Substance Misuse

Substance misuse has been identified as a major issue for LGBT people. Some of us start using alcohol, drugs and tobacco as a way of coping with the stress of coming out, experiencing homophobic abuse and lack of support in adolescence. Click on alcohol, drugs and tobacco for further information. Here is a presentation on statistics.

Alcohol use among the Lesbian, Gay, Bisexual, Transgender (LGBT) Community from drugsdotie on Vimeo.

Whatever your sexual orientation or gender identity, smoking and misusing alcohol or drugs can seriously affect your health. For LGBT people, however, using alcohol and drugs as a way of coping can create specific problems.

  • It means we can get stuck in the coming out process: instead of developing the strength and courage we need to work our way through the coming out process, we get stuck in the early stages with internalised self-hatred. This stops us developing real pride and a positive identity (as opposed to false pride brought on by substances). For example, some of us use alcohol and/or drugs as a way of maintaining a double life. Click here to see me reading Lucy's story.

  • Because of homophobia, LGBT people are vulnerable to mental health problems. There are also clear connections between substance misuse and mental health problems, especially depression and suicide attempts, but also schizophrenia and other serious mental health problems. Substance misuse makes us even more vulnerable. Click here to access Julie's story, and here to access Paula's story.

  • American research has found that LGBT people are more likely than heterosexuals to have experienced sexual violence. We can be highly vulnerable when coming out; even more so if we experience homophobic bullying, do not have support from our parents and are unable to access support elsewhere. Add onto this substance misuse and we are more likely to put ourselves in dangerous situations. Click here for John's story.

  • There are also clear links between substance misuse and risky sexual behaviour, have a look at this article by Matthew Todd, The roots of gay shame regarding the continuing high levels of HIV amongst men who have sex with men.

    What can we do?

    Most mainstream services set up to support people with substance misuse problems have a long way to go before they can begin to support LGBT people.

    In March 2010 the theme of the annual GALYIC residential was minority stress and how this applies to LGBT young people. We particularly looked at substance misuse as a way of coping, why LGBT young people are vulnerable to substance misuse and what we can do about it. Click here to access the report which looks at what an 'ideal' service for LGBT young people with substrance misuse problems might look like.

    Not all substance misuse problems amongst LGBT young people are connected to homophobia; some are made more complicated because their parents have drink or drug problems; others for some other specific reason. However, it is highly likely that issues concerning sexual orientation or gender identity will play a significant role for many and this must be faced honestly for treatment to be successful. Here is a presentation on reasons why we are vulnerable.

    We need to campaign to get local and national strategies to acknowledge the vulnerability of LGBT people to substance misuse and smoking. The research is there; it begs the question, why are we not included?

    The UK Drug Policy Commission published a literature review about drug use amongst the LGBT communities in 2010: The Impact of Drugs on Different Minority Groups: A Review of the UK Literature, Part 2: LGBT Groups as well as a briefing document and implications for policy and practice.

    As a result, the government's new 2010 Drug Strategy states, "Services also need to be responsive to the needs of specific groups such as black and ethnic minorities and Lesbian, Gay, Bisexual and Transgender users."

    In April 2011 the new Public Sector Equality Duty came into force which means that public services should, by law, meet the needs of those groups identified in the Act; this includes LGBT young people. Under the Duty, services can develop Positive Actions to meet any unmet needs identified. Very few substance misuse services are currently meeting the specific needs of LGBT people. Here is a presentation on why current services are inappropriate.

    We can also take responsibility for our actions: we don't have to use alcohol, drugs or tobacco; we can develop other ways of reducing and coping with stress.

    It is crucial if you are just coming to terms with being LGBT that you get appropriate support. You do not have to travel this journey on your own; doing so makes you more vulnerable. Contact your local LGBT youth group. Here you will find other young people who have been through very similar situations.

    Going to a local gay youth group - if you are lucky enough to have one in your area - means that you will be able to experience the 'normal' developmental tasks of adolescence: learning how to make friends, develop relationships, how to cope in a world that can sometimes be very oppressive. All this in a safe environment where you meet other young people the same age as you.