For decades, research on rates of alcohol, substance use, and addiction in the adult LGBTQ community yielded conflicting data. Many studies showed high rates of binge drinking and illicit drug use in gay men. Others showed high rates of alcohol use disorder in lesbians. Still, other studies showed no significant differences in alcohol and drug use between gay and straight populations, male or female. Despite the varying and inconclusive evidence about adults, there was consensus in the mental health community about LGBTQ youth. Most therapists and researchers agreed they were at greater risk for developing substance use disorders, as compared to their heterosexual peers.

In their 2012 publication, “A Providers Introduction to Substance Abuse Treatment for Lesbian, Gay, and Transgender Individuals” the Substance Abuse and Mental Health Services Administration (SAMHSA) offered a logical explanation:

“LGBT youth use alcohol and drugs for many of the same reasons as their heterosexual peers…However, LGBT youth may be more vulnerable as a result of the need to hide their sexual identity and the ensuing social isolation. As a result, they may use alcohol and drugs to deal with stigma and shame, to deny same-sex feelings, or to help them cope with ridicule or antigay violence.”

Data collected in the 2015 National Survey on Drug Use (2015 NSDUH) finally cleared up the confusion and confirmed what the majority of early studies suggested: rates of alcohol and substance use were unmistakably higher in sexual minority populations – i.e the LGBTQ community – than in sexual majority populations.

Rates of Substance Use in the LGBTQ Community

Here are the most relevant data points from the 2015 NSDUH:

• LGBTQ individuals showed higher rates of substance abuse than sexual majority individuals.
  • Between 20-30% of LGBTQ individuals reported substance use problems, as opposed to about 10% of the sexual/gender majority.
• LGBTQ individuals showed higher rates of alcohol use than sexual majority individuals.
  • Around 25% of LGBTQ individuals reported problem alcohol use, as opposed to around 7.5% of the sexual/gender majority.

And here’s an additional set of data from the Human Rights Campaign issue brief, Preventing Substance Abuse LGBTQ Teens. Evidence shows LGBTQ teens are:

• 1.3 times more likely to engage in heavy alcohol use
• 1.6 times more likely to use marijuana
• 2.9 times more likely to inject drugs intravenously
• 3.3 times more likely to use cocaine.

Further data on bisexual adolescents, specifically, shows:

• Bisexual adolescents have rates of substance use 3.4 times higher than heterosexual adolescents
• Bisexual adolescent females were 4 times more likely to use substances than heterosexual females.
• Transgender adolescents were twice as likely to use cocaine, methamphetamine, and prescription pain medication than their non-transgender peers

This data is the reason we make a point to celebrate Gay Pride Month. It’s important to us to let LGBTQ teens know we’re allies. We know many of them are hurting and in need of our help. We don’t judge, discriminate, or question anyone’s choices about their gender identity and sexuality. Instead, we work to help LGBTQ teens become who they want to be, on their own terms, and in their own time.

LGBTQ Teens: Social Challenges

Although the stigma around sexual and gender minorities is slowly fading from our society, it still exists. Powerful and damaging stereotypes about LGBTQ individuals persist even today. LGBTQ youth often navigate a judgmental, negative, and unforgiving environment. Experts from SAMSHA theorize these difficult external circumstances increase their risk developing and experiencing significant internal “…conflict, identity confusion, or even self-hate.”

We open our hearts to these teens. We know they have significant hurdles to clear every day, simply because of who they are.

From years working with LGBTQ teens, we also know that in addition to all the typical pressures of adolescence, being in the sexual minority exposes LGBTQ teens to risks teens in the sexual/gender minority don’t have to face. Data shows LGBTQ teens are at increased risk of:

Stigmatization

• When teens come out, it doesn’t always go well. Their family, friends, teachers, and society in general may start to treat them differently than they treat individuals in the sexual majority.
• The heteronormative patriarchy is firmly entrenched, and some days LGBTQ feel like it’s an uphill battle just to be themselves.

Social isolation

• Their sexual and gender identity might cause them to withdraw from friends, family, and most social situations.
• They may no longer identify with the friends, hobbies, and activities they did only a couple of months ago.

Bullying

• Being in the sexual or gender minority increases their risk of verbal bullying and abuse from peers, teachers, and strangers on the street.
• They may also be the victim of anti-LGBTQ violence, in the form of both physical violence and interpersonal aggression.

This default situation explains – to us, at least – why many LGBTQ teens turn to alcohol or drugs initially, and develop substance use disorders subsequently. They’re coping mechanisms that help shield these vulnerable youth from difficult and painful emotions.

Treatment Works for LGBTQ Teens

LGBTQ youth struggling with addiction benefit from a compassionate, welcoming, and understanding therapeutic environment. Recovery is a challenging prospect for anyone. The added issues LGBTQ youth face – isolation, alienation, interpersonal aggression, lack of acceptance, and internal conflicts – can make achieving and sustaining sobriety all the more difficult. Decades of research prove a robust social support network is crucial in helping non-LGBTQ individuals live a life free of drugs and alcohol, and recent studies show targeted interventions – also centered around social support and an inclusive, non-judgmental milieu – are effective in reducing drug use, increasing coping skills, and helping LGBTQ individuals develop the skills necessary for recovery and lifelong sobriety.

When seeking treatment for your LGBTQ teen, ask any provider you consider if they employ therapists with expertise in helping LGBTQ youth. Also, make sure the culture of the treatment facility not only accepts LGBTQ teens, but embraces them.

To help begin your search, you can use these two online resources:

• The Lesbian and Gay Child and Adolescent Psychiatric Association is an affiliate of the American Academy of Child and Adolescent Psychiatry (AACAP) and is committed to serving the mental health needs of sexual minority youth.
• The SAMSHA treatment locator allows you to specify your search to identify substance abuse professionals with experience in treating LGBT clients.