Understanding LGBT Drug Use & Substance Use Disorder Within The LGBTQ Community

Key points:

• LGBTQ youth and adults experience significantly higher drug use rates.
• Race and ethnicity, socioeconomic status, mental health conditions, and several other factors increase this risk.
• Culturally competent healthcare and community programs are needed to address LGBTQ drug use.

Filled with unique individuals united by a common struggle, the LGBT community is also experiencing a substance misuse problem. LGBTQ drug use rates soar far above national averages, creating a public health crisis that demands attention.

Young members of this community are especially vulnerable to substance abuse problems. Discrimination, family rejection, and social isolation create the perfect storm for substance abuse. Meanwhile, treatment centers scramble to provide care that meets the unique needs of LGBTQ patients.

Understanding the scope of this crisis is the first step in forging a realistic and compassionate way forward.

The LGBT Drug Use Problem

The 2023 National Survey on Drug Use and Health, published by the Substance Abuse and Mental Health Services Administration, reveals several striking disparities between LGBTQ and non-LGBTQ drug use.[1]

Among the most troubling trends revealed by the survey were the following:

Nicotine vaping: Young LGB+ female respondents were about twice as likely to have vaped nicotine in the past month when compared with straight female youths of comparable age.[2] LGB+ men in the same age classification showed the same trend.

Alcohol consumption: Approximately one in ten LGB+ respondents consumed alcohol in the past month, which is more than their straight counterparts for both genders.[3] LGB+ status was more influential over non-binge alcohol use than binge drinking.

Illicit drug use: Rates of marijuana and illicit drug use among LGB+ female respondents were more than double that of straight female respondents.[4] For men, LGB+ respondents were just less than twice as likely to have used marijuana in the past year.[5]

Prescription drug misuse: Young LGB+ female respondents were approximately three times as likely to have misused prescription drugs in the past year as straight female youths.[6]

Research initiatives have traditionally not provided data that reveal substance use trends associated with gender identity and other demographic information. Now that more data is pouring in, public health organizations are gaining a clearer picture of how gender, ethnicity, and other elements affect LGBTQ drug use.

Factors that Influence Drug Use Among LGBTQ Youth

Family Acceptance

Whether or not the family of an LGBTQ person accepts their identity is a strong predictor of several vital health outcomes. For example, a study from San Francisco State University found that LGBQ young adults from families that rejected their identity were:[7]

• 8.4 times more likely to report a past suicide attempt
• 5.9 times more likely to report high levels of depression
• 3.4 times more likely to engage in unprotected sex
• 3.4 times more likely to use illicit drugs

Race and Other Demographic Information

Race influences both substance abuse rates and which substances are more popularly misused. For example, native and indigenous LGBTQ youth report regular marijuana use at higher rates than white LGBTQ youth.[8] Both native/indigenous and multiracial LGBTQ youth were more likely to report regular prescription drug misuse than white LGBTQ youth.[9]

Schooling Environment

Multiple research findings have concluded that school and other community-level initiatives aimed at LGBTQ youth reduce substance use behaviors (especially among girls).[10] This includes gay-straight alliance clubs in schools, pride events, LGBTQ youth-serving organizations, and more.

Socioeconomic Status

Healthcare outcomes are tied to economic factors for all populations, but LGB females (especially bisexual females) in lower-income families are among the most underserved subgroups.[11] Employment level, having health insurance, household income, and education level can all affect healthcare outcomes (including substance use rates) among LGBTQ youth.

The Mental Health Connection

Depression and anxiety fuel LGBTQ substance abuse at alarming rates. The minority stress model explains how chronic discrimination creates psychological distress. This distress often leads directly to substance use as a coping strategy.

Suicide attempts correlate strongly with substance abuse in LGBTQ populations. The Trevor Project’s 2022 survey found that LGBTQ youth who seriously considered suicide were nearly twice as likely to use substances.[12]

Post-traumatic stress disorder affects many LGBTQ individuals. Conversion therapy survivors show particularly high PTSD rates.[13] These trauma survivors often self-medicate with drugs or alcohol.

Body dysmorphia among transgender youth creates specific vulnerabilities. Many use substances to cope with gender dysphoria.

Barriers to Treatment

Traditional addiction treatment often fails LGBTQ individuals. Many treatment centers lack cultural competency training. Staff members may harbor unconscious biases that harm therapeutic relationships. Even well-intentioned staff may not have the knowledge or resources to adequately address the psychological aspects of caring for LGBTQ patients.

Religion-based treatment programs can cause additional trauma. LGBTQ individuals may face pressure to change their sexual orientation or gender identity. This approach often worsens underlying mental health conditions.

Fear of discrimination keeps many from seeking help. LGBTQ adults are almost three times more likely to have a negative healthcare experience than non-LGBTQ adults.[14]

Financial barriers disproportionately affect LGBTQ populations. Employment discrimination reduces earning potential. Many lack adequate insurance coverage for comprehensive treatment.

Taking What Works and Building On That Success

Evidence-based prevention programs show promising results. SAMHSA’s Strategic Prevention Framework emphasizes culturally tailored approaches. Communities implementing these frameworks see measurable reductions in LGBT drug use.

School-based interventions prove particularly effective. Fostering inclusive environments, discouraging bullying, and encouraging free expression of all LGBTQ students are the hallmarks of an effective school-based intervention strategy.

Family acceptance training also transforms outcomes. Parents seeking support now have access to culturally competent resources and services. Families completing these programs report improved relationships and reduced youth substance use.

Peer support networks provide crucial protective factors. Organizations like PFLAG offer family education and support groups. These communities create safety nets that prevent substance abuse.

Community-based prevention efforts target specific risk factors. Pride centers offering youth programming see positive outcomes. These safe spaces provide alternatives to substance-using social environments.

Digital prevention tools reach isolated LGBTQ youth. Apps like TrevorSpace connect young people with supportive communities. Online resources provide 24/7 access to crisis intervention and support.

Treatment Approaches That Work

Culturally competent therapy models improve treatment outcomes significantly. Therapists trained in LGBTQ-specific issues create safer therapeutic environments. These approaches address underlying trauma while treating addiction.

Group therapy with LGBTQ peers shows particular promise. Shared experiences create powerful healing environments. Participants report feeling understood in ways traditional groups cannot provide.

Trauma-informed care addresses the root causes of LGBTQ substance abuse. These approaches recognize the connection between discrimination and addiction. Treatment plans incorporate trauma healing alongside substance abuse recovery.

Medication-assisted treatment helps many LGBTQ individuals. However, providers must understand potential interactions with hormone therapy. Specialized knowledge ensures safe and effective treatment protocols.

Overcoming LGBT Drug Use Starts With You

As important as policy changes and healthcare reform are for the LGBTQ community, taking action on an individual level is absolutely essential to forging a brighter future for all.

If you or someone you know is struggling with substance misuse, there are professional detox and rehab services available to provide the help you need. Recovery is possible for every LGBTQ person looking to create a brighter future for themselves, no matter what happened in the past.

Find the support you need today and move forward with a renewed sense of confidence and well-being.