Lgbt addiction

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  • 1. Substance Abuse and Counseling in the LGBT Community
    By
    Nicole Folmar
  • 2. Substance Abuse Problems in the LGBT Community
  • 3. Sexual orientation minority populations report higher rates of drug use and related problems (Grellaet al, 2009).
    Many studies that demonstrate this result have used convenience sampling, where subjects are drawn from gay bars and pride parades where a great deal of celebration and drinking is present, so this finding may not be accurate.
    Possible reasons for abuse:
    Internalized homophobia: one study showed a small to moderate correlation (Brubaker et al, 2002).
    Heterosexism
    Harassment and intolerance
    Shame
    Family rejection
    Gay bars as a center for social life
    Acceptability of use within the community
  • 4. Other Reasons
    Low self-esteem
    Loneliness
    Less societal support for self and relationships
    Depression and anxiety
    Lack of traditional social roles that slow drinking and substance abuse.
    Studies show that SA is moderated by marriage, employment, and children (Hughes & Eliason, 2002).
    Fewer LGBTs have children, commitment unions are not as supported by society, and employment discrimination is rampant (Hughes & Eliason, 2002).
  • 5. Good News for LGBTs
    Substance use among lesbians and gay men— particularly alcohol use—has declined over the past two decades (Hughes & Eliason, 2002).
    LGBTs are more likely to seek treatment and help for abuse and addiction problems as opposed to their heterosexual counterparts (Stahl et al, 2001).
  • 6. Race and Ethnicity
    White men and women are more likely than their nonwhite counterparts to report use of almost all licit and illicit drugs.
    Blacks report lower rates of current, binge, and heavy alcohol use and lifetime illicit drug use than do Whites.
    In recent years, however, Blacks have reported slightly higher rates of current illicit drug use (9.7% vs. 8.1%).
    Blacks also experience more frequent and more severe consequences of drug and alcohol use, including poorer physical health outcomes and more severe social consequences, such as higher incarceration rates.
    Latino gay men may have higher rates of drinking than either group (African American or Caucasian) alone.
    (Harawa et al, 2008)
  • 7. Special Issues for LGBT couples with Substance Abuse Problems
    Questions to ask:
    What is both partners’ level of comfort being LGBT person ?
    What stage of coming out are they both at?
    Do both members of the couple have an adequate family/support/social network?
    Are there significant health factors (either resulting from substance abuse or not)?
    Under which circumstances and situations did they use?
    Are there connections between the partners’ drug use and sexual identity or sexual behavior?
    Do both partners use?
  • 8. Have either of the clients experienced gay bashing ?
    Is same-gender domestic violence present ?
    Was the client or their partner out as LGBT in past treatment experiences ?
    Is any of the above correlated with periods of sobriety?
    (NIDA, 2010)
  • 9. Couples Therapy for Treatment of Addiction
    A meta-analysis of drug user treatment outcomes demonstrated that not only is family-couples therapy more effective than no therapy, it also documented that family-couples therapy is more successful than (1) individual counseling (2) peer group therapy, and (3) family psychoeducation (Stanton & Shadish, 1997).
    Positive treatment outcomes include better relationship satisfaction and reductions in substance abuse.
    Note: this research was done on a heterosexual population.
    Mutual support, the acquisition of better problem-solving skills, and enhanced communication may be the reason (illustrated in Fig. 1)
  • 10. Communication Skills Training
    Increased caring behaviors
    Problem-solving skills
    Continuing Recovery Plan
    Standard Substance Abuse
    Treatment
    Recovery Contract
    Self-help Support
    Figure 1. ‘Virtuous cycle illustrating concurrent treatment for substance use and relationship functioning.
    (Stewart et al, 2009)
  • 11. Special Problems for Couples Facing Substance Abuse Problems
  • 12. Sex
    Many people in recovery report sexual problems (heightened inhibitions and anxieties, higher levels of depression, etc.).
    Some partners of LGBTs having sexual dysfunction in sobriety may feel it is their fault.
    Many substance abusing partners may have had unprotected sex or sex with another party without their partners consent or knowledge.
    This places their partner at increased risk for disease as well as creates distrust in the relationship.
  • 13. Lies
    Substance addicted partners often have to lie to continue using their drug of choice.
    This creates distrust between partners
    The addict sees his partner as someone to hide important information from.
    The partner sees the addict as someone whose word they cannot trust.
    Addicted persons may have stolen from their partners or their loved ones.
  • 14. Irresponsibility
    Substance addicted partners may have a history of failing to show up for important events and appointments, not coming home at night, and failing to keep jobs or finish tasks.
    Partners may feel the need to compensate or overcompensate for their addicted loved ones failings.
    They may find themselves lying for their addicted partner or making justifications for their substance abuse or irresponsible behavior.
    Partners end up feeling just as isolated and out of control as their addict counterparts.
  • 15. Abuse
    Physical, verbal, and emotional abuse can be an issue.
    The abusive partner may or may not be the addict/alcoholic.
    Frustrated partners of addicts can resort to abuse when they run out of options to prevent the addictive behaviors.
  • 16. The Six S’s for Partner’s Affected by Addiction (Ligon, 2004)
    1. Separate yourself, detach from the problem.
    2. Set limits, roles, and boundaries.
    3. Solidify your position, know where you stand.
    4. Support sobriety.
    5. Simplify your approach by setting up goals.
    6. Sustain your physical, mental, and spiritual health.
  • 17. Support Groups
    In addition to therapy, couples can seek individual support groups to help them with their specific needs
    Alcoholics Anonymous—gay and lesbian meetings exist that can help to provide social support and friendship with other LGBT alcoholics.
    Al-anon—friends and family of alcoholics and addicts are encouraged to attend to learn to live with their partners and to stop enabling their addictions.
  • 18.
  • 19. References
    Freese, T. (December 5, 2010). NIDA blending addiction science and practice: evidence‐ based treatment and prevention in diverse populations and settings. Retrieved fromhttp://www.seiservices.com/blendingalbuquerque/doc/13%20Freese.pdf
    Brubaker, M.D., Dew, B. J., & Garrett, M. T. ( 2009). Examining the relationship between internalized heterosexism and substance abuse among lesbian, gay, and bisexual individuals: a critical review. Journal of LGBT issues in counseling, 3, pp. 62-89.
    Cochran S.D., Ackerman D., Mays V.M., Ross M.W. (2004)Prevalence of non-medical drug use and dependence among homosexually active men and women in the US population. Addiction, 99(8), pp. 989-998.
    Fals-Stewart, W., Lamb, W., Kelley, M.L., (2009). Learning sobriety together: behavioural couples therapy for alcoholism and drug. Journal of Family Therapy, 31.
  • 20. Grella, C. E., Greenwell, L., Mays, V. M., & Cochran, S. D. (2009).  Influence of gender, sexual orientation, and need on treatment utilization for substance use and mental disorders: findings from the California quality of life survey. BMC psychiatry, 9 (52).
    Harawa, N. T., Williams, J. K., Ramamurthi, H.C., Manago, C. Avino, S., & Jones, M., (2008). Sexual behavior, sexual identity, and substance abuse among low-income bisexual and non-gay-identifying africanamerican men who have sex with men. Archive of Sexual Behavior, 37, pp. 748–762.
    Hughes
    Ligon, J., (2004). Six Ss for families affected by substance abuse: family skills for survival and change. Journal of Family Psychotherapy, 15, 4.
    Paul, J. P., Stall, R., & Bloomfield, K.A., (1991). Gay and alcoholic: epidemiologic and clinical issues. Alcohol health & research world, 15 (2), pp. 151-160.
  • 21. Stall R., Paul J.P., Greenwood, G., Pollack L.M., Bein E., Crosby G.M., Mills T.C., Binson D., Coates T.J., & Catania J.A. (2001). Alcohol use, drug use and alcohol-related problems among men who have sex with men: the urban men's health study. Addiction, 96, pp. 1589-1601.
    Stanton, M. D., Shadish, W. R. (1997). Outcome, attrition, and family- couples treatment for drug abuse: a meta- analysis and review of the controlled, comparative studies. Psychological bulletin, pp.170–191.
    Hughes, T. & Eliason, M. (2002). Substance use and abuse in lesbian, gay, bisexual and transgender populations. The Journal of Primary Prevention, 22, 3.
    Torres, H.L. & Gore-Felton, C., (2007). Compulsivity, substance use, and loneliness: the loneliness and sexual risk model (LSRM). Sexual addiction & compulsivity, 14.