SUBSTANCE USE IN THE LGBTQ COMMUNITY

Research indicates that LGBTQ people use some substances, such as tobacco, alcohol, and other drugs, at a rate 2-4 times that of the broader population.(1) LGBTQ substance use must be understood within the context of the stigma, prejudice, and discrimination to which LGBTQ people are constantly exposed. The Centre for Addiction and Mental Health notes that “isolation, alienation and discrimination from a homophobic society is stressful,” and that escaping from these feelings is one of the main reasons why LGBTQ people use substances.

When substances are illegal and unregulated there is no control over their purity or strength. This puts people who use substances at added risk for illness and overdose. People may also face risks such as criminalization, stigma, and discrimination as a result of their substance use. For these reasons, people who use substances may be hesitant to discuss their use, even with their health care providers.

Substance use is often viewed as a source of harm. While this can be true, it is also important to recognize substance use as a way to reduce harm and suffering in people’s lives as well. Use may mitigate emotional or physical pain, or it may enable people to socialize with others and find a community of support and acceptance. For this reason, it is important to understand substance use in the context of an individual’s social and personal life. This is especially true of LGBTQ people who experience high rates of discrimination and stigma.

WHY DO LGBTQ PEOPLE HAVE HIGHER RATES OF USE?

Being LGBTQ does not cause substance use, nor is substance use always related to an individual’s LGBTQ identity. LGBTQ people may use substances for the same reasons that other people do. However, it is also important to realize that there are some culturally specific reasons that LGBTQ people have high rates of substance use:

Lack of non-bar space: For many years, discrimination against LGBTQ people made visibility unsafe, and there were few options for socializing in LGBTQ environments apart from bars or parties. As a result, many LGBTQ people associate socializing with the use of alcohol and other drugs. When bars are a primary social outlet LGBTQ people may develop a peer set that uses alcohol or other substances regularly. Even now, not everyone within our communities has safe non-bar space in which to socialize.

Cultural acceptance: The use of some substances may be accepted within LGBTQ communities, or may be considered a part of cultural life, demonstrating or confirming personal identity and group belonging. A Toronto study of racial minority gay and bisexual men who attended circuit parties and clubs, for example, found that some participants reported feeling a sense of pressure or obligation to use drugs, especially if their friends were using them.

Criminalization History: Until 1969, homosexuality was illegal in Canada, and police repression of LGBTQ communities was constant. As a result, the fact that a drug is illegal may not communicate the same certainty of risk to LGBTQ people as it might to their straight peers—the lived experience of many LGBTQ people is that not everything that is criminalized is wrong.

Coping with Stigma: Some LGBTQ people use substances to cope with the stress of coming out, rejection from family and friends, discrimination, harassment, or internalized biphobia, transphobia, or homophobia.(12-13) Since LGBTQ people may deal with stigma throughout their lives, they may not exhibit the reduction in substance use with aging that is seen within the general population.

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Coping with trauma: A small US study found that experiences of violence, feeling unsafe on campus, and stress were associated with increased substance use among LGB students (trans students were not included in this study). A US study of HIV+ people found that traumatic stress related to their HIV status was associated with increased use of cocaine and crack.

Altering Mood: Studies with HIV+ trans people and men who have sex with men (MSM) found that feelings such as shame and internalized homophobia were associated with methamphetamine (meth) use. Researchers speculate that this may be a causal relationship.

Self-Medicating: Some LGBTQ people use substances to reduce the effects of health problems. The use of marijuana, for example, has been associated with anxiety and other mood disorders, but the directionality of the association (whether cannabis increases anxiety or whether anxiety draws people to use cannabis) has not been determined.

Recreation: The Addiction Research Foundation of Ontario noted that cannabis use enhances sensual pleasure, facilitates socializing, supports introspection and alleviates pain.(20) Other substances may offer similar benefits that outweigh or reduce the perceived risks of use.

SUBSTANCE USE BY LGBTQ YOUTH

Studies indicate that LGBTQ youth are more likely than their straight peers to use substances. Available data suggest that bisexual youth report the highest rates of use. However, apart from a large BC study, very little Canadian data is available about substance use by LGB youth, and almost no information is available about substance use by trans youth.

• A study of 509 high school students in Vancouver and Victoria, aged 13-19, found that LGB students were more likely than their straight peers to report using substances

• A study of youth ages 12-19 in BC high schools found high rates of drug use among bisexual students Similarly elevated rates of use among LGB students have been found in large US studies.(23-25) Among females, bisexuals report the highest levels of drug use, followed by lesbians, and straight youth. Among males, bisexuals report slightly higher rates of drug use than gay males, although both significantly outpace their straight peers.

• A study of racial minority trans women ages 16-25 found high rates of substance use. Marijuana use was most common, reported by 75% of young trans women, followed by alcohol (66%), ecstasy (23%), and cocaine (21%).
   

• Young people may use substances to reduce their anxieties about having sex. The BC high school study found that 32% of bisexual males and 14% of gay males reported using alcohol or other drugs before having sex. Among females, 34% of bisexuals and 27% of lesbians reported using alcohol or other drugs before sex.(22) A study of trans women under 25 found that 53% reported having sex while intoxicated.

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• A 2003 study of BC students aged 12-19 found that intoxicated driving was reported by 13% of gay male students, 10% of lesbians, 19% of bisexual females and 20% of bisexual males.

• Riding in a vehicle with an intoxicated driver within the past month was reported by 15% of bisexual males and 10% of gay males, compared with 18% of their straight male peers.

• Among females, the trend was reversed, with bisexual and lesbian students more likely to report riding with an intoxicated driver: 37% of bisexual females and 33% of lesbians had done so, vs. 23% of straight female students.

• The risk of driving intoxicated, or riding with an intoxicated driver, may be higher in rural areas where travel is reliant upon cars and trucks.

• LGB students may use substances as a way to cope with stressful experiences. LGB youth have rates of physical and sexual abuse far higher than their straight peers, report higher rates of relationship violence, discrimination, and victimization, and are less likely to feel safe at school.

• A study of Canadian high schools found that 70% of students heard homophobic expressions in school every day, including comments made by teachers. LGBTQ students also reported high rates of verbal, physical, and sexual harassment.

• Although the support of family, teachers, and friends has not been found to reduce substance use, it has been found to reduce the negative effects of substance use, and to buffer the effects of rejection on substance use.

• LGBTQ youth may be more likely to seek substance use treatment if they have negative experiences that outweigh the benefits of substance use. Young LB women were twice as likely as straight youth to lose friends due to drug use, and to report having sex when they did not want to. They were also twice as likely to receive substance use treatment.

• Contrary to stereotypes that associate high rates of substance use with urban areas, sexual minority youth in rural BC were more likely to report substance use than those in urban areas.

• This difference may be due to discrimination, lack of social support, and/or lack of LGBTQ services.(13) Rural youth may also have less access to harm reduction programs, such as needle exchanges.

• Substance use may be affected by sexual difference, even among youth who do not identify as LGB. Young women who identify as “mostly heterosexual,” reported drug use rates 1.5-4 times that of exclusively straight women.

• One study found drug use rates for “mostly heterosexual” males to be 2-3 times that of exclusively straight males.

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​This information is provided by Rainbow Health OntarioFor more detailed information, please visit RHO_FactSheet_LGBTDRUGUSEHARMREDUCTION_E.pdf

ALCOHOL & DRUG TREATMENT OPTIONS IN WINDSOR-ESSEX

For more information on alcohol and drug treatment options, please see the following link below
http://www.eriestclairclinic.com/img/get_help_in_wec_final_letter_size_mar_18_2013.pdf