Why Does the LGBT Community Face Higher Risk for Substance Abuse and Addiction? | Center on Addiction

Why Does the LGBT Community Face Higher Risk for Substance Abuse and Addiction?

Why Does the LGBT Community Face Higher Risk for Substance Abuse and Addiction?


Substance use and addiction is a significant problem in the lesbian, gay, bisexual, and transgender (LGBT) community. People who identify as LGBT are at a greater risk for substance use and mental health issues compared to those who identify as heterosexual.

More than twice as many LGBT adults compared to heterosexual adults reported using drugs in the past year, according to the latest data from 2015. Those who identified as LGBT were also more likely to smoke cigarettes, drink alcohol and binge drink, and nearly twice as likely to have had an alcohol or drug problem in the past year.

Additionally, LGBT individuals are much more likely than heterosexual individuals to have depression, anxiety or other emotional or behavioral problems and to think about or attempt suicide, all of which increase the risk of substance use.

Why are Substance Use Rates so Much Higher in the LGBT Community?

Members of the LGBT community face chronically high levels of stress. While we have made great strides in gay rights over the last 20 years, many LGBT individuals still have endured a long personal history of social prejudice. This can include discriminatory laws and practices in employment, housing, relationship recognition and health care, as well as stigma and challenges with their family and friends. This type of stress can lead to higher levels of anxiety, fear, isolation, depression, anger and mistrust, which can increase the risk of self-medicating with tobacco, alcohol and other drugs.

Limited Treatment Services for LGBT People

Addiction treatment facilities are often unable to meet the unique needs of LGBT people. A national study found that of the 854 treatment programs that reported to have specialized treatment services for LGBT people, only 62 confirmed these services actually existed during a telephone follow-up. This means that about 70 percent of the addiction treatment services noted as specialized for LGBT people were really no different from those provided to non-LGBT people.

Potential Discrimination in Addiction Treatment

In addition to limited specialized services, LGBT individuals may be reluctant to seek treatment or disclose their sexual orientation during treatment out of concern that treatment providers might be unaware of their specific needs or might be hostile to them. Stigma, intolerance and open discrimination are the most substantial barriers to substance use prevention and treatment in the LGBT community.

Improving Addiction Treatment for LGBT Individuals

LGBT alumni from various addiction treatment programs identified the need to improve treatment for LGBT individuals with addiction by offering separate units or facilities that are welcoming to them and their allies and treatment that is provided by LGBT and/or LGBT-affirming staff.

Just as efforts have been made to tailor addiction treatment based on sex, age, and cultural background, more needs to be done to ensure that LGBT individuals, who face unique challenges and a long history of stigma and discrimination, receive the care they need and deserve.

Adrianna Maldonado, M.A., ED.M.

Adrianna Maldonado is a research associate at Center on Addiction



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