Individuals who identify as lesbian, gay, bisexual, transgender, or questioning (LGBTQ) face many challenges that heterosexual individuals don’t. Social stigma, discrimination, harassment, and violence; these stressors increase the risk of behavioral and mental health issues as well as addiction

An estimate of 20 to 30 percent of the LGBTQ community abuse substances. This is compared to 9 percent of the population as a whole. In fact, one study found that transgender students are 2.5 times more likely to use meth or cocaine. Also, they are more likely to abuse prescriptions such as opioids or benzodiazepines

LGBTQ-specific treatment centers understand the needs and underlying issues of the LGTBQ community. Treatment should address unique factors like homophobia/transphobia, social isolation, family problems, and violence. According to the NIDA (National Institute of Drug Abuse), treatment centers that offer specialized programs for the LGBTQ community, have a much higher success rate than centers who do not. 

Challenges in the LGBTQ Community

Substance abuse is significantly higher in the LGBTQ community than in the population as a whole. The obstacles that the LGBTQ community faces that the heterosexual community does not play a big part in the increase in substance abuse. 

A few challenges include:

  • Discrimination
  • Hate crimes
  • Humiliation
  • Shame and rejection
  • Loss of employment
  • Internalized self-hatred 

These obstacles often lead LGBTQ individuals to turn to drugs and alcohol to self-medicate. Substances can numb the feelings they are experiencing. Emotions such as anxiety, anger, fear, and depression can be overwhelming, and numbing with substances can lead to addiction.

Why Substance Use Rates Are Higher in the LGBTQ Community


Members of the LGBTQ community face high levels of stress. While LGBTQ rights have come a long way over the past 20 years, many still face social prejudice. These can include discriminatory laws in employment, housing, parental rights, and health care. Some individuals are disowned by their families and mocked by their friends. The stress these issues cause can lead to anxiety, isolation, depression, anger, and fear and increases the risk of substance abuse.

Limited LGBTQ Treatment Centers

Many addiction centers are unable to meet the unique needs of the LGBTQ community. A study found that of the 854 treatment centers that report having specialized treatment services for LGBTQ, only 62 of these centers confirmed it by phone. This shows that around 70 percent of the centers that report specialized programs for LGBTQ do not actually offer any. This keeps many individuals from entering treatment.

Discrimination in Addiction Treatment

Because of the lack of LGBTQ services in treatment, many people are afraid of entering treatment and not receiving proper treatment due to their sexuality. Other patients and even therapists can turn a safe environment into a hostile one if they do not agree with their lifestyle. Open discrimination, intolerance, and stigma prevent many LGBTQ individuals from seeking help.

LGBTQ Facts on Addiction

According to 2015 data from the National Survey on Drug Use and Health, LGBTQ adults were over twice as likely as heterosexual adults (39.1 percent vs. 17.1 percent) to have previously used an illicit drug. 


Gay men are 3.5 times more likely to use cannabis than heterosexual men. And nearly a third of LGBTQ adults (30.7) used marijuana in the last year compared to heterosexual adults (12.9).


Individuals in the LGBTQ community are 12.2 times more likely to abuse amphetamines. While almost 10.4 percent of LGBTQ individuals misuse prescription pain relievers compared to 4.5 percent of heterosexual adults.


People in the LGBTQ community are 9.5 times more likely to abuse heroin compared to heterosexual individuals. 


A 2013 survey by the U.S. Census Bureau found that LGBTQ adults between 18 and 64 report binge-drinking at a higher percentage than heterosexuals. While 20 to 25 percent of the LGBTQ community have moderate to severe alcohol abuse issues.


LGBTQ members are 200 times more likely to use tobacco than heterosexuals. In a meta-analysis, lesbian, gay, and bisexual individuals are 90 percent more likely to use substances than heterosexuals. Bisexual minors used substances 3.4 times more than heterosexual minors. And lesbians and bisexual females used substances 4 times higher than heterosexual females. 

Co-occurring Disorders in the LGBTQ Community

Many of the members in the LGBTQ community live a “closeted” life. They hide their sexuality in fear of rejection from friends and family. The effects of this fear can become cumbersome and lead to mental health disorders and cause emotional distress.

Common co-occurring disorders include:

  • Major depression
  • Increased stress levels
  • Generalized anxiety disorder
  • Suicidal thoughts and tendencies

Physical and behavioral issues that can lead to addiction include:

  • Sexual dysfunction
  • Sexual assault or abuse
  • Compulsive sexual behavior
  • Anxiety-related to sex or HIV

Many LGBTQ individuals have co-occurring and sexual disorders. These disorders lead to substance abuse and eventually, addiction. Substance use disorder treatment should focus on any co-occurring disorders to help facilitate a successful recovery.

What are LGBTQ Substance Abuse Treatment Centers?

An LGBTQ treatment center or program focuses on the needs of the LGBTQ community. These centers offer specialized programs categorized by sexual orientation and gender identity. The staff is also part of the LGBTQ community and familiar with the issues within the community.

One of the benefits of LGBTQ substance abuse treatment centers understanding. Individuals share a shared understanding of the experiences that members of the LGBTQ community go through. Substance abuse treatment centers that offer services to straight individuals and LGBTQ individuals may also have staff from both communities. Staff who are not from the LGBTQ community will be specially trained to understand the needs of all their clients. 

LGBTQ substance abuse treatment centers and their staff should provide a welcoming and non-judgmental environment. This allows all individuals to recover from substance abuse and co-occurring disorders. LGBTQ treatment centers offer the same complete range of the programs provided in straight facilities.

The benefit to an LBGTQ treatment center is the added focus on specific issues like:

  • Homophobia/transphobia
  • Discrimination
  • Family rejection
  • Coming out

Mental health issues are prevalent in the LGBTQ community. So the most beneficial LGBTQ substance abuse treatment should have a strong focus on dual-diagnosis. A significant contributor to gaining control over and beating addiction is self-acceptance. 

Many individuals are still in the “closet” due to the fear of rejection. Not being able to be your “true” self keeps people in the darkness of addiction. LGBTQ substance abuse treatment not only treats addiction but helps individuals live “loud and proud” with confidence.

What to Look for in an LGBTQ Substance Abuse Treatment Center?

It can be a daunting task trying to find an LGBTQ treatment center. But it is vital to choose a facility that has a deep understanding of the social and psychological issues in the LGBTQ community. The center should provide a variety of treatments that offer support surrounding the problems. The goal of an LGBTQ substance abuse program is to help individuals cope with and manage daily life stressors without drugs and alcohol. 

A good LGBTQ substance abuse treatment center will help individuals learn how to:

  • Respond to discrimination in various settings. 
  • Handle anxiety and shame surrounding their sexual orientation or gender identification.
  • Handle peer pressure in a variety of environments.
  • Cope with coming out and the results of doing so.

Transgender individuals also need to be clear about housing and gender grouping. If it is a center that meets the needs of members from both the LGBTQ and straight communities will you:

  • Be able to attend group sessions with the gender you identify with?
  • Be able to stay in the residential facility with the gender you identify with?

Affirmative Treatment Centers vs. LGBTQ-Inclusive Treatment Centers

It is imperative to distinguish between programs that are LGBTQ-inclusive and those that offer affirmative treatment. In an LGBTQ-inclusive treatment setting, the center recognizes the LGBTQ community’s issues in its programs and activities. But, they do not openly reach out and invite LGBTQ individuals. In some instances, a center may label themself “inclusive” but does not provide extra support or make them feel welcome. 

An LGBTQ affirmative center is welcoming and accepting and even reaches out to the LGBTQ community. Affirmative treatment centers focus on the primary factors of LGBTQ substance abuse, including:

  • Discrimination
  • Harassment
  • Violence
  • Trauma

In an affirmative treatment program, the validation of identity is the center element of treatment. The LGBTQ experience is front and center. 

LGBTQ Substance Abuse Treatment Programs

Substance abuse treatment programs for LGBTQ individuals comes in many forms. They offer all the features of a typical recovery program plus more. Programs should offer LGBTQ individuals comprehensive, evidence-based, trauma-informed recovery treatment. The programs should allow LGBTQ individuals the freedom to explore who they truly are in a safe and secure environment.

Programs in an LGBTQ substance abuse treatment center include:

  • Safety
  • Trauma-informed care
  • Cognitive-Behavioral therapy
  • Dialectical Behavioral therapy
  • Motivational interviewing
  • Acceptance therapy
  • 12-step programs

A successful treatment plan for LGBTQ individuals should include:

  • Substance use counseling
  • Individual, group, and family therapy
  • Medical care
  • Medical detox
  • Medication management
  • Psychiatric evaluation
  • Aftercare

An LGBTQ substance abuse treatment plan should focus on the acceptance of identity. It should work to provide the tools necessary for coping with the challenges of acceptance. The most significant benefit of an LGBTQ substance abuse center is the environment of acceptance. Also, the lack of judgment or discrimination is most helpful.

LGBTQ Substance Abuse Treatment at Coastal Detox

At Coastal Detox, we offer a variety of programs and services to the LGBTQ community. Our professional staff understands the unique needs of the LGBTQ community. Our dual diagnosis program strives to heal the complete person and facilitate a life of sobriety.

What are you waiting for? Contact us today and learn about all the programs and services we offer to fight addiction in the LGBTQ community.