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Substance Abuse Trends in the LGBT Community

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Carver Ealy

on 4 June 2014

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Transcript of Substance Abuse Trends in the LGBT Community

Substance Abuse Trends in the LGBT Community
LGBT...LGBTQ...LGBTQIA
Extremely diverse population
Ask your client how they identify, never assume
Confirm what pronoun, and terminology that is unoffensive to the client
Treatment and Intervention for Women in the LGBT Community
• Most lesbian and bisexual women attend treatment programs or self-help groups that are designed for heterosexual individuals.

• In these programs, lesbian/bisexual woman may face the same prejudices and discrimination as they do in everyday life, but at a time when they are even more vulnerable and need support for sobriety or stability.
TRENDS OF SUBSTANCE USE |

MEN IN THE LGBT COMMUNITY

A major trend for gay men is meth, but she also sees a lot of pot use. This is so the meth is balanced out. Other addictions are alcohol. Processing addictions are sex. She said pot is huge among 20 and 30 year olds.

Heroin and cocaine use is also present and the age range is full spectrum.
Meth are all users. Users in their 30's started meth when they were younger. She explained meth as a huge prevalent in gay culture.

When asked what factors are present in env/social/cultural? She answered: "LGBTQ community could not be themselves at all in those areas. Hence, it becomes complex and leads to developing relations with community members that are drug addicted."
TREATMENT OF SUBSTANCE USING LESBIANS CONTINUED...
Stigma contributes to substance abuse in many ways, through the means of internalized oppression, and external social stigma which can result in exclusion, discrimination, harassment and violence.

Creates a great deal of stress for lesbians, especially coming from families or religious backgrounds that are more negative about same sex relationships
Working with Transgender Clients
WHAT DOES TRANSGENDER MEAN...
REFERENCES
Benotsch, E. (2013). Non-medical use of prescription drugs, polysubstance use, and mental health in transgender adults. Drug and Alcohol Dependence, 132, 391-394.

Comprehensive List of LGBTQ+ Term Definitions | Gender, Sexuality. It’s Pronounced Metrosexual. (2013). Retrieved from http://itspronouncedmetrosexual.com/2013/01/a-comprehensive-list-of-lgbtq-term-definitions/

Eliason, Ph.D, M. J. Best Practices for Lesbian/Bisexual Women with Substance Use Disorders. LGBT TRISTAR, 1-5. Retrieved May 5, 2014, from http://gilgerald.com/storage/research-papers/09%20report%20women.pdf

Flentje, A. Characteristics of transgender individuals entering substance abuse treatment. Addictive Behaviors, 39, 969-975.

Gay and Bisexual Men’s Health | Substance Abuse. Center for Disease Control and Prevention. (2013, March 22). Retrieved from http://www.cdc.gov/msmhealth/substance-abuse.htm

Grant, J. E., Flynn, M., Odlaug, B. L., & Schreiber, L. N. (2011). Personality Disorders in Gay, Lesbian, Bisexual, and Transgender Chemically Dependent Patients. American Journal On Addictions, 20(5), 405-411. doi:10.1111/j.1521-0391.2011.00155.x

Jordan, K. M. (2000). Substance Abuse Among Gay, Lesbian, Bisexual, Transgender, and Questioning Adolescents. School Psychology Review, 29(2), 201

Lesbian, Gay, Bisexual and Transgender Drug Rehab - Drug and Alcohol Help for the LGBT Community. (2014). Lesbian Gay Bisexual and Transgender Drug Rehab. Retrieved May 5, 2014, from http://lgbtdrugrehab.com/

Resources | Transgender FAQ. Human Rights Campaign. Retrieved from http://www.hrc.org/resources/entry/transgender-faq

Szymanski, D. M., Kashubeck-West, S., & Meyer, J. Internalized Heterosexism: A Historical and Theoretical Overview. The Counseling Psychologist, 36, 510-524. Retrieved May 5, 2014, from http://www.researchgate.net/publication/ 237454242_Internalized_Heterosexism_A_Historical_and_theroretical_overview



Mosier, C. (2014, May 15). Personal interview.
Kamenetsky,J. (2014, May 15) Phone interview.
TRENDS CONTINUED...
JEFFERY ZACHARIAS, LCSW, CAADC, BRI-I | NEW HOPE AND RECOVERY
Works primarily with gay men and men who sleep with men but do not identify themselves as gay.
All clients suffer from addiction. The services offered are partial hospitalization, intensive outpatient and after care.
Zacharias, J. (2014, May 17). Personal interview.
DRUGS AND PROCESS ADDICTIONS
Meth, sex addiction, and technology (grinder)."It's a trifecta."
He has observed a major increase in process addiction "only because it has always been there but people are now taking notice that you can be addicted to anything. Addictions are layered. Process addiction is everywhere you just have to look for it."
DRUG CHOICE
Lesbians px, alcohol.
Gay men meth, coke, ecstasy.
Meth is seen as a dirty drug because it messes with your appearance and that is why coke is making a comeback.
Young gay men it's pot and px.
sedatives are always in the mix to help come down from meth such as Special K and GHB.
TRENDS IN SUBSTANCE ABUSE + GAY MEN CONTINUED...
ENVIRONMENTAL, SOCIAL, & CULTURAL FACTORS

A shame cycle and can lead to addiction.
Environmental
: what type of household were you raised in?
Social
: How was the coming out experience?
Cultural
: Ethnic background
AGE FACTORS
Older gay men? (age 45 and above) stick more with alcohol .
Younger gay men

(below age 45) use meth and more party drugs.
"If your coming out experience was bad then coming out about your addiction may be difficult due to that past experience."
Zacharias, J. (2014, May 17). Personal interview.
“The most prevalent choice of drugs are alcohol and tobacco within the LGBT
population. Alcohol and tobacco are highly advertised and easily accessed.

• These substances exploit the connection many LGBT individuals have to bars and clubs as safe spaces for socializing and increase easy access to alcohol and tobacco” (Mosier).

• “Marijuana, crack cocaine, and methamphetamine are other highly popular and addictive drugs within this population although crystal meth is more common among gay men. Lesbians are more hesitant to use meth because of the shame attached to it” (Mosier).
• Alcohol abuse occurs at a higher rate among lesbians than the general population

• Reasons include: incidences of prejudice, trauma, social problems due to orientation, and Dual Diagnosis conditions

• Dual Diagnosis conditions such as depression and anxiety have lead many individuals to attempt self-medication by drinking.
ALCOHOLISM IN THE LESBIAN COMMUNITY
• According to Dr. Mosier, Internalized heterosexism, internalized homophobia, and internalized transphobia have been prominent implications in working with this population.

• “Experiences with heterosexism among LGBT individuals can elicit insecurities and confusion in coming out” (Mosier).
IMPLICATIONS OF WORKING WITH THE LESBIAN POPULATION + SUBSTANCE USE
According to Dr. Mosier, opiates are highly abused among the LGBT population; pain meds in particular (Vicodin)

LGBT individuals often abuse prescription opiates such as pain killers to escape from societal pressures and produce feelings of calm and relaxation.
METHODS OF TREATMENT & SUPPORT GROUPS
• Lesbian and bisexual women may choose from a variety of settings for treatment:

- LGBT specific services
- Women specific services
- Other setting such as NA/AA or other social support types of programs
Lesbian, Gay, Bisexual and Transgender Drug Rehab - Drug and Alcohol Help for the LGBT Community. (2014). Lesbian Gay Bisexual and Transgender Drug Rehab. Retrieved May 5, 2014, from http://lgbtdrugrehab.com/
Eliason, Ph.D, M. J. Best Practices for Lesbian/Bisexual Women with Substance Use Disorders. LGBT TRISTAR, 1-5. Retrieved May 5, 2014, from http://gilgerald.com/storage/research-papers/09%20report%20women.pdf
Source: Eliason, Ph.D, M. J; Best Practices for Lesbian/Bisexual Women with Substance Use Disorders.
Transgender – or trans – is an umbrella term for people whose gender identity or expression is different from those typically associated with the sex assigned to them at birth (e.g., the sex listed on their birth certificate).
Conversely, cisgender – or cis – is the term used to describe people whose gender identity or expression aligns with those typically associated with the sex assigned to them at birth.
WHAT DOES CISGENDER MEAN...
BARRIERS TO TREATMENT |
Transgender Men
Transgender men are 5 times more likely to live with a substance abusing partner than cisgender men
BARRIERS TO TREATMENT |
Transgender Women
More likely to use methamphetamines
http://www.hrc.org/resources/entry/transgender-faq
Report higher levels of family conflict than cisgender individuals and transgender women
More reports of physical health problems upon entering substance abuse treatment that must be addressed
Flentje, A. Characteristics of transgender individuals entering substance abuse treatment.
Addictive Behaviors
, 39, 969-975.
TRENDS OF SUBSTANCE USE |
Transgender Community
Average age of first use: TM - 15, TW - 19
Transgender identity is not associated with higher odds of specific substance use among men
No more or less likely to than cisgender counterparts to report use of primary substance in the past 30 days prior to treatment
Higher levels of needle use
High rates of non-medical use of hormones, stimulants, and analgesics
(Benotsch, 2013
)
Flentje, A. Characteristics of transgender individuals entering substance abuse treatment.
Addictive Behaviors
, 39, 969-975.
Benotsch, E. (2013). Non-medical use of prescription drugs, polysubstance use, and mental health in transgender adults. Drug and Alcohol Dependence, 132, 391-394.
More likely to abuse hormones for non-medical purposes: FTM - 4.3%, MTF - 45.8%
Trends or Stigmas?
Twice as likely to be diagnosed with some form of substance use disorder compared to heterosexual adults. (Grant, 2011)
94% of chemically dependent LGBT clients may present with a DSM IV Personality Disorder (Grant, 2011)
More likely to have higher rates of substance abuse, and continue heavy drinking later in life. (CDC)
MSM
WSW
ZHE
Post-Op
Bottom
MTF
FTM
Queen
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