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LGBTQ+ Addiction Care: What Does It Look Like?

LGBTQ+-friendly addiction treatment is essential to members of this community who have succumbed to drug and alcohol abuse. Imagine growing up and feeling alone and unaccepted. Different than everyone else. Maybe your family does not accept who you are. Maybe you haven’t accepted yourself yet. Maybe your community has shamed you into believing that who you are is wrong. So, like many others, you turn to drugs or alcohol to cope with those feelings. You numb them out.

But that can only work for so long, and soon your life becomes unmanageable. So you decide to get help. You go to a treatment center to help you heal from only when you’re there, the same issues that brought you there in the first place come up. Maybe the staff does not understand your unique needs, maybe your peers stigmatize you and say discriminatory slurs. Whether it be subtle insensitivities or outright discrimination, what happens when the place you go to for help perpetuates the same feelings and problems that landed you there in the first place?

Addiction in the LGBTQ+ Community

According to SAMHSA’s National Survey on Drug Use and Health, people in the LGBTQ+ community are more than twice as likely as the general population to have a substance use disorder. Those that identify as transgender are almost four times as likely to struggle with substance use. LGBTQ+ have a 120% higher risk of experiencing homelessness. 40% of transgender individuals will attempt suicide in their lifetime in contrast with less than 5% in the general population. People in this community are more likely to experience depression, anxiety, and PTSD.

As a therapist, I operate by the rule, first do no harm. For someone who is part of the LGBTQ+ community to go seek help in a place that does not understand their unique experiences, needs, and traumas- It may cause more harm than help.  It’s very clear to those who work with this population that people in the LGBTQ+ community have their own set of struggles that need to be addressed.

So What DOES LGBTQ+-Friendly Addiction Treatment Look Like?

Overall, treatment encompasses an array of things from the staff, to medical providers, to therapists, and case managers. Part of providing quality care is making sure that there is a holistic approach being taken where the client is being cared for in all areas of needs.

One thing most important things people want when asking for help is to feel understood and accepted. This starts with the professionals entrusted with their care. When seeking treatment, an individual will interact with an array of different staff members that all play a vital role in their recovery journey. For quality care, it is essential that these staff members, from the therapists, to tech staff, to medical providers, are well educated in understanding the unique needs of the LGBTQ+  population. Education encompasses a variety of things including understanding different terms (E.g, transgender, cisgender, polyamory, etc) to being educated on how to appropriately communicate when there is a lack of knowledge. Being able to ask such things such as “what is your preferred pronoun?” is something that may require special education for some people.

Behavioral Therapy in LGBTQ+ Addiction Treatment

Therapists need to be properly trained in processing the issues that may arise for people in this population. This means having the cultural competency to manage the different concerns. Let me provide an example. I have worked with clients that identify as part of that community that came from very religious families. Families that made them believe that if they lived out their authentic self, they would “go to hell”. As a therapist, one has to understand both the LGBTQ+ side of things as well as the religious background they grew up in. Quality care is not negating a person’s belief system and how they grew up but allowing them to make sense of how they could still have a relationship to God and be themselves at the same time. These are just a few people’s experiences but an example of the wide variety of knowledge that a mental health provider needs to learn in order to properly serve this population and provide that quality care.

Acute Medical Care in LGBTQ+ Addiction Treatment

Medical providers that are caring for the LGBTQ+ population have their own education they need to undergo. Take an individual who identifies as transgender for example. If a client is undergoing transition, the medical provider that is caring for their detox and mental health concerns need to take that into consideration. Not only this, people in the LGBTQ+ community are less likely to receive quality medical care than their cisgender counterparts. Having medical providers that are well versed in this population’s needs and provide a welcoming and accepting environment is key in someone’s recovery.

Then there is a more difficult piece to manage when providing quality care. While staff members can be understanding and well versed in working with a diverse population, the other individuals who are also seeking help may not be. A big part of the treatment experience is the connection and bonds that people build with their peers. One of the reasons that 12 step programs have been so successful is that they are built on community- one addict helping another. One of our greatest motivators as human beings is the need to belong. To feel a part of. Take that away from someone, and the results are catastrophic.  Individuals in the LGBTQ+ community often site feeling alone and different as a contributing factor to their using. Providing quality care is ensuring that a safe space is created so that every individual that walks in through those doors does not feel the same feelings that led them to come there in the first place.

Setting the Tone for Tolerance and Compassion

As a clinical director, I have a zero-tolerance policy for discrimination. This is not always easy to do, having an array of clients coming from different cultural backgrounds with different belief systems. Staff is trained to monitor and pay attention to how the clients interact with one another and any form of verbal discrimination, bullying, or negative behavior that may cause a person to feel less than based on their identity and sexual orientation is not tolerated.

Within the LGBTQ population, the transgender community has some additional needs that need to be considered. People in the trans community will seek treatment at various stages of their transition. To provide quality care, treatment centers need to be mindful of that. Often, groups are separated based on gender. This is done for therapeutic purposes. There are gender-specific issues that may come up while in treatment that is important to be addressed. In addition, it is important to provide a safe space for people to express their experiences. Part of the group therapy experience is for people to find relatability to others and as a result, feel less alone.

This is something to consider when someone who identifies as transgender enters the group. In order to provide quality care, it is important to ensure that everyone in the group is able to gain the benefits from the group, including those who identify as transgender.  Transgender clients have their own unique experience that sometimes does not always fit into gender-specific groups.

It is important to adjust the groups that are done to make sure it is in line with the needs and experience someone who is transgendered may have. Not doing so could lead to feelings of not belonging, inadequacy, and rejection- the same feelings that often lead to using in the first place. Instead, having groups that talk about experiences that are more related to those in the trans community and the LGBTQ+ community as a whole is essential to the healing process.

Additional Factors to Consider

In addition to considerations in the group, there needs to be extra considerations in the person’s living environment. Again, this is a space where residences are often separated by gender. Providing quality care means making those in that community feel safe and accepted. This means making sure that individuals are able to reside in residences that fit their gender identify needs.

Addiction in itself is a difficult thing to go through. It causes an array of issues including life becoming unmanageable, strained relationships, financial difficulties, legal issues, and health concerns to name a few. When you add to it the unique difficulties faced by those in the LGBTQ+ community, it is that much harder to stay clean. For many, using is their solution to a bigger problem. Seeking help means allowing yourself to explore the issues that lead to your use, depression, and anxiety in the first place. Providing quality LGBTQ+ friendly addiction treatment means helping people identify what those core issues are, helping them heal, and most importantly, providing them with a safe space where they no longer feel alone.

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