LGBTQ+ & Addiction: The Unique Barriers To Addiction Treatment

For the LGBTQ+ community, there is a wealth of misunderstanding and stigma, add to this that some suffer from addiction and appropriate addiction treatment can be truly difficult to access.

The Lesbian, Gay, Bisexual, Transgender and Queer/Questioning (LGBTQ+) community encompasses a diverse array of people from various cultural backgrounds, races, ethnicities, religions and socioeconomic statuses.

The healthcare needs of the lesbian, gay, bisexual, transgender, or queer person can often be more complex than that of a heterosexual biological male or female.

Addiction affects people from all walks of life and is a recognised medical illness. The LGBTQ+ community are often put into a similar category when in reality people are just being their true authentic selves.

Being anything other than heterosexual and identifying with the gender you were born with, is not an illness, nor is it a choice. We don't choose the body we are born into, nor do we choose our sexual preferences. This is something that comes from deep within, and to deny or try to suppress that truth can be a catalyst for substance use.

Why The Stigma Exists For The LGBTQ+ Community And Those With Addiction

Sadly, The American Psychiatric Association once classified LGBTQ as a psychiatric disorder. However, in 1973, its members voted to decide whether homosexuality was a disease. The outcome of the vote resulted in a compromise and "sexual orientation disturbance" replaced homosexuality as a diagnosis for those who were in conflict with their sexual practice and orientation. Finally, in 1987, homosexuality was completely removed from the DSM.

Similarly, the DSM 1 (Diagnostic and Statistical Manual of Mental Disorders) categorised alcohol addiction under Sociopathic Personality Disturbance in 1952. Words such as addiction and alcoholism have been frequently used in the following editions of the DSM. It was not until the current edition of the DSM 5 that words such as addiction were removed and replaced by substance use disorder. This is due to the negative connotations that the word addiction still unfortunately carries.

Although the medical world has come a long way in recent years, these terminologies have stuck throughout the generations and still have negative associations today - both for the LGBTQ community and for those with substance use disorders.

The NIH (National Institutes on Healthcare) advise that healthcare providers should bear in mind the following practices when treating a patient from the LGBTQ community:

• Avoid discriminatory beliefs
• Basic knowledge of issues in the LGBTQ community including depression, discrimination, domestic violence, harassment, HIV, homophobia, safe sex, sexually transmitted diseases, substance abuse
• Use of appropriate language

The same advice is given to those that suffer from an addiction. Words, knowledge and approach really do matter when treating addiction and are especially important in the LGBTQ+ community

The Unique Challenges The LGBTQ+ Community Face To Addiction Treatment

As previously mentioned, LGBTQ+ individuals often have more complex needs when it comes to treating addiction and staying in long-term recovery. This is due to their varying treatment needs, which are often overlooked by healthcare professionals - mainly through a lack of knowledge and training that is specific to this group of people.

When it comes to healthcare and the LGBTQ+ community, there are many different variations that can present as barriers to effective treatment.

Barriers to Addiction Treatment For The LGBTQ+ Community Include:

• There are higher rates of anxiety, depression, and stress in the LGBTQ community
• Increased incidents of eating disorders
• Higher rates of homelessness
• Patients experiencing difficulty in openly discussing sexual health issues
• Higher rates of chlamydia, gonorrhoea, HIV, and syphilis, as well as immunisation for hepatitis A and B in MSM and CDC which require regular screening, treatment and education
• Healthcare professionals are unfamiliar with gender modification surgeries
• Lack of sensitivity in addressing sexual acts or complications unique to the LGBTQ community
• Patients may have previous traumatic experiences with healthcare professionals
• Failure to use gender-neutral terms such as significant other or partner
• Patients may be reluctant to share sexual practices and individual hormone use
• Judgement towards individuals that may engage in relationships with multiple partners or use substances to facilitate sex (Chemex and sometimes sex addiction)
• Lack of understanding of behaviour or terms
• Clinicians being afraid to ask questions and around the meanings of the terminology used in the LGBTQ community
• Making assumptions based on appearance or behaviour
• A lack of education about the use of black-market hormones
• Using language or words that are, insensitive, demeaning or discriminate
• Judging or being unsupportive of those who wish to have children but cannot biologically bear them
• Not truly understanding the unique challenges that the LGBTQ+ community face, or being willing to find out
• Failure to address trauma related to substance use and LGBTQ

Knowledge and Understanding Are Vital To Effective Addiction Treatment

People from the LGBTQ community are less likely to seek help for an addiction due to the above factors and previous poor experiences with unsympathetic or unknowledgeable clinicians. Yet, substance use is more frequent in this group of people than in the general population.

This is one of the many reasons that celebrating Pride month in June is so important as it provides a platform where the LGBTQ community have a voice. Those that truly want to help, will listen carefully to their needs

Everyone is welcome at Recoverlution

Recoverlution has developed a platform specifically for anyone affected by addiction or recovering from addiction. We understand that addiction transcends beyond a person's skin colour, economic background, gender or sexual preferences. We understand as we have been there ourselves.

Addiction is not a moral failing and can affect anyone. However, those that have suffered trauma, who are genetically predisposed, or who have had adverse environmental factors are more likely to develop a substance use disorder. Many in the LQBTQ+ community have faced adverse environmental factors, unique challenges, discrimination and trauma. Perhaps this is why there is a higher incidence of substance use and addictive behaviours within this population.

As we celebrate Pride Month in June with the LGBTQ+ community, we encourage those struggling with substance use to join our platform and connect with like-minded others. Often, people with addiction from different cultures, religions and other minority groups including LGBTQ can experience difficulty in having someone who truly understands. In the treatment field, this can present many difficulties for a person trying to get help.

We hope that by providing an all-encompassing safe platform where you can join or create your own support groups and meetings, the LGBTQ+ community will have more support of the right kind in overcoming addictive disorders.

References:

• The Classification of Substance Use Disorders: Historical, Contextual, and Conceptual Considerations:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5039518/
• Cultural Competence in the Care of LGBTQ Patients: https://www.ncbi.nlm.nih.gov/books/NBK563176/