The ABC's of LGBTQ Addiction

Addressing unique issues often overlooked in traditional treatment programs

LGBTQ-specific programs can more effectively treat sexual minorities with substance use disorders by addressing unique issues that are often overlooked in traditional programs. James Barry, counselor and LGBTQ specialist at the Hazelden Betty Ford Center in Rancho Mirage, CA, explores the ABC's of working with LGBTQ clients, parallels between addiction and sexual orientation/gender identity and intra-cultural connections, externalized-internalized homophobia, and LGBTQ-specific stressors. In addition, he provides an overview of the LGBTQ-integrative addiction treatment, which is geared towards supporting long-term health and recovery with respect, integrity, and positive affirmation.

Key Takeaways:

  • 50-75% of gay men and lesbian women do not disclose sexual orientation to healthcare providers.
  • 64% believe disclosure would lead to a substandard care.
  • LGBTQ = Lesbian, Gay, Bisexual, Transgender, Questioning
  • Gender and Sex are different identities.
  • Think "inclusive" not accepting.
  • Embrace differences.
  • Increase awareness and mindfulness.
  • Practice respect and acknowledge mistakes.
  • Stigma and discrimination = negative health effects.
  • Follow the patient's lead.
  • Don't make assumptions.
  • Be respectfully curious.
  • Research suggests that LGBTQ individuals benefit from uniquely tailored addiction treatment that is affirming and integrative.

The LGBTQ community is made up of many communities already at greater risk for substance use and mental health issues:

  • Two to four times higher rate of substance use disorders compared to the national average.
  • Nearly three times as many detox episodes.
  • Nearly two times as many inpatient treatment episodes.
  • 92% rate of co-occurring disorders.
  • 50% higher rate of history of depression diagnosis.
  • 50% higher rate history of anxiety diagnosis.
  • Two times as likely to report history of emotional abuse.
  • Two times as likely to report a history of physical abuse.
  • Three times as likely to report a history of sexual abuse.
  • Two times the rate of alcohol and other substance use disorders.
  • Two times the rate of cannabis use disorder.
  • Three times the rate of cocaine use disorder.
  • Three times the rate of methamphetamine use disorder.

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