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People who identify as LGBTQ and are battling addiction will require treatment and therapy that consider their unique experiences, stigmas, and personal self-discovery.

Overcoming addiction is a tough battle to take on and identifying as LGBTQ doesn’t make it any easier.

The term LGBTQ—which stands for lesbian, gay, bisexual, transgender, and “queer” as an umbrella term for other sexual/gender identities (e.g. asexual, nonbinary) or “questioning” for those who aren’t certain what their sexual orientation or gender preference is—can be an overwhelmingly all-encompassing label used to apply to several groups of people with different experiences associated with their sexuality and gender.

And while some people may believe “addiction is addiction”, implying that merely going through the Twelve Steps and a round of detox will work, this negates the intrinsically personal side of addiction that every client must address while in drug treatment.

LGBTQ people have unique experiences and challenges that, if met with a lack of understanding and acceptance, will be detrimental to their recovery. These clients can benefit from traditional addiction treatment in terms of self-improvement, but will need therapists and a support system that puts emphasis on self-acceptance, self-discovery, and self-love.
Keep reading to learn more about LGBTQ substance abuse and some primary concerns to be addressed in treatment.

Drug use and alcohol addiction in LGBTQ communities is 2 to 3 times higher than the average population, says SAMHSA.


challenges in lgbtq community

LGBTQ people face unique challenges beyond the stigma that goes with being an addict. In many cases, substance abuse is used as a self-treating method to deal with the prejudice that comes with being in a marginalized group, especially for individuals who also identify with other factors that are susceptible to added discrimination, such as race and ethnicity, religion, and age.

While everyone’s addiction past is unique to their own experiences, some common challenges LGBTQ people face that have led them to use substances are:

LGBTQ people who are still closeted or have yet to come out to certain individuals, such as to family and friends or in work, will deal with stress in hiding their sexuality and/or gender preferences—and potentially more stress after coming out and facing societal consequences for it.

LGBTQ people are more likely to face discrimination, such as public humiliation, being denied services, and intrusive questioning in interviews or from health providers.

Homophobia, transphobia, or preconceived beliefs about LGBTQ people can affect the person’s livelihood, career advancement, ability to buy a house or adopt, marriage benefits, or relationships from reaching their full potential.

Sadly, being outcast from the family after coming out is a real consequence for some LGBTQ people, who may not have any other support system to rely on and thus are more vulnerable to associating with “the wrong crowd”.

LGBTQ people are more susceptible to physical and emotional abuse, hate crimes, sexual harassment or assault, threats, and violence.

Internalized homophobia or self-hatred can greatly affect an LGBTQ person’s mental health, which can lead to depressive or anxious episodes and substance abuse as a self-coping mechanism.

Unless the person lives in an urban metropolis or an LGBTQ-friendly neighborhood, many find it difficult to meet other likeminded individuals or will have to settle for gay bars/clubs, where substance abuse is a frequent occurrence.


common lgbtq substances

The National Survey on Drug Use and Health added two questions about sexual identity and sexual attraction in 2015, making it “the first nationally representative, comprehensive source of federally collected information on substance use and mental health issues among sexual minority adults.”

That survey, along with the 2010 National Transgender Discrimination Survey Report on Health and Health Care, collectively report that LGBTQ people are more likely to engage in substance abuse, suffer from a substance use disorder, and require addiction treatment—compared to heterosexual respondents.

Some common substances used are:

  • Alcohol
  • Tobacco
  • Marijuana
  • Cocaine
  • Methamphetamine
  • Party drugs (MDMA, molly, GHB/GBL, etc.)
  • Amyl nitrates (poppers)
  • Heroin

The NSDUH data revealed specific drug data for “sexual minorities,” which was defined as gay and bisexual men and women, and showed higher rates for tobacco, alcohol, and illicit drug use. Compared to 7.8 percent of sexual majority adults, 15.1 percent (nearly double) of sexual minority adults had an alcohol or illicit drug use disorder.

With regards to binge drinking, 36.1 percent of sexual minorities reported binge drinking in the past 30 days, compared to 26.7 percent of the sexual majority.

Other drugs that showed higher rates were:

  • Prescription tranquilizers (5.9 vs. 2.2 percent), which includes opioids
  • Cocaine (5.1 vs. 1.8)
  • Hallucinogens (5.0 vs. 1.6), which includes MDMA and other party drugs
  • Other stimulants (4.2 vs. 1.9)
  • Methamphetamine (2.3 vs. 0.6)
  • Heroin (0.9 vs. 0.3).

Eight percent of transgender or gender non-conforming (GNC) individuals reported current alcohol and drug use and 18% said they had done so in the past, but these rates more than doubled (19% for current use and 36% for past use) if the individual also participated in sex work, drug dealing, and other underground economies, which was also described as a means for survival due to discrimination.

If you or a loved one are struggling with addiction or going through addiction withdrawal, call our 24-hour helpline at (855) 619-8070. Drug Treatment Center Finder can help you get the treatment you need. Don’t suffer alone.


lgbtq mental health

Several addiction treatment centers offer dual-diagnosis programs, which address other co-occurring mental illnesses alongside substance use disorder.

Addiction can be a result of LGBTQ people trying to cope in a world that doesn’t accept them, or mental disorders can be a result of giving in to substance abuse and not being able to recover on their own. Stress from having a lack of control over their lives and surroundings can greatly attribute to both of these causes.

Below are some of the most common mental health concerns LGBTQ people may face every day:

Those who have been rejected from loved ones or feel stigmatized from society for how they identify their sexual orientation and/or gender can suffer from chronic depression or major depressive episodes. Bullying from homophobic or transphobic people, physical and emotional abuse, and social exclusion can also lead to depression.

LGBTQ people who feel unsafe in their environment because of harassment, threats, or bullying can develop anxiety. People who are still closeted or who are trying to repress themselves may also grow anxious each time they have to actively hide feelings from the people around them. Stress from living double lives can lead to unhealthy coping mechanisms.

Gender dysphoria involves a conflict between a person’s assigned or biological gender and the person’s gender that they choose to identify with. Recently updated in the DSM-V, gender dysphoria (previously known as “gender identity disorder”) will cause the affected person to feel uncomfortable with their body (not to be confused with body dysmorphic disorder, or BDD), as well as the expected roles of their assigned gender. This disconnect can lead to other mental illnesses, such as depression or anxiety, especially if the person does not have the means to begin transitioning to or living as their preferred gender.

LGBTQ persons have some of the highest rates for suicide than any other group in the United States. According to the American Association of Suicidology, a study found that gay men were six times more likely than heterosexual men to attempt suicide and gay women or lesbians were twice as likely as heterosexual women.


lgbtq sexual health

Substance abuse will always affect a person’s sexual health, but below are specific issues that the LGBTQ community faces when living with drug and alcohol addiction:

Alcohol and drug use lowers a person’s inhibitions, which can make them vulnerable to having unprotected sex while under the influence and contracting sexually transmitted diseases. While some STDs can be treated (e.g. chlamydia, gonorrhea), others may not have any cure and will require lifelong treatment (e.g. herpes, HIV/AIDS).

Chronic drug and alcohol abuse can develop issues with sexual performance from cis gay and bisexual men, who may mix erectile dysfunction pills with substances (e.g. alcohol, cocaine) in order to have sex. Other men take these pills to prolong their erections for marathon sex and combine them with methamphetamine and other party drugs in chemsex parties or orgies. This can be a deadly combination that triggers heart attack, stroke, or overdose.

Sex addiction and substance abuse tend to mix, whether one comes before the other. Causes for sex addictions in LGBTQ people can stem from how a person was introduced to the community. Counseling for dual-diagnosis sex and drug/alcohol addiction may have to address learned sexual behaviors (e.g. associating “good” sex with drugs), sexual assault during childhood, or sexual repression/repulsion.

Hormone replacement therapy (HRT) is not always an available option for people who wish to transition, especially if health providers aren’t willing to give coverage for these medications. Some trans individuals may resort to buying HRT drugs illegally on the streets, which makes them vulnerable to potentially buying the wrong substances, mismanaging appropriate dosage intakes, and health risks from unsupervised HRT.


lgbtq friendly addiction treatment

LGBTQ people face separate stigmas and discriminations beyond substance abuse if they are struggling with addiction, which is why going into traditional addiction treatment centers may not always be the best option. Other sociopolitical issues may need to be addressed in order to get to the root of an LGBTQ person’s addiction, along with any other intersectional factors that may contribute to the person’s identity.

Questions to Ask When Searching for a Drug Treatment Center:

  • Is the residential facility gender-specific (e.g. men-only, women-only, trans-friendly)?
  • Does the staff, including counselors, have training for LGBTQ issues?
  • Is the staff trained for conflict resolution concerning LGBTQ harassment?
  • What treatment programs are available? Is there an LGBTQ tract?
  • Will there be aftercare available (e.g. halfway housing, job placement, support groups, etc.)?

Going to specialty treatment centers that are LGBTQ-friendly is always ideal, but can be difficult to find if you’re not sure where to look. Call our 24-hour helpline at (855) 619-8070 and one of our agents will answer any questions you may have about addiction treatment or finding services that are LGBTQ-friendly. Start your recovery in a safe environment that accepts you for your experiences and who you are.