LGBT Alcohol and Drugs

Substance misuse has been identified as a major issue for LGBT people.


The Lesbian and Gay Foundation published findings from a five year study in 2014 which found that lesbians, gays and bisexuals were seven times more likely to use illegal drugs and twice as likely to binge drink as heterosexuals.

This supports the findings of Gay and Lesbian Youth in Calderdale: Click on alcohol, drugs and tobacco for further information.

Here is a presentation of international statistics.

Research from Canada published in May 2014 found that minority stress is the main reason why LGB young people binge drink.

Why Are We More Vulnerable?

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.

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 and here to access research.

  • 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. Here is 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.

    Here is an Irish video with LGBTs talking about alcohol misuse

    from drugsdotie on Vimeo.

    Here is a presentation (mostly academic) on reasons why we are vulnerable.

    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 link to an excellent American website with videos aimed at reducing tobacco use amongst LGBT young people: This Free Life.

    What To Do?

    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.

    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, including suggestions for dealing with stress. Click here to access the report which also looks at what an 'ideal' service for LGBT young people with substrance misuse problems might look like.

    There are only a handful of support services that are specifically aimed at supporting LGBT people with substance misuse problems. In the North West, the Lesbian and Gay Foundation provide specialist services. In London, there is Antidote. To be honest I am not sure whether there are any other services but I think it unlikely.

    Improving Services

    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.

    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 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." However, to be honest, there does not seem to be much support from government to tackle substance misuse amongst LGBTs.

    In April 2011 the 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 LGBTs.

    Here is a presentation on why current services are inappropriate.

    London Friend have published a report, Out of Your Mind, improving provision of drug and alcohol treatment for lesbian, gay, bisexual and trans people, 2014. The scoping study examines how drug and alcohol treatment services could better meet the needs of LGBT people. It explores models of provision, and mechanisms for improved strategic inclusion of LGBT people when planning and delivering drug and alcohol support services. There are national and local recommendations plus various audit tools and guidance for commissioners, providers and practitioners.

    In a new book, Fundamentals of LGBT Substance Use Disorders, released by Columbia University Press, clinician Michael Shelton sums up what is known about the prevalence of LGBT substance abuse and treatment, and emphasizes the importance of affirmative therapy practices - counseling that supports and embraces client sexual identity. The book looks at not only how lesbians, gay men, bisexuals, and transgender individuals differ in their susceptibility to substance abuse, but stresses that treatment programs must consider many additional factors, including race, ethnicity, age, family relations, and place of residence in order to succeed.


    We can take responsibility for our actions: we don't have to use alcohol, drugs or tobacco but it is a hard struggle once we have become addicted. We can develop other ways of reducing and coping with stress.

    Here are some suggestions from LGBT young people: stress balls; counselling; alternative therapies; baking; relaxation; physical exertion; physical relief; spending time with mates/family (but only if you are out and they are supportive!); screaming; singing and dancing; listening to tuneage; swearing at pillows; hard day's work; getting enough sleep; cross-dressing; herbal teas/horlicks.