) psychiatric disorders. For example, gay and bisexual men and lesbian and bisexual women report greater odds of frequent mental distress and depression than their heterosexual counterparts.” Transgender individuals, especially children and young adults, struggle with high levels of depression, self-harm, and eating disorders.
Developing New Treatment Strategies
Discrimination, harassment, or physical abuse directed toward a person due to their sexual orientation or gender identity is a traumatic experience unique to individuals who do not identify as cisgender or heterosexual. Mental health professionals need to devise treatment options for LGBTQ+ patients steeped in values of self-acceptance and affirmation. Though the LGBTQ+ community is often treated as a homogenous entity, identities within the larger community are very different and each requires specialized attention. Transgender individuals, for example, face suicidal thoughts with more frequency than bisexual individuals according to recent statistics. The treatment program designed for a member of the transgender youth, therefore, should not be identical to the program designed for a member of the bisexual youth.
The Substance Abuse and Mental Health Services Administration (SAMHSA) offers grants to organizations that support LGBTQ+ health. The National Institute of Health (NIH), in collaboration with other federal organizations, published The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding (The National Academies of Sciences, Engineering, and Medicine) to address gaps in the medical field and propose solutions to increasing rates of substance abuse in sexual minority communities. When we recognize the severity of the issues, we can engender change in the medical field and protect LGBTQ+ health.
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