Why substance abuse is high in the LGTBQ+ community

Tis the season to be jolly- responsibly! TQ international guest writer Daniel Hochman discusses the relationships we have with alcohol.


Substance abuse is at least two times higher within the LGBTQ+ community. We are going to review why this is. Hint: it’s not genetic.

Throughout my study as a psychiatrist (and in studies from around the world), I worked with some of the leading minds in the addiction field, which sparked my interest to understand why we hurt ourselves even when we know better. My focus on the root causes of symptoms has brought me on a journey that has revealed a more holistic understanding of how addiction works.

Addiction finds its way into every corner of our society, but it especially hits those people in our society who suffer most. It’s not because afflicted people have worse genes or chemistry for harmful behaviour. Addiction always tells the story of a person – or a people – who are cast out, different, unwanted, unrecognised, unappreciated, etc. 

Addiction is the story of someone, or some group who is being left out.

The facts don’t lie: groups who suffer socially develop bad habits to cope. People of native descent only began to suffer from alcoholism after a series of multi-generational trauma. It’s the same for people of colour, veterans, people in poverty… the groups go on. The LGBTQ+ community is another unfortunate group of people who turn to substances to deal with being denied social acceptance.

Let’s not also forget that rates of trauma are significantly higher for the LGBTQ+ community. For example, they are four times more likely to experience violent assaults, including sexual assault, robbery, and aggravated assault. These all produce various forms of mental illness, with rates of PTSD ten times higher than the general population. Needless to say, this all creates further drive to find temporary relief through a substance. 

Trying to belong.

While the tide has been shifting for the better, still members of the LGBTQ+ community often feel wrong for being who they are. It is tiring to always navigate a world where you feel like you don’t belong and to constantly manage something inherent about you. 

Try and appreciate that endless effort for a moment, (I really mean it: pause for 10 seconds and sit with that). That’s the very state that drives a person to look for relief somewhere, somehow.

Sometimes seeking relief can lead to “people pleasing,” and other times drugs and alcohol. Both only further entrench that person in shame, feeling wrong for who they are. And so the cycle goes. 

Addiction in relationships.

For my LGBTQ+ patients, getting drunk or high is often the only way they know to suspend that self-judgment, and facilitate a free connection for just a little while. Now understand that both parties find the same relief in connecting without judgment. It’s easy to imagine how quickly a pattern of drinking or using together can establish a bad pattern in a relationship from the start. The same happens with a group, where everyone involved is collectively in need of a judgment-free place for an evening.

In a relationship then, it is often normalised and can indeed help them connect with each other in a more free manner. But of course, there are obvious costs. Costs to physical health, risks of accidents or sexually transmitted diseases, and ultimately the cost of shame.

The benefits of receiving private recovery solutions.

Very few rehabs or clinics are designed to consider and deal with the various factors at play here. It’s hard enough to show up for treatment in general… and even harder when you have to honestly question how accepted you will be when you get there. For example, homosexuality was a psychiatrically diagnosed illness up until 1973, and similar religious and secular notions remain. That can get in the way of seeking help at all. 

One of my motivations to create SelfRecovery.org was to allow anyone to access the highest quality programming without unnecessary barriers or distractions. Our philosophy is that the more free you are to focus on yourself, the more progress you’ll make. Privacy is critical to this process. I’ve found that individuals I’ve worked with in the LGBTQ+ community love Self Recovery because they can get right to work. If you know someone who needs help but seems stuck, please let them know about SelfRecovery.org

Whatever you do to climb out of the throes of addiction, find ways to ensure your healing process is not interfered with. Do your research to find somewhere you don’t have to simultaneously navigate extra issues around acceptance by peers or providers in treatment. Your treatment should not only be politely accommodating but warm and meaningful. Your existence should not be questioned or feared but respected and honoured.

Daniel Hochman, M.D, is a board-certified Psychiatrist and the creator of a revolutionary, science-based online addiction recovery program, SelfRecovery.org

UK Based readers can find links to help groups and organisations via the NHS website.

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