ABSTRACT
Substance use disorder (SUD) health disparities exist for LGBT individuals, who demonstrate elevated rates of SUDs and variability in patterns of use by sexual orientation, gender, age, and race/ethnicity. Progression to a SUD is based on a complex interaction among the characteristics of the specific drugs themselves and their route of administration, an individual’s biology, genes, age, and the environment. Substance use has emotional, psychological, physical, and financial ramifications for families, and family-based interventions are strongly recommended; their goals are to stabilize the family system and promote abstinence. Assessment, withdrawal management, and placement in appropriate levels of care are necessary considerations for those seeking SUD treatment. A culturally nuanced approach considers LGBT-specific risk factors such as minority stress, internalized heterosexism, the coming out process, use of bars and clubs as primary social outlets, trauma, sexual activity, invisibility, and how these continue to influence current substance use patterns as well create obstacles for recovery efforts. The principles of trauma-informed and affirmative treatment guide treatment for LGBT individuals, couples, and families. Also, a culturally sensitive approach acknowledges the challenges that could arise with 12-step or other self-help group involvement, a common recommendation for those with a SUD.
