From Stigma to Support: Addressing Substance Use in the LGBTQ+ Population

It is true that members of the LGBTQ+ community consume substances at a higher-than-average rate, however, it is important to note that this statistic is not due to any moral failings. To help reduce the stigma and judgment that this topic can inspire, let’s discuss a theory as to why this statistic exists: the large amount of social stigma and discrimination that LGBTQ+ people face.

The Facts about the LGBTQ+ Community and Substance Use

The term “LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, and all related identities) community” includes anyone whose sexuality and/or gender identity is outside of heterosexuality or identifying as cisgender.

Adults who identify as LGBTQ+ are about twice as likely as those outside of the community to use drugs and/or have substance use disorder. The data is similar for adolescents who identify as LGBTQ+, with LGBTQ+ teens having a 190% higher likelihood than their peers outside of the community to use substances and/or die from an overdose. Due to the severe lack of scientific research on the LGBTQ+ community, there is a drought of data on how substance use varies when considering additional identities and backgrounds within the community.

What is “Substance Use”?

Substance use, as defined by the CDC’s National Center for Health Statistics, is the “use of selected substances, including alcohol, tobacco products, illicit drugs, inhalants, and other substances that can be consumed or otherwise absorbed into the body”. Substance use disorder is defined as the “consumption of a substance inappropriately or in ways that cause harm to themselves and the people around them.” Substance use can develop into a substance use disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (also known as an addiction) when substances are used for an extended period, begin to impact someone’s life or functioning, and/or are relied upon to cope with difficult feelings or situations.

The term “substances” serves as an umbrella for alcohol and drugs including (but not limited to) marijuana/cannabis (weed), cocaine, opioids (painkillers), and heroin. There is notable nuance in the potential harm of each substance and the methods of obtainment, but any use of a substance can develop into an addiction or cause harm.

Individuals who use substances but do not meet the criteria for substance use disorders are often still affected by their use and may experience side effects including legal consequences, social/relationship conflicts, or negative health outcomes. However, there is an important distinction between substance use in general (i.e. drinking alcohol infrequently during social situations only and without engaging in behaviors that could cause harm to self or others) and substance use that is considered a disorder or an addiction.

Why do People Use Substances?

With all the stressors that many of us face in our everyday lives, it is common to look for sources of relief. For some individuals, using substances is an avenue to quickly obtain that relief.

Consuming substances floods the brain with dopamine, which is a neurotransmitter that affects rewards, motivation, and pleasure, leading to an alteration of our brain’s “reward system”. This is why substance use can become an addictive way to cope with stress.

Because of the portions of the brain that are triggered when using, substances can start to become a crucial part of someone’s daily routine, forcing an individual to change their lifestyle; even if the individual may not want to continue consuming the substance. What starts as an attempt to cope can quickly become a chemical dependence and cause additional challenges that an individual never wanted.

Putting it All Together

With this knowledge, we can begin to connect the dots as to why the LGBTQ+ community has a higher rate of substance use and substance use disorders.

Members of the LGBTQ+ community often experience minority stress, which means that members of minority groups (racial/ethnic, gender, sexuality, religion, etc.) experience a greater level of stress due to adversity and social stigma, which often causes poorer health outcomes and a lower level of well-being.

The LGBTQ+ community also experiences higher rates of a variety of traumatic events, including homelessness, family conflict/rejection, poverty, bullying, harassment, and physical and sexual violence, contributing to the level of minority stress within the population. Due to the high rates of trauma and stress that members of the LGBTQ+ community often face, substance use is frequently cited as a way to temporarily “check-out” of difficult feelings. As such, substance use becomes a temporary solution to larger systemic problems.

Identifying Resources for Resilience

Now that we’ve discussed the correlation between substance use and the LGBTQ+ community, let’s review the resources that are available for those using substances and recovering from a substance use disorder:

Outpatient Mental Health Therapy

Therapy can be a great way to build strategies for reducing use and addressing the factors that led to the use of substances, including past traumatic experiences. Here at Avance Care, we have therapists specializing in addiction/substance use that offer in-person visits throughout North Carolina or virtual visits. To learn more and see a list of our available therapists, visit here.

Avance Care also has psychotherapy groups focused on those who experience substance use and/or desire to reduce their use. If you are interested, you can call (984) 263-0846 for more information.

Psychiatric Services

Psychiatric care, also called medication management, is another avenue to pursue treatment for addictions/substance use and other mental health conditions.

Avance Care has an Addiction Care program that provides medication management, at-home detox, and more with a licensed mental health provider. To learn more, visit here.

Rehabilitation Facilities

There are many facilities throughout North Carolina that specialize in medical care to promote recovery from a variety of substances. These facilities contain various levels of care, such as inpatient, residential, intensive outpatient, and outpatient services based on your level of need. Several of them also provide financial assistance, sliding scale services, therapy services, medication management, and case management services to help with the additional challenges that may increase stress levels. Here are some examples:

Support Groups

Support groups are free meetings comprised of other individuals who use substances that are focused on providing mutual support, upholding accountability, and building skills to uphold recovery. All groups have a different structure and culture, so it is recommended to try multiple groups to find a good fit. Many of these groups have specific sessions for members of the LGBTQ+ community. Here is a list of some groups online or in-person throughout North Carolina:

If you are using substances and are finding it difficult to stop, you are not alone. Recovery is possible and there are resources available to you to help you down this journey.

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