People who identify along the LGBTQ spectrum are at an increased risk for mental health issues and substance use disorder. The reasons for this are unclear, but there is a solution if someone is struggling with either of these issues independently, or co-occurring substance abuse and mental health issues. Here, we hope to provide helpful resources that can help educate, inform, and advocate the fact that recovery is possible, no matter your problem.
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Depending on the specific group, non-heterosexual people are between ~3-12 times more likely to use drugs and have a substance use disorder.
LGBTQ people, on average, experience mental health issues at greater rates than the sexual majority, anywhere from 1.7 to 3.5 times more frequently.
We have a list of over a dozen LGBTQ-specific addiction recovery resources.
LGBTQ People & Substance Use Disorder
In America today, members of the LGBTQ community experience significantly higher rates of substance abuse than do the sexual majority. This has many contributing factors, and while the reasons may be obscure, the facts are not.
One study found that LGBTQ people were more likely to suffer from several substance use disorders as opposed to straight people.
Gay men, on average, were:
- 2.9 times more likely to become alcohol dependent
- 4.4 times more likely to use marijuana
- 3.4 times more likely to use any drug
Bisexual men reported significantly higher substance abuse rates than straight men and were:
- 5.7 times more likely to use any drug
- 5.2 times more likely to become alcohol dependent
Lesbian women were much more likely to have a substance use disorder or substance dependence issue, as they were:
- 3.2 times more likely to use any drug
- 12.4 times more likely to suffer from any drug dependence
Bisexual women showed significantly higher rates of alcohol, marijuana, and other drug use and dependence than heterosexual women, although the exact figures are unavailable in this study. Another study found that bisexual women were:
- 4.2 times more likely to report past-year drug use than heterosexual women
While substance use and dependence seems to occur at much higher rates in the LGBTQ community, LGBTQ people are also more likely to reach out for help when they are struggling. The single largest contributing factor toward someone’s chances for recovery is their willingness and ability to reach out for help. Thankfully, the LGBTQ community is a vibrant and compassionate one, and no matter what you’re struggling with, someone has gone through something similar. Aside from help in the community, there are also LGBTQ-centered recovery programs that can help address someone’s substance abuse problems, so long as they are willing to receive help and do the work.
Mental Health in the LGBTQ Community
In addition to substance abuse rates, there is also a significantly higher occurrence of mental health issues in the LGBTQ community. This, too, has many contributing factors, not the least of which is the unfortunate social stigma and prejudice that many sexual majorities display towards a non-standard sexual identity. This can lead to bullying, discrimination, violence, and a sense that someone is an outsider. This can increase stress, anxiety, and depression while also worsening any pre-existing mental health issues.
To illustrate, let’s take a look at one study which examined the increased rates of mental illness among LGBTQ people compared to their heterosexual counterparts, separated by sexual identity:
- Gay men were 1.79 times more likely to experience mental illness
- Bisexual men were 3.53 times more likely to have a mental illness
- Bisexual women were 1.94 times more likely to have a mental illness
The occurrence of a serious mental illness is also increased in the LGBTQ population as opposed to the sexual majority. A serious mental illness is defined as a psychological disorder that substantially interferes with one or more major life activities. This may have environmental as well as neurological roots, as LGBTQ people often face significant hardship at the hands of people who do not accept their gender/sexual identity. This could include the aforementioned depression and anxiety, but also PTSD if there was significant trauma in their life.
There is also a tendency for LGBTQ people to experience more co-occurring conditions than their heterosexual peers. This could include more than one mental illness, or a substance use disorder and a mental illness. The rates are as follows:
- Gay men are 2.95 times more likely to have co-occurring conditions
- Bisexual men are 2.84 times more likely to have co-occurring conditions
- Lesbian women are 3.25 times more likely to have co-occurring conditions
It should be reiterated that LGBTQ people are more likely to open up and seek help for any mental health or substance abuse issue they are facing, so while the rates of distress may be higher, the rate of recovery is also higher.
As far as treatment of co-occurring conditions is concerned, SAMHSA states:
“Integrated, concurrent treatment that addresses both conditions simultaneously has generated strong empirical support, appears to be preferable to clients, and is increasingly considered the current standard of care, particularly when combining psychosocial and pharmacologic approaches.”
Excerpt from the Treatment Improvement Protocol 42 (2020 Update), Page 87
In short, if someone is struggling with co-occurring conditions, their best chances for long-term recovery depend upon them receiving treatment and care for both conditions simultaneously. An integrated and parallel approach to treating co-occurring disorders has been shown to result in a greater chance of long-term recovery, and more positive long-term outcomes.
If someone has been struggling with mental health, substance abuse, or co-occurring conditions, there are ample avenues to get help. The first, and oftentimes scariest, first step is to tell someone you are struggling. The next step may be to enter treatment, find a support group, or find a therapist, but this all begins when you say that one magic word: Help!
LGBTQ-Specific Crisis Hotlines
There are a number of crisis hotlines, text lines, and online chat options for LGBTQ folks who are struggling with mental health or substance abuse issues. Some of these hotlines include:
- Trans Lifeline: Call 1-877-565-8860 in the US, or 1-877-330-6366 in Canada to speak with a volunteer crisis counselor between 10:00 am to 5:00 am EST.
- Oprima 2 para hablar con un operador en español.
- LGBT National Hotline: Call 1-888-843-4564 between 4:00 pm to Midnight EST, Monday through Friday, and Noon to 5:00 pm EST on Saturday. They also have an online chat option.
- GLBT Youth National Talkline: Intended for LGBTQ people under 20 years old. Call 1-800-246-7743 Monday-Friday between 4:00 pm to Midnight EST, and on Saturdays between Noon to 5:00 pm EST. They also have an online chatroom available.
- LGBT National Senior Hotline: For LGBTQ people 50 years and older. Call 1-888-234-7243 between 4:00 pm to Midnight EST Monday-Friday, and Noon to 5:00 pm EST on Saturday.
- Trevor Lifeline: Call 1-866-488-7386 to speak to a crisis counselor and find support services near you. They also have Trevor Chat online chat service. They also provide Trevor Text which you can access by texting START to 678-678 and Trevor Space, a social network for LGBTQ people ages 13 to 24.
- National Runaway Hotline: Call 1-800-786-2929 anytime, 24/7/365 to be connected with a crisis center team.
- THRIVE Lifeline: Text THRIVE to 1-313-662-8209 anytime, 24/7/365 to be connected to a crisis counselor.
- SAGE LGBT Elder Hotline: Intended for older LGBT people, anyone can call 1-877-360-5428 to speak with a certified crisis responder. They are open 24/7 and have Spanish speaking responders, as well as translation services for over 180 different languages.
- National Sexual Assault Hotline: Call 1-800-656-4673 anytime, 24/7 to be connected to a trained staff member. A service provided by RAINN, this hotline helps people get connected to sexual assault treatment providers in their local area. They also provide an online chat option.
- National Domestic Violence Hotline: Call 1-800-799-7233 anytime, 24/7 to speak with a domestic abuse or sexual assault counselor. They also provide an online chat option through their website.
Dual-Diagnosis Support Resources for LGBTQ People
Aside from helplines, there are many online LGBTQ-specific resources for finding help when someone is struggling with a mental health issue, substance abuse, or co-occurring issues. Some of these can include:
- The Trevor Project: This site provides a variety of LGBTQ-specific resources for young people who may be struggling.
- Human Rights Campaign – Healthcare Equality Index: This site provides evaluations of healthcare facilities to see if they provide an LGBTQ-inclusive approach to treatment. Search for LGBTQ-friendly healthcare providers in your local area.
- GLMA – Health Professionals Advancing LGBTQ Equality: A site dedicated to helping LGBTQ people find high-quality, trustworthy healthcare from medical professionals. They have a provider search tool that will identify LGBTQ-friendly healthcare professionals near you.
- It Gets Better: A non-profit aimed at inspiring and helping people who are struggling with mental illness, gender identity, social acceptance of their sexual or gender identity, and many other issues. They have some great stories from survivors of mental illness crises, substance abuse, and a variety of other struggles.
- National Institute on Mental Illness – LGBTQI: A helpful guide that provides a variety of mental health and substance abuse resources for LGBTQ people.
- Association of LGBTQ+ Psychiatrists: An organization made up of psychiatrists that work to educate and advocate on behalf of the LGBTQ+ community.
- Love Is Respect: A non-profit that is aimed at preventing dating and domestic violence. They have a page specifically geared towards LGBTQ+ relationships and dating violence.
- Anxiety and Depression Association of America – LGBTQ+ Communities: A site that provides LGBTQ-specific resources to inform, educate, and help someone find treatment for their own specific mental health needs.