Substance use in the LGBTQ+ community is a significant problem.  Statistics show that LGBTQ+ adults are more than twice as likely as their heterosexual counterparts to use illicit drugs and almost twice as likely to have a substance use disorder (Source: SAMHSA NSDUH Data Review, October 2016, Medley, et al. (Figure 11).

The issue is especially pressing for LGBTQ+ youth.  Statistics show that LGBTQ+ youth have significantly higher rates of substance use compared to their straight peers and are 25% more likely to report using alcohol and marijuana (Source: Kann L, McManus T., Harris W.A., et al. (2018). Youth Risk Behavior Surveillance — United States, 2017. MMWR. Morbidity and Mortality Weekly Report (SS-8),1–114.)

What contributes to the higher rates of substance use in the LGBTQ community?

• Stigma.  While acceptance and progress have been made, almost every LGBTQ+ person has experienced discrimination and homophobia.  This is often in the form of harassment, hate crimes and bullying. 
• Lack of Support.  Many members of the LGBTQ+ community experience rejection from family, friends, and co-workers.  This can come in the form of disapproval, mistreatment and/or violence.  Sometimes LGBTQ+ youth are forced out of their family home. 
• Internalized homophobia.  This happens when the person self-identifies with anti-gay stigmas.  LGBTQ+ people have been taught from childhood that heterosexuality is the norm and heard negative and derogatory depictions of LGBTQ+ persons.  This can cause the person to internalize these messages and develop self-loathing and hatred.

Alcohol and drug use temporarily dulls the pain from these messages and silences the negative feelings from having a stigmatized identity. 

Preventing Substance Use in the LGBTQ+ Community

• at schools.  Schools need to establish strong anti-bullying policies, provide teacher and staff trainings, create safe spaces for LGBTQ+ youth to retreat to during school, and establish gay-straight alliances.
• Create safe and nurturing environments at work.  Employers need to establish policies that protect LGBTQ+ workers safety, create opportunities for advancement and encourage employing a diverse workforce.
• Create Safer Communities.  Create and support community safe spaces for LGBTQ+ members to socialize and gather.  Create stigma free communities.
• Legislation.  Advocate for fair and equitable opportunities for everyone.
• Substance Use Treatment.  Create prevention and treatment programs aimed at LGBTQ+ adults and youth that address their specific needs.  Ensure that treatment providers understand the issues that LGBTQ+ people encounter and provide trainings for staff to build cultural competency.
• Become an Ally.  Anyone can become an ally for LGBTQ+ persons.  There are no requirements, just a genuine desire to support people who face discrimination.  Allies are very important to the LGBTQ+ community and are effective and powerful advocates, who can stand up for the equal and fair treatment of people who are different than themselves.