Addiction and Lesbian, Gay, Bisexual and Transgender (LGBT) Issues

Abstract

This chapter examines addiction issues particular to lesbian, gay, bisexual, and transgender (LGBT) people. This includes a description of the available epidemiological data on substance use and addiction in the LGBT community, as well as a discussion about unique psychosocial issues that LGBT people face that increase their risk of substance use, such as stigma, social rejection, discrimination, harassment, HIV, issues specific to adolescents and young adults, internalized homophobia, and transphobia. Because the vast majority of research on substance abuse in the LGBT community is from North America, examples of social settings and substances specific to this LGBT community are used to illustrate how specific drugs can develop a unique appeal to an LGBT community in response to the psychosocial environment and stressors that a specific LGBT community faces. Substances discussed include methylenedioxymethamphetamine (MDMA, ecstasy), methamphetamine, gamma-hydroxybutyrate (GHB), anabolic steroids, and cross-gender hormones. In other LGBT communities, different psychosocial stressors lead to unique substance abuse patterns that must be understood to adequately treat addiction in those populations. General recommendations are made regarding the provision of clinically competent care for cases of LGBT addiction, and common clinical scenarios are discussed. The need for research on substance abuse patterns in LGBT populations is sternly emphasized in order to improve understanding of local patterns of substance abuse and to improve the provision of treatment to those populations.