Substance Use Among LGBTQ Individuals

A Q&A with a research scientist

National surveys have estimated that two to 11 percent of Americans self-identify as LGBTQ (Lesbian, Gay, Bisexual, Transgender, and Questioning). Yet as a population, these individuals have historically been underrepresented in addiction research. As scientists have worked over the past three decades to remediate this gap, substance use characteristics and addiction treatment factors present among the LGBTQ population have begun to emerge.

In this Q&A, Bethany Ranes, PhD, research scientist with the Hazelden Betty Ford Foundation Butler Center for Research, comments on the recent Research Update, "Substance Use Factors among LGBTQ Individuals."

Q: What do you hope professionals glean from this Research Update?

A: The Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ) community has historically been underrepresented in addiction research, despite the fact that they are often at higher risk for substance abuse and dependence than heterosexual and cisgender individuals. As our field makes ever-growing strides in the direction of prioritizing culturally-competent care, I hope professionals are conscious of the importance of including LGBTQ awareness and competencies in their treatment services.

Q: What implications do these findings have for addiction treatment?

A: The primary implications of the current research demonstrate that many patients identify as LGBTQ, and their needs have to be met in an effective and culturally-competent way. The need to provide a safe environment, free from stigma or judgment, is particularly important for these individuals. There is still so much negativity directed toward the LGBTQ community. It was heartbreaking to see that there are so few services for these individuals across the nation. As late as the mid-2000s, we were still seeing studies identifying significant numbers of counselors who endorsed negative attitudes about LGBTQ patients. As treatment providers, the provision of a safe environment for therapeutic services, especially for our LGBTQ patients, has to become a critical priority.

Q: Where can professionals learn more about this issue?

A: As scientists and other professionals are becoming more aware of the need for addiction research on culturally-competent and effective services for LGBTQ individuals, a number of great peer-reviewed journals that are focused on LGBTQ-centered topics have started to gain traction. Some that I have come across include the Journal of Gay and Lesbian Social Services and Journal of Gay and Lesbian Psychotherapy.

The Fenway Institute, which is part of Fenway Health, is an organization whose work revolves around the identification and elimination of medical and mental health care disparities for LGBTQ patients. They have a great report available called Improving the Health Care of Lesbian, Gay, Bisexual, and Transgender People that gives information about providing culturally-competent health care to LGBTQ patients. That report also includes some helpful information about the LGBTQ community, overall, for those who may feel they are not familiar with LGBTQ cultural issues and considerations.

Q: What does the future hold for treatment in light of these findings?

A: As with any other issues related to traditionally underserved or underrepresented communities, we can only hope that the future holds a clearer understanding of the diversity and complexity of our patient population and how some needs may differ from others. As in many other fields, we have long held too narrow a view of what a patient looks like (or is supposed to look like), which significantly limits our ability to provide effective care to everyone who needs it. By broadening our field's understanding of the needs and cultural norms of the LGBTQ community, we add a completely new layer to our view of our patient population and include many more patients who can be treated successfully in the future.

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