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PAT CASH - WAKE UP - LET'S TALK ABOUT LGBT SEX AND DRUGS

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Let's Talk About LGBT Sex & Drugs - 03/11/14 Thank you to Timothy Lock and Lock and Key Films for these videos from our Let's Talk About LGBT Sex & Drugs event at The Joiners Arms. It was part of the Fringe Queer Film & Arts Fest, and funded by Tower Hamlets Council.

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1. Lesbian and Gay Addiction Treatment Needs

2. Facts About Addiction Treatment for LBGT Individuals

3. Benefits of Choosing a Gay-Friendly Treatment Center

4. Making the Transition to Aftercare and Staying Sober

Drug and alcohol addiction treatment is becoming increasingly specialized. Treatment designs have been evolving as a result of numerous studies indicating that recovery success is promoted when issues that distinct demographic groups might face are specifically embraced and addressed as part of the rehabilitation efforts. One such group to benefit from targeted clinical practices is that of lesbian, gay, bisexual and transgender individuals (LGBT).

As a group, the LGBT community has historically had many health care needs overlooked or flatly denied. Strides have been made in the last few decades, however - substance abuse treatment, as a part of evolving medical care, has been no exception.

If you or someone you love is in need of a addiction treatment for LGBT individuals center call our 24-hour hotline toll-free at Who Answers?. Our gay addiction treatment center professionals specialize in finding the best possible addiction treatment center to fit your individual needs. All calls are confidential.

A quality gay addiction treatment center is staffed by compassionate and professional clinicians. Effective treatment for the gay and lesbian community takes place in an environment where diversity, sexual orientation and one's personal choices are respected, where a person can establish new social and emotional networks that are capable of supporting their recovery.

Lesbian and Gay Addiction Treatment Needs

The Substance Abuse and Mental Health Services Administration (SAMHSA) has been proactive in outlining standard of care for addiction treatment centers for the LGBT community. A free publication, titled A Provider's Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual and Transgender Individuals is available to download from their website.

The guide contains educational materials to inform and prepare the addiction treatment clinicians and program administrators to meet the needs of those in the gay community in need of substance abuse treatment. At more than 200 pages, the guide provides a wealth of information to anyone: including epidemiologic data about the specific types of drugs that are being used, special concurrent medical concerns that the LGBT community faces as well as some of the issues and discrimination that might contribute or worsen substance abuse in the LGBT population (including gay youth and teens) to begin with.

Who Answers?

Facts About Addiction Treatment for LBGT Individuals

As with anyone suffering from substance abuse, there are many factors that contribute to the problem. While there is obviously much overlap and commonalities with the general population, there are added factors that play a role in the development of substance abuse in LGBT people. Some of these distinctions include:

Discrimination/public disapproval that, in some places, limits social outlets for LGBT people to bars and clubs - potentially places of heightened alcohol and drug use.

Potential frequent engagement in substance use and abuse to mute the emotional pain / conflict felt in the face of a discriminating general population.

Attempts to "self-medicate" for underlying and accompanying mood or behavioral disorders, or simply to quell inward directed anger.

For some LGBT youth, succumbing to the peer pressures of drinking and drug taking is enhanced by a desire to "fit in" with social circles.

Benefits of Choosing a Gay-Friendly Treatment Center

Patients in treatment bring a host of unique personal factors with them. It should always be expected that counselors and addiction treatment professionals understand and respect these and further, incorporate specifically tailored treatment techniques based on some of these distinctions. Addiction treatment centers that make specific efforts in accommodating an LGBT population guarantee the understanding, respect and careful attention that will be required to promote recovery.

Counseling to address many of the painful issues that one may have experienced or is still experiencing can help to alleviate some of the exacerbating factors contributing to substance abuse. Specific health concerns of an LGBT population can also be tended to throughout the duration of treatment at a facility specializing in gay addiction treatment.

Many substance abuse rehabs incorporate some level of "LGBT" sensitivity into their treatment design. Still, some have made much more effort than others, and have transcended a level of "LGBT tolerance" to actual "LGBT sensitive treatment" or "LGBT affirming treatment". In the latter, the program is specifically targeted to gay substance abusers. There are a number of benefits in choosing one of these specialized addiction treatment center for the gay, lesbian, bisexual, transgender and questioning (GLBTQ) community.

Patients will receive targeted treatment for their drug or alcohol addiction with comprehensive assessments from licensed clinicians who are sensitive to the impact of heterosexism and homophobia. Patients will also receive effective therapies and education in a safe and affirming environment with a treatment focused on acceptance, integration, risk taking behaviors and coming out. It is not until a patient in a gay addiction treatment center learns healthy ways of coping with their addiction that they can experience any chance of long-term recovery.

Making the Transition to Aftercare and Staying Sober

After a patient completes an addiction treatment program in a gay and lesbian addiction treatment center they may be asked to participate in a part of the program that gradually reintroduces them into real world situations. Evaluation of social supports and living arrangements will be an integral part of discharge planning, as release into a hostile environment could be devastating to recovery goals.

Similarly, best efforts should be made for LGBT sensitive aftercare plans and continued recovery support groups after leaving the treatment center. By conquering these challenges inside a gay-friendly addiction treatment center, the patient has a greater chance of effectively dealing with their feelings and avoiding addictive behavior.

Don't hesitate to call our 24-hour helpline. We can help you locate a gay addiction treatment center that will respect your individual needs and point you in the direction of recovery. Call us now toll-free at Who Answers? to place a confidential call.

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Lesbian and Gay Addiction Treatment Needs Facts About Addiction Treatment for LBGT Individuals Benefits of Choosing a Gay-Friendly Treatment Center Making the Transition to Aftercare and Staying Sober Drug and alcohol addiction treatment is becoming increasingly specialized.

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Bunny Gets Donald Trump & Bianca Del Rio Confused

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Sam & Robby Discuss Femshaming & Bullying

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Best of Alaska Thunderfuck | RuPaul 's Drag Race All Stars

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Is Sexuality and Substance Abuse Correlated Within the LGBT Community? | Fill in The Blank | Logo

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Join couples as they discuss what it was like to struggle with substance abuse and how it affected their relationship. What was the drug of choice? Did your sexuality play a role in your substance abuse? How would you describe addiction in the LGBT community?

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It was January of 2005. I had returned a few days earlier from Guest House, an alcohol rehab facility for priests in Rochester, Minnesota where I had spent the previous 3 months working through the issues surrounding my alcohol addiction. All those being discharged were encouraged to find AA meetings in their areas to begin this "new life" of recovery.

I went online and located the page for the "Miami-Dade Intergroup of AA" where I was living at the time. There was no lack of meetings in the South Florida area but I was also seeking a special kind of meeting, the ones with the "G" next to the meeting description, "Gay". I located the meeting schedule for a place called "Lambda/Dade". It was not far from the university where I was living and working.

At the first meeting I attended I was warmly welcomed when I came in and was recognized as being new to the group. I introduced myself as "Warren, and I'm an alcoholic" but it would take months for me to introduce myself fully.

One night at an "S", a Speaker Meeting, the scheduled speaker failed to show up. The secretary of the group approached me and asked if I would be willing to "share my story". In that instant, every conceivable excuse that I could come up with to say no flashed through my mind yet somehow I heard my mouth say "ok".

As I sat in the chair in the front of the room everyone quieted down and I took a deep breath and I said something that I had never said publically before; "Hello, my name is Warren, I'm an alcoholic, I'm gay, and I'm a Catholic priest". Much to my surprise, the ceiling did not collapse, the walls did not cave in, the crowd did not rush at me to stone me and cast me out into the night. Everyone calmly replied; "Hi Warren".

For a guy who lived his whole life in "compartments", the "good little boy" compartment and the "gay boy" compartment it was no wonder why I resorted to the use of alcohol. If secrets make us sick, and they do, I had 2 big ones. With my family and friends, I was the good kid who was rather spiritual at a young age and who was going to be a priest (like it or not) but I wouldn't dare mention my "gay" secret. When I would cross the river into New York City to be with my "gay tribe" I wouldn't dare mention my "catholic" secret. It was only in a meeting of alcoholics anonymous that the walls of my "compartments" came crumbling down and I felt a freedom that had eluded me for most of my life.

There have been times since then that because of life's circumstances I wanted to put the walls of the compartments back up but I knew that to do that would surely lead me to a drink. By continuing to go to meetings and staying in the center of the program not only do I not fear putting the walls back up but I realize that I just don't need those walls anymore.

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It was January of 2005. I had returned a few days earlier from Guest House, an alcohol rehab facility for priests in Rochester, Minnesota where I had spent the previous 3 months working through the issues surrounding my alcohol addiction. All those being discharged were encouraged to find AA meetings in their areas to begin this "new life" of recovery.

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My story of survival and transformation along with observations about drug addiction and how it affects the LGBT community

I was used to opening my eyes and not knowing where I was or how I got there. Often the last thing I would remember was wishing that I could forget. One night, stomach full of liquor and pills, I was only vaguely aware of the glaring fluorescents and the shrill siren. The lights and sounds didn't faze me; it wasn't my first ambulance ride. It also wasn't my first overdose, and it wouldn't be my last. That night, what drew me out of my drunken stupor was the face of a man I loved - a man who had seen me at my worst more times than anyone before. I had called 911 on my boyfriends before - he was the first to call 911 on me. I was too far gone to recognize his face, but I could feel his gaze, his palpable concern saturating the back of the rig. As I slipped back into a coma, I realized that I wouldn't be offered the choice to leave the hospital in the morning.

Growing Up Gay

I knew that I was gay before I turned 12. I started drinking at age 14. By 16 I had taken up cigarettes, marijuana, and narcotics. At 18 I abused cocaine. Through college, I lost a battle to nearly every drug short of heroin. But my most potent vices were alcohol and opiates: prescription painkillers that I had stockpiled from athletic injuries or anxiolytics that I hoarded and binged on irregularly. I bought countless "know your body" books through adolescence. Each one, if it even mentioned homosexuality at all, resigned being gay to a one-line quip about "hormonal imbalances" that would disappear over time. So I never brought it up.

I Hid My Substance Abuse From Most Friends and Family

Nobody close to me knew that I was gay for almost ten years. A few friends and family members were aware of my substance abuse, but none of them realized the gravity. I lived most of my life in secret. I was, and still am, a master of emotional disguise, of pretending to be "normal" and convincing others that I'm "just fine." Lying is a defense mechanism I had to learn as a gay man. Lying about my sexual identity protected me from the violence of my father and grandfather growing up; it protected me from being assaulted in school or harassed on the street; today, it protects me from being legally evicted by my landlord and legally fired from my job. Sometimes I still struggle to be honest with the people I love and am brave enough to trust, despite the fact that I'm now "out of the closet" and have been for years.

The LGBT Reality - Few Gay People Are Ever Afforded Support
Find a rehab that treats addiction and caters to your specific needs, LGBT or otherwise.
The fact of the matter is that many LGBT individuals typically don't recognize or respond to support systems in the same way as other minority groups; few gay people are ever afforded support to begin with. Many of us grew up among "adult role models" who publically disapproved of, even condemned, our identities - families, schools, and churches, often strongholds of kinship within oppressed populations, were some of the most dangerous places for us to be ourselves.

Alcohol Offered an Escape From Social Hostility

Therein, countless LGBT individuals turn to drugs and alcohol to cope with the shame they've been taught to internalize and the feelings they've been told to deny. For me, alcohol offered both an escape from social hostility and a crutch for my fear and anger about being gay.

For gay addicts, especially those of us who grew up in a world where homosexuality was still illegal, homophobia and bigotry devalue our self-worth and convince us to direct our blame inward. But few people realize that heterosexism, or the mere assumption that heterosexuality is "normal," is equally crippling to our psyche. When gay individuals are taught from a young age that they are "flawed", the potential damages of drugs are less deterrent, welcoming even.

Before I Went to Rehab, I'd Survived Acute Alcohol Poisoning Three Times

In the year before I went to rehab for alcohol and other things, I'd survived acute alcohol poisoning three times with a BAC just under 0.40%, a level where the risk of death from respiratory arrest increases exponentially. And that only counts the times I was fortunate enough to be found by a Good Samaritan who called 911. Most days I'd wake up outside or in unidentified apartments with unfamiliar wounds and the weight of the world on my shoulders.

Few Substance Abuse Surveys Even Ask About Sexual Orientation

In the gay community, we are adept at finding nuanced indications of our safety among strangers. Despite great strides in civil rights, many of us remain wary of revealing our "true selves" and most medical professionals and mental health specialists do not realize the façade we hide behind. This makes LGBT-oriented studies exceedingly complicated to perform. Few substance abuse surveys even ask about sexual orientation or are unsure how to address the expanding spectrum of gender identity and sexual expression. There are not even reliable statistics about how many LGBT people are in this country: estimates range anywhere from 1% to 10% and most fail to distinguish among lesbian, gay, bisexual, transgender, and non-conforming individuals.

LGBT Substance Abuse Rates Are at Least as High as, If Not Higher Than, National Rates

Despite the dearth of data, there is growing consensus among mental health professionals that LGBT substance abuse rates are at least as high as, if not drastically higher than, national rates. In the United States, it is estimated that around 10% of people over the age of 12 have abused drugs or alcohol. Among LGBT individuals, these estimates jump to over 30%. The upsurges are most drastic among bisexual and transgender individuals, non-straight females, and those under the age of 18; the NIH currently reports that each group is 340%, 400%, and 190% more likely to abuse drugs, respectively.
Learn about evidence-based treatment. It may be the right choice for you.
Alcohol Is Drug Most Commonly Abused in the LGBT Community

Abuse and Mental Health Services Administration (SAMHSA), the drug most commonly abused in the LGBT community is alcohol, especially among lesbians, followed by synthetic stimulants such as ecstasy, ketamine, and GHB, which are more popular with gay men. The largest surge in abuse is among methamphetamines, which, when injected, have also been linked to upticks in the transmission of HIV and hepatitis C, simultaneously worsening the two epidemics that have plagued the LGBT community.

Co-Occurring Disorders Among Gay Addicts

And yet STDs are not the only co-occurring disorders among gay users. Most of us suffer from similar mental health issues prevalent in the general population: psychiatric disease, mood disorders, and eating disorders. I battled anorexia to try to exert greater "control" over my body, and I continue to live with depression and anxiety. I also suffer from PTSD secondary to years of abuse. Just like straight people, gay people succumb to addiction in response to many of the same triggers.

What Complicates Addiction for Many LGBT Individuals Is That We Sidestep Discussions of Sexuality With Doctors

What complicates addiction, and its health-related issues, for many LGBT individuals is that we often do not participate in, or we actively lie about, our personal health management to evade the stigma of healthcare professionals. This evasion of medical care leaves co-disorders unrecognized and untreated. Despite being a healthcare professional myself, I still sidestep discussions of sexuality with my doctor, not because I believe he is prejudiced, but because I find him generally uneducated about and ill-equipped to discuss my experiences as a gay man. But my avoidance impairs a holistic dialogue about my health and risks further complications.

Nontraditional Support Systems Are Essential to Helping Recovering LGBT Addicts

Homelessness is also rampant among LGBT youth, especially young men of color who have run away from intolerant households and no longer have access to food or shelter. Per federal reports, LGBT youth disproportionately accounts for 20 to 40% of the homeless population under the age of 18. As a result, LGBT youth often turns to what is referred to as a "family of choice", which may be any collection of relatives, partners, or friends who care for them outside of their biological family. In many ways, I am still much closer to my family of choice, who took me in when my home was unsafe, than to my immediate relatives. Distinguishing and capitalizing on such nontraditional support systems is essential to aiding recovering LGBT addicts.

Drug and Alcohol Abuse Is Not Only Tolerated Within "Gay Culture" It Is Often an Essential Component

"Gay culture" is a broad, imprecise term whose meaning diverges widely and is oft disagreed upon by LGBT individuals. However, the variation of customs and practices among gay communities is a significant factor related to illicit substance exposure. The prevalence of drugs at circuit parties, raves, and among the underground ballroom culture provides a social context for easy exchange and communal addiction. In fact, this lends itself to a confusing reality that I experienced as an addict in an area where such settings were common: drug and alcohol abuse is not only tolerated within "gay culture", it is often an essential component. Drugs are valued for their mind-altering and inhibition-lowering qualities, chemically creating a "safe space" where LGBT people can feel unreserved and permitted to act on impulse, perhaps promiscuously, without judgment.

Availability of Drugs and Alcohol Obscures Our Ability to Seek Help, Remain Sober

Drugs and alcohol are often woven into LGBT sexual encounters to stimulate euphoria. This obscures our ability to seek help, remain sober. Some gay men may view sobriety as inconsistent with maintaining a partner or a social life. This leads to an increase in relapse rates. One of my ex-boyfriends had gone to multiple halfway houses before he was able to get clean because each time he returned, he was surrounded by opportunities to indulge. This effect seems to be more pronounced among non-straight men, who more commonly share methamphetamines. I've watched more than one ex fatally overdose at a public party surrounded by "friends" and "lovers".
We offer access to the best medical detox. You can get clean starting today.
Overdoses Are Far and Away the Most Common Among Transgender Individuals

On the other hand, lesbians, who suffer from higher rates of alcoholism and express different LGBT "norms", seem to be prone to a longer timeline of chronic abuse with fewer acute overdoses. But overdoses are far and away the most common among transgender individuals, who also endure the highest rates of violence and discrimination and appear to compensate in kind.

Life in Rehabilitation for an LGBT Person

Per SAMHSA, the only LGBT subgroup that has demonstrated a greater willingness to seek rehabilitation than the general population is lesbians - gay, bisexual, and transgendered persons are all less likely to seek help. It's not clear whether this is a result of fluctuating stigmas, a variance in behavior, or due to the drugs abused by each group. Regardless, to reach the LGBT community, successful rehabilitation programs cannot ignore unique influences that sexuality and gender identity have on addiction. In my experience, drawing from the stories of friends and loved-ones, and in alignment with current mental health research, the best of these programs are not merely "tolerant" or "sensitive" to LGBT struggles, but actively affirm our lives.

An Ex-Boyfriend Died From an Opiate Overdose After His Parents Kicked Him out of Their House

One of my first ex-boyfriends who enrolled in rehabilitation struggled to recover because the facility actively avoided the topic of sexuality altogether - his family's lack of acceptance kept him closeted. He was discharged from the center with no support network, still harboring society's ill view of him. A few weeks later his parents kicked him out of the house and he died from an opiate overdose.

Counselors Focused More on Sexual Proclivities and Erratic Behavior Than Drug Abuse

I later had a close personal friend who attended an LGBT-"oriented" addiction center. He was HIV-positive as well as manic-depressive; so despite the context of a gay-only audience, he remained stigmatized. The counselors were trained to focus more on his sexual proclivities and erratic behavior than his drug abuse. He is alive but continues to relapse regularly.

One Sponsor Believed My Homosexuality Was Merely a Symptom of Alcoholism

I avoided AA and similar anon support groups for years because of the credo citing a "higher power" - a reference that awoke unsettling memories of church and sermons about eternal damnation. Once I finally committed to a group, my sponsor took it upon himself to try to "convert" me, insisting that my homosexuality was merely a symptom of alcoholism. This preoccupation with "cures" within rehabilitation seems to misconstrue gay identities and behaviors as elements of their disease process. As we learn more about the vital role human connection has in dispelling addiction, it is crucial to avoid ostracizing those brave enough to seek help.

I Remember the Trip to the Rehab Because I Realized How Much I Was Loved

The morning after that fateful overdose was my intervention, and it only transpired because I had stumbled too close to home one night. Regrettably, I can't recall much of what happened or what was said - I felt numb and far away. But I remember the trip to the rehabilitation facility. I knew the road well because I had watched too many close friends and ex-lovers driven down it before. For the first time in years, I felt afraid. And yet I felt somehow safe because I realized how much I was loved.

There Is a Middle Ground Where Rehabilitation Centers Neither Evade nor Pigeonhole the LGBT Community

It would seem there is a middle ground where rehabilitation centers neither evade nor pigeonhole (even with good intentions) the LGBT community and their unique barriers. My most positive therapeutic encounters were with a counselor who was also a gay man in a group of mixed individuals - I felt neither singled out, nor overlooked. Because I had a shared identity with my counselor, I trusted him, and he was able to meaningfully address my concerns. I do not take this to mean that only gay therapists should advise gay individuals. My program's strengths were in its diverse therapies and balanced approach: involving my family of choice while respecting my professional privacy, encouraging active responsibility while avoiding passive judgment, and establishing follow-up without making cultural assumptions.

Encouraging LGBT Addicts to Seek Rehabilitative Services

Unfortunately, the greater hurdles are encouraging LGBT addicts to seek rehabilitative services in the first place and preventing relapse in a polarized society still rampant with hate crime. Younger generations appear to be more vocal about their identities, and one can hope they will be vocal when they are vulnerable. Silence has always been a substantial obstacle for the LGBT community.

The Year After I Left Rehab My Support System Splintered

I conquered addiction, eventually. The year after I left rehab, my support system splintered when my boyfriend left me and my family of choice moved across the country. I relapsed several times before getting clean. I had spent over a decade chemically coping, and it took months to get reacquainted with my body. But I learned; I learned a healthier way to participate in gay culture - the only community I'd ever felt connected to. I found inspiration within my career, passion among pastimes I had abandoned, stamina through team athletics, and serenity in meditation. I appreciated how to be alone without feeling alone.

I'm No Longer Afraid to Wake Back Up

There are still holes in my memory from nights I chose to drink away. I'll never get that time back. But what I have now is a profound desire to keep remembering. Now, every night when I close my eyes, I'm no longer afraid to wake back up.

- Mason Michael

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Growing Up Gay with Alcohol and Prescription Painkillers | Addiction to Sobriety

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I was used to opening my eyes and not knowing where I was or how I got there. Often the last thing I would remember was wishing that I could forget. One night, stomach full of liquor and pills, I was only vaguely aware of the glaring fluorescents and the shrill siren.

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LGBT Addiction Is Not the Same as Straight Addiction

Addiction within the LGBT community is real - and rampant.

That this problem exists, according to these findings from the U.S. Centers for Disease Control and Prevention, should not surprise us. Compared to heterosexuals, LGBT patients have higher rates of substance abuse, lower levels of abstinence from alcohol and drug use, and a greater likelihood to continue heavy drinking for a longer period of time.

What is shocking is how deceptive a Google search for LGBT addiction treatment is, yielding 493,000 results (in 0.70 seconds). These numbers, at first glance, appear to be a testament to the significance of this challenge; they suggest a ready and willing collection of centers, conversant in these matters and conveniently located within every major town or city throughout the United States.

Unfortunately, the majority of these places are referral sites - a search for LGBT addiction treatment produces pages upon pages of sites that leverage these keywords (and others) - that redirect visitors to the homepage of a general alcohol and drug treatment facility.

Translation: A page that speaks to the concerns of the LGBT community, by its layout and design as well as the design of the owners of that featured page, is very misleading; it appropriates the language of our friends and comrades, and our brothers and sisters, and it conveys a sense of trust by acknowledging the work of, say, the Substance Abuse and Mental Health Services Administration or the Center for American Progress, while never conceding the truth: That once you enroll in one of these centers - an expensive facility with little or no history of treating LGBT patients - you will not get the care you need, period.

For example: Mental and Behavioral Health professionals working with the LGBT population receive more than their share of phone calls from distraught parents and colleagues, each reporting their alarm at the lack of concern (and the general absence of compassion) involving treatment programs that do not accommodate the needs of this group.

I can attest to this fact, since I received a call late last year (near the end of autumn) from a family en route to Oregon because they had no choice but to request the discharge of their son (at his insistence) - after just three days of "treatment" - from a facility in Los Angeles.

By placing this patient with 14 heterosexual men, most of whom were there for treatment for heroin addiction, the overall environment could not and did not help to heal a shy young man overcome with a sense of isolation, and thus more vulnerable to succumbing to this potentially fatal addiction.

Steve Lapuk, a licensed marriage and family therapist in private practice in Los Angeles, has his own story about a patient who, after multiple failed attempts at sustained sobriety, enrolled in a residential treatment facility. (The patient chose this place because of its emphasis on the "gay and lesbian track" only to discover that no more than four people, out of approximately 60 patients in the same program, were gay.

If a treatment center is not conversant with the individual needs of LGBT patients, it should direct these men and women to a place that can help them. Applying generic approaches to addiction and ignoring specific treatment goals for this population may contribute to a higher incidence of failure.

Treatment programs must reflect the dynamic between the drug and the patient, or the forces between a specific addiction and a particular addict. Safety in a treatment environment is essential, so that person may speak without fear of judgment and get the care necessary for long-term recovery.

Not only does the risk of recidivism increase exponentially among those centers with no experience in the matters mentioned above, the fact that there are differences between heterosexual and LGBT addicts of the same drugs must not remain an issue of silence.

For silence does indeed equal death if this facade persists.
Find out more information on treating LGBT addiction here and here.
MANNY RODRIGUEZ is the executive director of La Fuente Hollywood Treatment Center.

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LGBT Addiction Is Not the Same as Straight Addiction

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LGBT Addiction Is Not the Same as Straight Addiction Addiction within the LGBT community is real - and rampant. That this problem exists, according to these findings from the U.S. Centers for Disease Control and Prevention, should not surprise us.

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Many Use to Cope with Discrimination and Prejudice

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In the movement for gay and transgender equality, issues like marriage and workplace discrimination dominate media headlines as well as the time and attention of most advocates. The focus on these headline issues has been successful on some fronts in recent years, with the repeal of "Don't Ask, Don't Tell" and passage of the Matthew Shepard and James Byrd, Jr. Hate Crimes Prevention Act, a hate crimes law that is inclusive of gay and transgender people. Other issues that impact the overall equality and wellbeing of gay and transgender people, however, don't always garner as much attention.

Gay and transgender health is one of these issues. This issue brief examines the disproportionately high rates of substance use by gay and transgender people, which is a significant impediment to the health of this group. Although data on the rates of substance abuse in gay and transgender populations are sparse, it is estimated that between 20 percent to 30 percent of gay and transgender people abuse substances, compared to about 9 percent of the general population.

The stress that comes from daily battles with discrimination and stigma is a principle driver of these higher rates of substance use, as gay and transgender people turn to tobacco, alcohol, and other substances as a way to cope with these challenges. And a lack of culturally competent health care services also fuels high substance-use rates among gay and transgender people.

In order to lower these rates, our health care system needs to better meet the needs of gay and transgender people, and our government needs to advance public policies that promote equality for this population.

This issue brief explains why we see higher rates of substance use in the gay and transgender population, provides a brief overview of these rates, and makes recommendations that can help end antigay and antitransgender discrimination and reduce substance use rates.

Rates of substance use and abuse in the gay and transgender population

In this section we provide some topline numbers on substance abuse rates in the gay and transgender population. Note that there is little national data on gay and transgender people overall, so the statistics here are best estimates of these rates.

Tobacco

Gay and transgender people smoke tobacco up to 200 percent more than their heterosexual and nontransgender peers.

Alcohol

Twenty-five percent of gay and transgender people abuse alcohol, compared to 5 to 10 percent of the general population.

Drugs

Men who have sex with men are 3.5 times more likely to use marijuana than men who do not have sex with men.

These men also are 12.2 times more likely to use amphetamines than men who do not have sex with men.

They are also 9.5 times more likely to use heroin than men who do not have sex with men.

Factors leading to these rates of substance use and abuse

Gay and transgender people report higher rates of substance use than others due to three main factors.

First, many gay and transgender people live with a high level of stress that comes from social prejudice and discriminatory laws in areas of daily life such as employment, relationship recognition, and health care.

Second, a lack of cultural competency in the health care system discourages gay and transgender people from seeking treatment for substance abuse, and-if they do seek help-often leads to inappropriate or irrelevant services.

Finally, targeted marketing efforts by alcohol and tobacco companies exploit the con- nection many gay and transgender people have to bars and clubs as safe spaces for socializing and increase easy access to tobacco products and alcohol. Below, we look at each of these factors in turn.

Minority stress

Minority stress -the negative effects associated with the adverse social conditions experienced by individuals of a marginalized social group-is something gay and transgender people have to deal with every day. This stress is triggered by general social prejudice against being gay or transgender, as well as discriminatory laws and policies.

Antigay and antitransgender social prejudice stems from the belief that being gay or transgender is somehow wrong or bad. It can be expressed in subtle ways (for example, a receptionist at a pediatrician's office asking a lesbian couple which of the pair is their child's "real" parent), or it can be expressed in verbal and physical violence (two men holding hands getting taunted with antigay epithets or a transgender person getting jumped by a group of strangers).

Karen and Marcye Nicholson-McFadden of New Jersey understand this prejudice all too well. They are the parents of two children and have a civil union because same-sex marriage is not legal in their state. Whenever they visit the doctor or go to their children's school, they are treated differently because they have to deal with people who don't know what a civil union is, and they have to explain their family to the staff. Karen and Marcye regularly cross out items on government, school, and doctors' forms to reflect their family structure. For example, a family headed by two moms often has to cross out "name of father" on forms.

Or take the 2010 case of a 14-year-old student at Nassau BOCES Career Preparatory High School in Hicksville, New York, was assaulted by four of his classmates who perceived him to be gay. The student was stomped and kicked by his classmates as they spewed antigay epithets at him on his bus ride home from school. The very next day the student was once again the subject of abuse as two of his classmates from the day before made antigay remarks toward him and slapped him across the face and head. His classmates were later arrested and charged with assault and harassment for their actions.

This kind of prejudice can force some gay and transgender people to avoid social settings or neighborhoods that might put them in harm's way. The end result is higher levels of anxiety and fear of being attacked when doing something as simple as walking down the street. And this can lead them to use substances to ease this anxiety.

Discriminatory laws and practices are another source of minority stress that negatively impacts the gay and transgender population and can lead to drug and alcohol use. In particular, discrimination in employment, housing, relationship recognition, and health care are major areas of concern.

Discrimination in employment

It is currently legal in 29 states for gay and transgender individuals to be denied employment, fired, or discriminated against just because of their sexual orientation or gender identity. A recent article by the Center for American Progress reported that 43 percent of gay and 90 percent of transgender people have experienced discrimination and harassment on the job.

Workplace discrimination poses a real and immediate threat to the economic security of gay and transgender workers by leading to job instability, which affects a person's ability to earn a steady income and have access to employer-provided health insurance. These issues not only impact the person who has been discriminated against but also threaten the well-being of other people (a partner, spouse, or children) who are financially dependent on that person.

Discrimination in housing

Having access to safe and stable housing is key to well-being. Fifty-six percent of gay individuals and 70 percent of transgender individuals, however, report experiencing some form of discrimination in housing based on their sexual orientation or gender identity. Being denied stable and affordable housing makes it much more difficult to maintain employment, access health care, and maintain a safe and stable family structure.

Discrimination in relationship recognition

The debate over marriage for gay couples has been a nationwide news story for nearly two decades now, with frequent and prominent stories in the press that elevate and perpetuate antigay stereotypes and sentiments. Hearing these attacks on a regular basis increases antigay social prejudice and its negative impact on gay people.

Further, only eight states and the District of Columbia allow marriage for gay couples, which means that most families headed by same-sex couples are currently barred from accessing the many public policies and programs that are designed to bolster a family's economic security (child care tax credits, Social Security survivor benefits, employer-sponsored health insurance in many cases, and the ability to sponsor a partner for citizenship).

Discrimination in health care

A lack of access to affordable and culturally competent health care also contributes to gay and transgender minority stress. Gay and lesbian adults are roughly twice as likely as the general population to be without health insurance coverage, and rates of uninsurance are even higher for transgender and bisexual individuals.

Because our nation lacks a public health insurance system and individual coverage is currently prohibitively expensive, most insured people access coverage through their employers or their spouse's employer. Unfortunately, widespread workplace discrimination prevents many gay and transgender people from having consistent access to health insurance through their employers. Furthermore, many workplaces do not provide health insurance benefits to same-sex domestic partners. When they do, the cost is higher for these couples, since they have to pay taxes on the insurance benefit, a cost that different-sex married couples do not incur.

Moreover, most private and public plans including Medicare, many state Medicaid programs, and plans sold through the Federal Employees Health Benefits Program specifically target transgender people with exclusions that deny coverage for transition-related care. Such exclusions are frequently expanded in practice to deny even basic health care services to transgender people.

Finally, as we discuss in more detail below, many health care providers are not trained to serve gay or transgender patients, which negatively impacts quality of care. These and other forms of discrimination work together to make life for gay and transgender people more expensive, complicated, and difficult. The end result is additional emotional stress and pressure for many people who are gay or transgender.

Cultural competency

Gay and transgender individuals may be hesitant to utilize health care services that can help them overcome substance abuse because they are aware of the likelihood of meeting health care professionals who are unaware of their specific needs or are outright hostile toward them. As a result, gay and transgender individuals may delay substance-abuse treatment or choose not to disclose their sexual or gender minority status, which not only hinders recovery but also undermines their overall health.

Many tobacco-cessation programs are not welcoming of gay and transgender people, for example. A number of these programs do not provide any outward indications that they are inclusive of gay and transgender people and their unique needs, thereby isolating some gay and transgender people who are already apprehensive because of previous experiences they have had accessing care. Given that many gay and transgender people smoke because of stress factors related to their sexual orientation or gender identity, they might not feel comfortable enrolling in these programs or, if they do enroll, the programs might not address the root causes of their addiction.

Socialization and marketing

Bars, clubs, and restaurants have traditionally been places where gay and transgender people can socialize and feel safe. In many of these venues, smoking and drinking remain popular. As a result, higher rates of smoking, drinking, and sometimes drug use occur in these environments.

Tobacco and alcohol companies have exploited gay and transgender social networks to aggressively market their products for decades. In the early 1990s tobacco companies surveyed gay men for branding choices, which resulted in a new program called Subculture Urban Marketing, or SCUM, which targeted minority gay men in San Francisco.

According to a fact sheet by the American Cancer Society, tobacco companies also appeal to the gay and transgender population through direct advertising in national gay and transgender magazines; indirect mainstream magazines with a high number of gay and transgender readers, at times with same-sex undertones; and sponsorships of events or organizations that support gay and transgender issues.

The fact sheet also states, "The [tobacco] industry focuses advertising and sponsorships on themes important to the [gay and transgender] community: liberation, individual- ism, social success, and acceptance." Such targeted marketing campaigns exacerbate the higher rates of substance use in the gay and transgender population.

How to help

Below we discuss administrative and legislative recommendations whose implementation will help reduce the high rate of substance abuse within the gay and transgender population while helping advance overall gay and transgender equality.

Recommendations for the Department of Health and Human Services

As the Center for American Progress outlined last year, the Department of Health and Human Services, or HHS, can take a number of steps to reduce the rate of substance abuse within the gay and transgender population:

HHS's agencywide priorities should include strong support for the efforts of the Substance Abuse and Mental Health Services Administration, or SAMHSA, to specifically address gay and transgender substance-use disparities through SAMHSA's strategic plan, block-grant programs, cultural-competency initiatives, and other activities.

HHS should promote routine and ongoing cultural-competency training for medical and nursing students and other health professions students across the programs administered or supported by its operating divisions.

HHS should explicitly include gay and transgender cultural competence in the National Standards on Culturally and Linguistically Appropriate Services, or CLAS. The CLAS Standards, which are developed by the Office of Minority Health, offer health care organizations and individual providers guidance on making their services more culturally and linguistically accessible to patients from diverse backgrounds.

HHS should require any hospital, rehabilitation center, nursing home, or other facility receiving federal dollars to implement a comprehensive and high-quality gay and transgender cultural-competency training program for providers and other staff.

HHS should specifically recruit gay and transgender students and professionals for training initiatives focused on expanding and diversifying the health care workforce, including the National Health Service Corps, the U.S. Public Health Service, and pipeline programs administered by the Bureau of Health Professions.

HHS should adopt a boilerplate nondiscrimination policy for its programs and grants that prohibits them from discriminating against participants or prospective participants on the basis of sexual orientation or gender identity. Such a policy is part of the rule recently adopted by the Department of Housing and Urban Development.

Legislative recommendations

The following four pieces of federal legislation, if enacted, would substantially help address and eliminate the prejudice and discrimination that drive substance use disparities among the gay and transgender population:

Employment Non-Discrimination Act: The act would create federal protections against sexual orientation and gender identity discrimination at all federal, state, and local government agencies; employment agencies; unions; and private employers with 15 or more employees.

Housing Opportunities Made Equal Act: The act amends the Fair Housing Act to prohibit discrimination on the basis of actual or perceived sexual orientation and gender identity in housing sales and rentals, residential real-estate-related transactions, and brokerage services.

The Respect for Marriage Act: The act would repeal the Defense of Marriage Act and allow the federal government to recognize legally married same-sex couples. This would allow same-sex couples to take advantage of more than 1,100 federal benefits and protections that are currently denied to them.

The Health Equity and Accountability Act: The act addresses a wide range of health disparities that affect the gay and transgender population, including disparities in health status, access to health care, and protection from discrimination in the health system. It also calls for greater data collection on sexual orientation and gender identity through federally supported health surveys and programs.

Conclusion
Jerome Hunt is a Research Associate for LGBT Progress at American Progress.
Reducing rates of substance use in the gay and transgender population will require both a short- and long-term strategy. In the short term substance-abuse treatment programs and services need to become fully culturally competent and able to effectively and appropriately serve gay and transgender people. Over the long term laws that discriminate against gay and transgender people, as well as persistent antigay and antitransgender prejudice, need to be addressed head-on and dismantled.

Ending the problem of disproportionately high rates of substance use in the gay and transgender population will take considerable time and effort. But working to end this problem-and promoting overall health for gay and transgender people and their families-will make hard-fought legal victories for equality more meaningful and sustainable. Addressing this problem is not easy, but it is a necessary step in the movement toward full gay and transgender equality.

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Why the Gay and Transgender Population Experiences Higher Rates of Substance Use - Center for American Progress

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Many Use to Cope with Discrimination and Prejudice Posted on Download this issue brief (pdf) Read this issue brief on your browser (Scribd) In the movement for gay and transgender equality, issues like marriage and workplace discrimination dominate media headlines as well as the time and attention of most advocates.