Research shows that substance use disorders (SUDs) are more common among people who identify as lesbian, gay, bisexual, transgender, queer/questioning, or somewhere else on the gender and sexuality spectrum (LGBTQ) than they are within the general population.1

Many factors contribute to this, such as discrimination and social stigmas, as well as barriers that make it harder to find effective LGBTQ substance abuse treatment. Sexual and gender minorities (SGM) also have some unique treatment needs that treatment staff should be aware of and sensitive toward. Fortunately, there are specialized rehab centers and alcohol addiction treatment programs that can meet the needs of this community.

Addiction in the LGBTQ Community

In the United States in 2019, 2.6 million LGB adults had a substance use disorder (SUD). Almost 65% of these adults struggled with alcohol misuse.2

There are several risk factors specific to sexual and gender minorities (SGM) that may contribute to a higher rate of substance misuse and addiction in LGBTQ people than non-LGBTQ people. One theory that may explain why SGM groups are at an increased risk of developing SUDs is minority stress. This theory looks at how certain risk factors influence negative mental health consequences and connected coping behaviors, such as the use of substances to deal with related stressors.3 These risk factors can occur on a societal, personal, and family level and include:4

  • Discrimination. One study found LGBT people who have been discriminated against due to sexual orientation, gender, or race are 4 times as likely to develop an SUD than those who weren’t discriminated against
  • Increased risk of anxiety and depression.
  • Experiencing trauma, violence, and harassment because of sexual or gender identification.
  • Being ostracized or excluded.
  • Stress related to internalized transphobia or homophobia—that is, fear of rejection or retaliation—in those who aren’t publicly “out.”

In a study of LGBTQ young adults with a probable SUD published in Psychiatric Services, researchers highlighted how substances are often used to cope with these stressors. In addition, the availability of substances at LGBTQ social events may also contribute to the development of an SUD.3

On the other hand, research shows that LGBTQ adolescents with access to LGBTQ community organizations, programs, and support are less likely to use substances.5

Co-Occurring Disorders in the LGBTQ Community

Similar to the prevalence of SUDs, studies show that LGB adults are at a greater risk of severe mental illness (SMI) than non-LGB adults. In 2015, 37.4% of LGB adults had an SMI compared to 17.1% of non-LGB adults.6

When a mental health disorder and a substance use disorder are present at the same time, this is called a co-occurring disorder.6 Studies show that:1,7

  • In 2019, 1.9 million LGB adults had both a mental health disorder and an SUD.
  • Lesbian, gay, and bisexual youth report symptoms of depression, including chronic hopelessness or sadness, at more than twice the rate as heterosexual youths.
  • Transgender youth report symptoms of depression and suicidal thoughts at twice the rate of cisgender (someone whose gender identity matches their birth sex) youths, even those who are lesbian, gay, bisexual, or questioning.

LQBTQ Addiction Treatment Options

It is important to offer specialized treatment for substance abuse in the LGBT community, since traditional rehab centers commonly overlook the unique needs of this population.8 Specialized LGBT addiction recovery programs can offer a safe, supportive environment that respects and acknowledges your gender and sexual identity and expression, coming out, and experiences with prejudice without the fear of discrimination or stigma.8

Therapies such as motivational interviewing, cognitive behavioral therapy, and contingency management can help treat trauma, issues within the family, and co-occurring disorders as well as help you develop social supports and learn to manage triggers (the people, places, and things that make you want to use substances).1 These therapies are offered in many different rehab settings, which may include:

American Addiction Centers (AAC) recognizes the importance of addressing the unique needs of the LGBTQ community and offers specialized LGBT treatment tracks in many states across the country.

What to Look for in LQBTQ Rehab Centers

There are a number of factors to consider when seeking LGBTQ-competent care. These may include:3,9

  • Is it important to you that members of your care team share aspects of your sexual or gender identity and expression?
  • Does the rehab center create, implement, and enforce non-discriminatory policies regarding gender or sexual identity and expression?
  • Does the rehab center offer gender-neutral restrooms?
  • Does the rehab center offer ongoing professional training for staff that includes cultural affirming care for the LGBTQ community?
  • Avoid any rehab centers that offer “conversion,” “reorientation,” or “reparative” therapy. These are harmful therapies that are not evidence-based.
  • Does the rehab center ask about gender pronouns and use them accordingly with the understanding that these pronouns may change while in treatment?
  • Does the rehab center express acceptance, openness, and nonjudgmental attitudes toward patients as well as avoid assumptions about gender and sexual identity, expression, and behaviors?

Knowing your answers to these questions can help you further narrow down treatment centers that will be a good fit for you.

Finding LGBT-Friendly Rehab Centers Near Me

American Addiction Centers (AAC) offers specialized alcohol addiction treatment programs for members of the LGBTQ community as well as treatment for co-occurring disorders such as anxiety, depression, and post-traumatic stress disorder (PTSD). AAC also offers free screenings.

If you’re ready to start your recovery, call 1-888-685-5770 or get a text to speak to a compassionate admissions navigator about your options. Your call is completely confidential, and our alcohol hotline is open 24 hours a day, 7 days a week.

Additional LGBTQ Resources

Various groups offer support especially for the LGBTQ community. These include:

Note: Variations of the LGBTQ+ acronym are used in this article to reflect that substance use studies have historically been limited to LGB populations and use binary identity classifications.

Sources
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  1. National Institute on Drug Abuse. (n.d.). Substance use and SUDS in the LGBTQ* populations.
  2. Substance Abuse & Mental Health Services Administration. (2020, September). 2019 National survey on drug use and health: Lesbian, gay and bisexual (LGB) adults.
  3. Corliss, H. L., Felner, J. K., Haley, S. J., Jun, H. J., Katuska, L., Williams, T., & Wisdom, J. P. (2020). Stress, coping, and context: Examining substance use among LGBTQ young adults with probably substance use disorders. Psychiatric Services, 71(2), 112–120.
  4. Serrano, B. C. & Wiswell, A. C. (2018). Drug and alcohol abuse and addiction in the LGBT community: factors impacting rates of use and abuse. Lesbian, gay, bisexual, and transgendered Americans at risk: Problems and solutions: Generation X and Generation Y, 91–112.
  5. Corliss, H. L., Eisenberg, M. E., Fish, J. N., Park, M., Saewyc, E. M., Taylor, A.B., & Watson, R.J. (2020). Associations between community-level LGBTQ- supportive factors and substance use among sexual minority adolescents. LGBT Health, 7(2), 82–89.
  6. Substance Abuse & Mental Health Services Administration. (2016, October). Sexual orientation and estimates of adult substance use and mental health: results from 2015 national survey on drug use and health.
  7. National Alliance on Mental Illness. (2021). LGBTQI.
  8. Substance Abuse and Mental Health Services Administration. (2012). A provider’s introduction to substance abuse treatment for lesbian, gay, bisexual, and transgender individuals.
  9. Meanley, S., Haberlen, S. A., Okafor, C. N., Brown, A., Brennan-Ing, M., Ware, D., Egan, J. E., Teplin, L. A., Bolan, R. K., Friedman, M. R., & Plankey, M. W. (2020). Lifetime exposure to conversion therapy and psychosocial health among midlife and older adult men who have sex with men. The Gerontologist, 60(7), 1291–1302.