Substance Abuse Within the LGBTQ+ Community

Sarah Borish, PhD
December 4, 2020
4 min read

Substance abuse is a serious issue that affects millions of people daily around the world. According to research, LGBTQ+ individuals are 2.5 times more likely than the general population to experience anxiety, depression, and substance misuse. Systemic biases, including discrimination and oppression, violence, and the denial of human rights are just some of the major issues individuals in the LGBTQ+ community face EVERY SINGLE DAY and could play a major part in why someone might turn to substances to cope.

Examples of LGBTQ+ discrimination:

  • Legal denial of access to health insurance, employment, housing, marriage, adoption, and retirement benefits
  • Bullying in school and a lack of laws protecting against it
  • Lack of social programs specifically designed for LGBTQ+ youth and adults
  • Shortage of healthcare providers who knowledgeable and culturally competent in LGBTQ+ health

A Deeper Look at Substance Abuse Factors for LGBTQ+ Individuals

LGBTQ+ Youth and Teens: The Stress of Stigma

Studies have found LGBTQ+ teens are twice as likely as their heterosexual peers to be bullied, excluded, or assaulted at school, and those who are victimized have higher rates of drug and alcohol abuse. And at home, LGBTQ+ teens are nearly 40% less likely to have an adult in their family they can turn to. When faced with the mounting stresses of stigmatized identity at school and loneliness at home, youth may turn to substances to cope.

Transgender Individuals Face Even More Discrimination

There are more than 1.4 million transgender individuals in the United States today, and even in 2020, the American Addiction Center reports this minority routinely faces denial in healthcare, marriage rights, housing, and employment. Due to this minority stress, research suggests transgender individuals are at a much higher risk of experiencing depression and anxiety than the general population.

Minority Within Minority: An Additional Challenge

Often individuals in the LGBTQ+ community also face discrimination and ignorance within an additonal group. For instance, an individual can identify as both LGBTQ+ and BIPOC, or someone who is lesbian, gay, bisexual, or transgender might practice a religion different from that of their neighbor. These added layers of complexity might make an individual feel isolated or alone in their experience and they may turn to drugs or alcohol to cope.

How Substance Abuse Affects Older LGBTQ+ Adults

A 2017 study conducted at New York University found older adults in sexual minorities were more than twice as likely as older heterosexual adults to use prescription tranquilizers nonmedically. They were also more likely to use prescription opioids nonmedically (4.7 percent vs. 2.3 percent) than older heterosexual adults.

Dual Diagnosis

Dual diagnosis refers to a subset of the population with both substance abuse disorders and a mental health diagnosis like depression or anxiety. In many of these cases, substances serve as a way to cope with emotional distress. LGBTQ+ adults are two times more likely to meet criteria for a mental health condition compared with their heterosexual peers, and transgender adults are four times more likely than cisgender peers. It’s, therefore, not surprising that roughly 30% of LGBTQ+ adults use drugs and alcohol compared with only 9% in the general population.

A Healthy Environment Can Reduce the Risk of Substance Abuse

Acceptance from friends, family, and community are crucial to the health of every individual, as is a safe physical environment. Since we know substance abuse within the LGBTQ+ community is often a result of experiences such as discrimination, oppression, trauma, and violence, creating safe physical and emotional environments for LGBTQ+ individuals is crucial when it comes to fighting this problem.

Healthy physical environments for LGBTQ+ individuals include:

  • Safe schools, neighborhoods, and housing
  • Access to recreational facilities, and activities
  • Availability of safe meeting places
  • Access to health services

Treatment Works

Working with providers and clinics who have experience with the unique issues facing the LGBTQ+ population is an integral part of recovery. Understanding the relationship between specific stressors, mood and anxiety, and substance use is a key element to treatment. Treatment can take the form of traditional therapy including weekly individual and group sessions, family therapy, as well as more intensive inpatient and outpatient programs. The severity of symptoms and degree of distress may determine the best approach. Here’s the good news: treatment works!

You are not alone. Carbon Health is here to listen.

At Carbon Health we believe in healthcare for everyone. For us, everyone really does include every person and identity. Our clinics are inclusive, judgment-free zones. Plus, no membership fees…ever.

If you think you or someone you know is suffering from substance abuse, find someone to talk to about your concerns. Carbon Health now has more virtual mental health sessions and providers available than ever before who are well-versed in the unique needs of the LGBTQ+ community. Our licensed therapists will not only help you during these challenging times but are here to listen and guide you through things you’re going through in your daily life.

Simply download the Carbon Health app, find a time that works for you and you’re all ready for your session. You are not alone. Carbon Health is here to listen.

Liked what you read? Learn more by downloading the Carbon Health app or visiting

Sarah Borish, PhD

Sarah Borish, PhD, is a clinical psychologist at Carbon Health. She enjoys focusing on the brain’s relationship to behavior and its effects on mental health.


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