Addiction Treatment Often Does Not Address Needs of LGBTQ Community: Expert

Addiction treatment professionals are often woefully unprepared to care for patients in the lesbian, gay, bisexual, transgender and questioning (LGBTQ) community, an expert said this week at the New York Society of Addiction Medicine annual meeting.

“Surveys of people in the LGBTQ community who have gone to treatment programs for alcohol or drug addiction find while some programs are very sensitive to their needs, too often they are not,” said Penelope P. Ziegler, MD, Medical Director and Chief Executive Officer of Professionals Resource Network in Fernandina Beach, Florida. “Too often we hear, ‘They put me in a private room because they didn’t know what I would do to my roommate. They treated me like a sex offender. Other patients made homophobic comments and it wasn’t even addressed.’”

LGBTQ patients who have these experiences find it extremely hard to get effective treatment, Dr. Ziegler noted. “Many go out of treatment and relapse. The situation is better than it was, but we still haven’t made nearly as much progress as we need to.”

There are many specific issues that this community faces in terms of addiction, she said. Among gay men, crystal meth and club drugs are popular. The particular drugs vary in different areas of the country. “In some urban areas with big rave scenes with electronic music, we see a lot of club drugs, synthetic marijuana and bath salts,” Dr. Ziegler said. “In other more rural areas, it’s a more alcohol-based scene with cocaine and other stimulants.”

Nicotine addiction is a major problem in the lesbian community, she said. “For reasons we don’t understand, the lesbian community is much less successful than the general population in quitting smoking. In addition to being a health hazard, smoking increases the likelihood a person won’t be able to maintain sobriety for other drugs. That means if you can stop smoking, your chances of staying in recovery are much better.”

Much of what is known about addiction in the transgender community is anecdotal, Dr. Ziegler observed. “From case reports and personal accounts, we know this community has serious problems with self-medication with drugs such as hormones that are not necessarily addictive, but are very dangerous if not used properly,” she said. “And people shopping online for hormones are also exposed to all sorts of opportunities to shop for other drugs, such as synthetic drugs.”

Medical professionals, including addiction specialists, are not keeping up with young people who consider themselves “gender fluid” or “gender queer,” she said. “These young people say, ‘Why should I have to pick between being male and female, or being straight or gay? Why can’t I just be me?’”

Some medical schools are beginning to address LGBTQ issues, Dr. Ziegler said. “But we also need to deal with older doctors, who are totally unprepared to deal with this issue.”

There are a number of resources available to the medical community about LGBTQ medical issues in general, and addiction in particular. These include the Gay and Lesbian Medical Association, the Association of LGBTQ Psychiatrists, which is affiliated with the American Psychiatric Association, and NALGAP, the Association of Lesbian, Gay, Bisexual and Transgender Addiction Professionals and Their Allies.

Read our Issue Brief on Preventing Substance Use Among LGBTQ Teens

We partnered with Human Rights Campaign to publish an issue brief on the unique challenges faced by LGBTQ teens that contribute to their heightened rates of substance use.

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