Health professionals in Alabama who work with lesbian, gay, bisexual and transgender (LGBT) clients suggest that LGBT people use more of all substances than the general population. Current research suggests that about 30% of the LGBT population abuse substances, while only about 12% of the rest of the population does.
Internalized homophobia, alienation, poor support structures, and high levels of depression all contribute to substance abuse among lesbian, gay, bisexual, and transgender individuals, with social activity at bars and clubs reinforcing addictive behavior. The threat of bias in treatment programs also prevents many from seeking help.
According to 2015 data from the National Survey on Drug Use and Health, adults defined as "sexual minority" (in this survey, meaning lesbian, gay, or bisexual) were more than twice as likely as heterosexual adults (39.1 percent versus 17.1 percent) to have used any illicit drug in the past year.
Nearly a third of sexual minority adults (30.7 percent) used marijuana in the past year, compared to 12.9 percent of heterosexual adults, and about 1 in 10 (10.4 percent) misused prescription pain relievers, compared to 4.5 percent of heterosexual adults.
Addiction treatment programs offering specialized groups for gay and bisexual men have shown better outcomes for those clients compared to gay and bisexual men in non-specialized programs; but in one study, only 7.4 percent of programs offered specialized services for LGBT patients.
Research is currently limited on rates of SUD among transgender populations, although research shows that transgender individuals are more likely to seek SUD treatment than the non-transgender population.
Current research suggests that treatment should address unique factors in these patients' lives that may include homophobia/transphobia, family problems, violence, and social isolation.
Sexual minorities with SUDs are more likely to have additional (comorbid or co-occurring) psychiatric disorders. For example, gay and bisexual men and lesbian and bisexual women report greater odds of frequent mental distress and depression than their heterosexual counterparts.
Transgender children and adolescents have higher levels of depression, suicidality, self-harm, and eating disorders than their non-transgender counterparts. Thus it is particularly important that LGBT people in SUD treatment be screened for other psychiatric problems (as well as vice versa) and all identifiable conditions should be treated concurrently.
LGBTQ people are also at increased risks for human immunodeficiency virus (HIV) due to both intravenous drug use and risky sexual behaviors. HIV infection is particularly prevalent among gay and bisexual men (men who have sex with men, or MSM) and transgender women who have sex with men. SUD treatment can also help prevent HIV transmission among those at high risk. For example, addiction treatment is associated not only with reduced drug use but also with less risky sexual behavior among MSM, and those with HIV report improvements in viral load.
What should you, LGBTQ person do for addiction treatment once you arrive at a rehab center? Fortunately, the onus is on the treatment centers themselves. If a facility is unaware of the issues that are unique to LGBT people and families, then it is the responsibility of the facility to refer the individuals to a place that can offer them exactly what they need. Forcing LGBT people into a generic addiction treatment program, and brushing aside the specific rehabilitation goals, can easily lead to higher rates of treatment failures and relapse. This is by and large avoided.
Addiction treatment programs for LGBT people in Alabama properly reflect the dynamic between the nature of the drug abuse and the clients themselves. It is imperative that clients feel safe and comfortable in their treatment environment, so they must be made welcome to speak about their experiences without the fear of judgment or misunderstanding.
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