Treating Addiction Within the LGBTQ Community: Not One Size Fits All

Treating Addiction Within the LGBTQ Community: Not One Size Fits All

High addiction rates within the LGBTQ community are well established, yet treatment focusing on the specific needs of this community are not. The fallback position tends to apply a one-size-fits-all approach to treatment—surely addiction is addiction is addiction. What works for one should translate to another.

But we know the facts don’t bear that out.

Truly serving the LGBTQ community in their addiction requires more thought and care, considering their unique needs and formulating treatment that addresses them directly.

Recent stats show that LGBT adults have higher illicit drug use, levels of past-month drinking, and rates of substance use disorders than their heterosexual counterparts by wide margins (between 7.3% and 22%). However, they were also more likely to seek treatment for these addictions. Yet they are also more likely to relapse and enter an addiction-treatment-relapse-addiction-treatment-relapse cycle.

Some studies show that part of the reason treatment isn’t working for the LGBTQ community is because, by and large, it isn’t focusing on the specific components that help create and support their addictions in the first place.

Risk factors and underlying causes for substance abuse and use disorders specific to the LGBTQ community include:

  • Family rejection.
  • Poor social support.
  • Cultural stigma.
  • Stress from representing a cultural minority.

However, the large-scale research that frequently supports the creation of treatment approaches rarely focuses on the LGBTQ community, leaving a gap in the available information. Still, we could draw from transgender theory principles in creating more LGBTQ-sensitive addictions treatment.

For instance, focusing on the how well a person incorporates their sense of self with practical parts of their identity—the everyday ways they present themselves to and interact with the world—can significantly reduce anxiety and depression that comes when these elements are in conflict. And when those distressing emotions subside, often the negative coping mechanisms— such as abusing drugs and alcohol—do as well.

Other basic assessment tools can help clinicians better tailor treatment plans for LGBTQ substance abusers, including questions about their sexuality, their coming out process and the response attitudes and behaviors of those they came out to, and how comfortably they currently identify with their sexuality.

Respectful curiosity is essential when reaching out to the LGBTQ community, making sure we ask questions about their experiences, listen carefully to their responses, and thoughtfully create addictions treatment that truly serves them well.


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