Substance Abuse in the LGBTQ+ Community
The LGBTQ+ community faces unique challenges and stressors that can contribute to higher rates of substance use and addiction. Discrimination, stigma, and social isolation, coupled with the pressure to conform to societal norms, can create a vulnerable environment.
Continue reading to learn more about specific factors that impact substance abuse in the LGBTQ+ community and highlight resources available to those seeking support and recovery.
What is a Substance Use Disorder?
According to the American Psychological Association (APA), substance use disorder (SUD) is a complex condition in which there is uncontrolled use of a substance despite harmful consequences. Individuals with substance use disorders have an intense focus — sometimes called an addiction — on using a certain substance(s) to the point where their ability to function in day-to-day life becomes impaired. These often include alcohol, tobacco, or other psychoactive substances. Individuals keep using the substance even when they know it is causing or will cause problems.
Substance use disrupts brain function, leading to the release of dopamine, a pleasure-inducing chemical. Once the temporary euphoria fades, individuals experience intense cravings in the brain and body, despite the harmful consequences. This cycle can lead to devastating impacts on emotional and mental well-being, relationships, education, and careers, and can even result in death.
It’s important to remember that like many other disorders, substance use disorders can range from mild to severe. However, regardless of the severity, these disorders are treatable, and help is available whenever you’re ready to seek it.
Substance Abuse in the LGBTQ+ Community
Over the past few years, substance abuse in the LGBTQ+ community has become an increasing problem. The 2023 Substance Abuse and Mental Health Services Administration report found the following statistics:
- Individuals who identify as gay or lesbian are more than twice as likely to have severe alcohol and tobacco use disorders.
- Individuals who identify as bisexual are three times more likely to have a substance use disorder.
- Individuals who are unsure of their sexual identity are five times more likely to have a substance use disorder.
- Transgender students are approximately 2.5 times more likely to use methamphetamines and cocaine compared to their cisgender peers.
Types of Substance Use Disorders
There are many types of substance use disorders. However, when it comes to substance abuse in the LGBTQ+ community, some disorders are more common than others, including:
- Alcohol use disorder
- Cannabis use disorder (marijuana)
- Phencyclidine use disorder
- Inhalant use disorder
- Opioid use disorder
- Sedative, hypnotic, or anxiolytic use disorder (benzodiazepines, zolpidem, and barbiturates)
- Stimulant use disorder (cocaine or methamphetamine)
- Other hallucinogen-use disorder (includes hallucinogens other than phencyclidine)
Signs and Symptoms of Substance Use Disorders
Since substance abuse in the LGBTQ+ community can take many forms, the signs and symptoms can vary depending on several factors. The type of substance and the severity of the individual’s dependence on it will both have an impact on the symptoms.
The symptoms and effects of substance use disorder depend on the specific substance used. These symptoms fall into two categories, related to whether the substance is currently active in the body: intoxication and withdrawal.
- Intoxication. These are the immediate, short-term effects of a substance on the body. Symptoms can range from drowsiness and calmness to excitement and intense emotions. Substances can also impair judgment, decision-making, and both physical and mental function.
- Withdrawal. These symptoms occur as the substance’s immediate effects diminish and it begins to leave the body. Withdrawal symptoms can be unpleasant and may include nausea, vomiting, diarrhea, sweating, insomnia, muscle cramps, and mood swings.
Generally speaking, the warning signs of substance use disorders can be broken down into three categories: physical, behavioral, and psychological.
Physical Warning Signs
- Bloodshot eyes, pupils larger or smaller than usual.
- Changes in appetite or sleep patterns.
- Deterioration of physical appearance and personal grooming habits.
- Runny nose or sniffling.
- Sudden weight loss or weight gain.
- Tremors, slurred speech, or impaired coordination.
- Unusual odors on breath, body, or clothing.
Behavioral Warning Signs
- Difficulties in personal and professional relationships.
- Engaging in secretive or suspicious behaviors.
- Frequently getting into legal trouble.
- Neglecting responsibilities at work, school, or home.
- Sudden change in friends, favorite places or hangouts, and hobbies.
- Unexplained need for money or financial problems.
- Using drugs under dangerous conditions.
- Increased drug tolerance.
- Misusing drugs to avoid or relieve withdrawal symptoms.
- Loss of control over drug misuse.
- Life revolves around drug use.
- Abandoning enjoyable activities to use drugs.
- Continuing to use it regardless of negative consequences.
Psychological Warning Signs
- Appearing fearful, anxious, or paranoid, with no reason.
- Lack of motivation, appearing tired or “spaced out”.
- Periods of unusually increased energy, nervousness, or instability.
- Sudden mood swings, increased irritability, or angry outbursts.
- Unexplained change in personality or attitude.
What Are Co-Occurring Disorders?
A co-occurring disorder is any combination of two or more substance use disorders and a mental health disorder. According to the National Survey on Drug Use and Health (NSDUH), approximately 21.5 million adults in the United States have a co-occurring disorder.
To be diagnosed with a co-occurring disorder, an individual must have any combination of two or more substance use disorders and a mental health disorder. The most common mental health disorders include:
- Generalized anxiety disorder
- Major depressive disorder
- Schizophrenia
- Bipolar disorder
- Post-traumatic stress disorder
- Attention deficit disorder
Mental Health Challenges in the LGBTQ+ Community
While sexual orientation and gender identity are not substance use disorders factors in and of themselves. However, individuals identifying as LGBTQ+ experience disproportionately higher rates of mental health challenges due to a variety of factors.
When individuals don’t have the proper support or guidance for coping with mental health disorders, they become more vulnerable to falling into unhealthy and self-harming behaviors, such as substance use dependency. Substance abuse in the LGBTQ+ community is often a result of these challenges, which include but are not limited to:
Discrimination and societal stigma. LGBTQ+ individuals may encounter homophobia from a wide range of people, including strangers, acquaintances, friends, and even family. Discrimination comes in many forms, such as employment discrimination, housing discrimination, and denial of services.
Violence and harassment. LGBTQ+ people can experience harassment in many ways from verbal attacks like slurs, derogatory language, or hate speech to physical and sexual assault. Members of this community are also more likely to experience hate crimes, bullying, microaggressions, and other forms of violence.
Lack of legal protection and healthcare. In many places, there are no laws protecting LGBTQ+ individuals from discrimination. Furthermore, members of the LGBTQ+ community may face barriers to accessing healthcare and a lack of insurance coverage.
Family rejection. Some LGBTQ+ individuals face rejection from their families, which can be particularly devastating. Without a strong support system, these individuals are more likely to end up without a home, a safe place to live, or other necessities and resources.
LGBTQ+ Mental Health Support
Bringing awareness to LGBTQ+ mental health is imperative to ensure members of this community feel seen, heard, and supported. One of the best ways to do this is to remain educated. Below, we’ve compiled a few key LGBTQ+ mental health statistics from the 2024 Trevor Project survey.
- More than 1 in 10 LGBTQ+ youth attempted suicide in the past year.
- 39% of LGBTQ+ youth seriously considered suicide last year.
- 50% of LGBTQ+ young people who wanted mental health care in the past year were not able to get it.
- 90% of LGBTQ+ young people said their well-being was negatively impacted due to recent politics.
If you or someone you know is experiencing suicidal thoughts, call the suicide prevention and crisis hotline, call us at 610-480-8919, or seek medical help at your local emergency room immediately.
At Malvern Behavioral Health, we strive to provide a safe and welcoming environment where every patient receives the same high-quality care we’d want for our own families. Our mental health professionals are dedicated to helping individuals struggling with substance abuse in the LGBTQ+ community find the most appropriate treatment programs and resources to meet their specific needs.
Our Wisteria Program provides mental health services to members of the LGBTQ+ community. Contact us today to see how we can help.
