Substance Abuse and Counseling in the LGBT Community<br />By<br />Nicole Folmar<br />
Substance Abuse Problems in the LGBT Community<br />
Sexual orientation minority populations report higher rates of drug use and related problems (Grellaet al, 2009).<br />Man...
Other Reasons<br />Low self-esteem<br />Loneliness <br />Less societal support for self and relationships<br />Depression ...
Good News for LGBTs<br />Substance use among lesbians and gay men— particularly alcohol use—has declined over the past two...
Race and Ethnicity<br />White men and women are more likely than their nonwhite counterparts to report use of almost all l...
Special Issues for LGBT couples with Substance Abuse Problems<br />Questions to ask:<br />What is both partners’ level of ...
Have either of the clients experienced gay bashing ?<br />Is same-gender domestic violence present ? <br />Was the client ...
Couples Therapy for Treatment of Addiction<br />A meta-analysis of drug user treatment outcomes demonstrated that not only...
Communication Skills Training<br />Increased caring behaviors<br />Problem-solving skills<br />Continuing Recovery Plan<br...
Special Problems for Couples Facing Substance Abuse Problems<br />
Sex<br />Many people in recovery report sexual problems (heightened inhibitions and anxieties, higher levels of depression...
Lies<br />Substance addicted partners often have to lie to continue using their drug of choice.<br />This creates distrust...
Irresponsibility<br />Substance addicted partners may have a history of failing to show up for important events and appoin...
Abuse<br />Physical, verbal,  and emotional abuse can be an issue.<br />The abusive partner may or may not be the addict/a...
The Six S’s for Partner’s Affected by Addiction (Ligon, 2004)<br />1. Separate yourself, detach from the problem.<br />2. ...
Support Groups<br />In addition to therapy, couples can seek individual support groups to help them with their specific ne...
References<br />Freese, T. (December 5, 2010). NIDA blending addiction science and practice: evidence‐ based treatment and...
Grella, C. E., Greenwell, L., Mays, V. M., & Cochran, S. D. (2009).  Influence of gender, sexual orientation, and need on ...
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....
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Lgbt addiction

  1. 1. Substance Abuse and Counseling in the LGBT Community<br />By<br />Nicole Folmar<br />
  2. 2. Substance Abuse Problems in the LGBT Community<br />
  3. 3. Sexual orientation minority populations report higher rates of drug use and related problems (Grellaet al, 2009).<br />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. <br />Possible reasons for abuse:<br />Internalized homophobia: one study showed a small to moderate correlation (Brubaker et al, 2002).<br />Heterosexism<br />Harassment and intolerance<br />Shame<br />Family rejection<br />Gay bars as a center for social life<br />Acceptability of use within the community<br />
  4. 4. Other Reasons<br />Low self-esteem<br />Loneliness <br />Less societal support for self and relationships<br />Depression and anxiety<br />Lack of traditional social roles that slow drinking and substance abuse.<br />Studies show that SA is moderated by marriage, employment, and children (Hughes & Eliason, 2002).<br />Fewer LGBTs have children, commitment unions are not as supported by society, and employment discrimination is rampant (Hughes & Eliason, 2002).<br />
  5. 5. Good News for LGBTs<br />Substance use among lesbians and gay men— particularly alcohol use—has declined over the past two decades (Hughes & Eliason, 2002).<br />LGBTs are more likely to seek treatment and help for abuse and addiction problems as opposed to their heterosexual counterparts (Stahl et al, 2001).<br />
  6. 6. Race and Ethnicity<br />White men and women are more likely than their nonwhite counterparts to report use of almost all licit and illicit drugs.<br />Blacks report lower rates of current, binge, and heavy alcohol use and lifetime illicit drug use than do Whites.<br />In recent years, however, Blacks have reported slightly higher rates of current illicit drug use (9.7% vs. 8.1%).<br />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.<br />Latino gay men may have higher rates of drinking than either group (African American or Caucasian) alone.<br />(Harawa et al, 2008)<br />
  7. 7. Special Issues for LGBT couples with Substance Abuse Problems<br />Questions to ask:<br />What is both partners’ level of comfort being LGBT person ? <br />What stage of coming out are they both at?<br />Do both members of the couple have an adequate family/support/social network? <br />Are there significant health factors (either resulting from substance abuse or not)?<br />Under which circumstances and situations did they use? <br />Are there connections between the partners’ drug use and sexual identity or sexual behavior? <br />Do both partners use? <br />
  8. 8. Have either of the clients experienced gay bashing ?<br />Is same-gender domestic violence present ? <br />Was the client or their partner out as LGBT in past treatment experiences ?<br />Is any of the above correlated with periods of sobriety?<br />(NIDA, 2010)<br />
  9. 9. Couples Therapy for Treatment of Addiction<br />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).<br />Positive treatment outcomes include better relationship satisfaction and reductions in substance abuse.<br />Note: this research was done on a heterosexual population. <br />Mutual support, the acquisition of better problem-solving skills, and enhanced communication may be the reason (illustrated in Fig. 1)<br />
  10. 10. Communication Skills Training<br />Increased caring behaviors<br />Problem-solving skills<br />Continuing Recovery Plan<br />Standard Substance Abuse<br /> Treatment<br />Recovery Contract<br />Self-help Support<br />Figure 1. ‘Virtuous cycle illustrating concurrent treatment for substance use and relationship functioning.<br />(Stewart et al, 2009)<br />
  11. 11. Special Problems for Couples Facing Substance Abuse Problems<br />
  12. 12. Sex<br />Many people in recovery report sexual problems (heightened inhibitions and anxieties, higher levels of depression, etc.).<br />Some partners of LGBTs having sexual dysfunction in sobriety may feel it is their fault.<br />Many substance abusing partners may have had unprotected sex or sex with another party without their partners consent or knowledge.<br />This places their partner at increased risk for disease as well as creates distrust in the relationship.<br />
  13. 13. Lies<br />Substance addicted partners often have to lie to continue using their drug of choice.<br />This creates distrust between partners<br />The addict sees his partner as someone to hide important information from.<br />The partner sees the addict as someone whose word they cannot trust.<br />Addicted persons may have stolen from their partners or their loved ones.<br />
  14. 14. Irresponsibility<br />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.<br />Partners may feel the need to compensate or overcompensate for their addicted loved ones failings. <br />They may find themselves lying for their addicted partner or making justifications for their substance abuse or irresponsible behavior.<br />Partners end up feeling just as isolated and out of control as their addict counterparts.<br />
  15. 15. Abuse<br />Physical, verbal, and emotional abuse can be an issue.<br />The abusive partner may or may not be the addict/alcoholic.<br />Frustrated partners of addicts can resort to abuse when they run out of options to prevent the addictive behaviors.<br />
  16. 16. The Six S’s for Partner’s Affected by Addiction (Ligon, 2004)<br />1. Separate yourself, detach from the problem.<br />2. Set limits, roles, and boundaries.<br />3. Solidify your position, know where you stand.<br />4. Support sobriety.<br />5. Simplify your approach by setting up goals.<br />6. Sustain your physical, mental, and spiritual health.<br />
  17. 17. Support Groups<br />In addition to therapy, couples can seek individual support groups to help them with their specific needs<br />Alcoholics Anonymous—gay and lesbian meetings exist that can help to provide social support and friendship with other LGBT alcoholics.<br />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. <br />
  18. 18.
  19. 19. References<br />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<br />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.<br />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.<br />Fals-Stewart, W., Lamb, W., Kelley, M.L., (2009). Learning sobriety together: behavioural couples therapy for alcoholism and drug. Journal of Family Therapy, 31.<br />
  20. 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). <br />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.<br />Hughes<br />Ligon, J., (2004). Six Ss for families affected by substance abuse: family skills for survival and change. Journal of Family Psychotherapy, 15, 4.<br />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.<br />
  21. 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.<br />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.<br />Hughes, T. & Eliason, M. (2002). Substance use and abuse in lesbian, gay, bisexual and transgender populations. The Journal of Primary Prevention, 22, 3.<br />Torres, H.L. & Gore-Felton, C., (2007). Compulsivity, substance use, and loneliness: the loneliness and sexual risk model (LSRM). Sexual addiction & compulsivity, 14. <br />

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