Abstract
The disparities between the LGBTQ+ community and heterosexual community, particularly the rate of substance abuse among these communities, have been a topic of interest in various research for decades. With the research finding being the existence of high rates of substance abuse among the LGBTQ+ community compared to their heterosexual counterparts, several factors are attributed to these differences. In this paper, the topic of substance abuse within the LGBTQ+ is explored, specifically the rates of substance abuse compared with their heterosexual counterparts.
This paper discusses contributing factors such as discrimination and Social Stigma, greater risk of experiencing violence and harassment, lack of care and family support, and peer pressure that exists within the group. The goal of this research paper is to increase the amount of available knowledge regarding substance abuse among the LGBTQ+ group to help understand this minority sexual group for healthy coexistence in the society between them and the heterosexual group.
Keywords: LGBTQ+ community, substance abuse, social stigma, discrimination, stereotyping, violence, heterosexual, heteronormative
Substance Abuse Within The LGBTQ+ Community
Substance abuse, for decades, has been an issue among the LGBTQ+ community. LGBTQ+ refers to the individuals who identify as lesbian, gay, bisexual, transgender, or questioning group. The sexual minority (LGBTQ+) individuals suffer from substance addiction and abuse. Commonly abused substances include alcohol and drugs such as methamphetamines, heroin, and opioids.
Substance abuse is more common in sexual minorities than in the general population. According to statistics, LGBTQ+ people are more than twice as likely as heterosexuals to take illegal substances and are nearly twice as likely to develop substance abuse issues. According to research, sexual minorities, such as lesbians, gays, and bisexuals, are at a greater prevalence of substance abuse and problems related to mental health than the heterosexual majority. Sexual minorities suffer a range of challenges trying to cope with their sexuality and dealing with social reactions that the heterosexual majority population does not.
In this regard, this literature review will discuss the reasons why the rate of substance abuse among the LGBTQ+ community is higher than that of those who are not. The review will strive to delve deep into the various contributing factors and the serious triggering issues the members of this community face on a daily basis. Some of the contributing factors discussed in this literature review include discrimination and Social Stigma, greater risk of experiencing violence and harassment, lack of support from family members and friends, and peer pressure.
The review will help deepen and advance the understanding of the critical issues that affect members of this minority group and aid researchers and policymakers in making appropriate decisions. In a society where mixed individuals with various sexual orientations exist, it is crucial to conduct studies and reviews that will help further the knowledge of individual groups to ensure a healthy coexistence between the sexual minority and the sexual majority, also called the heterosexual group.
Literature Review
Sexual attraction and sexual identity estimates from the National Survey on Drug Use and Health (NSDUH) were comparable to those from other national surveys. According to the 2015 NSDUH, 4.3 % aged 18 and up identified as members of a sexual minority, with 1.8 % identifying as lesbian or gay and 2.5 % identifying as bisexual (Medley et al., 2016).
Social stigma and discrimination that members of the LGBTQ+ group face all the way through their lifetime are stressors that may cause increased rates of use of substance within the LGBTQ+ community (Rosner et al., 2021; Ackermann, 2019; Anderson, 2018). These stressors can increase the risk of substance abuse among the sexual minority group. The acceptance of the sexual minority by the rest of American society is steadily growing. However, virtually every individual in the sexual minority group faces some challenges with stigma and discrimination. These may be perpetrated on them by strangers, friends, and even family members.
Anderson (2018) states that social stigma includes racial discrimination, employment discrimination, verbal harassment, and physical violence. He defines social stigma as the process of making labels, stereotyping, and rejecting the differences that exist among humans as a means of social control.
Stigmatization causes distress due to stress. This group is more vulnerable to these stressors within their environments as compared to the heterosexual group. The stressed individuals within the sexual minority group then find solace in substance use, resulting in increased substance abuse by the LGBTQ+ individuals. The LGBTQ+ individuals therefore suffer more from distress leading to substance abuse as compared to their heterosexual peers. Within the group, there is an increased prevalence of mental health problems like anxiety and distress. Stigmatization and discrimination usually affect LGBTQ+ individuals at the workplace or home, costing them their homes, jobs, healthcare, and many more. They would then resort to substance use and abuse.
According to the National Institute on Drug Abuse (2020), LGBTQ+ people experience social stigma and discrimination, as well as a slew of additional issues that heterosexual people do not. Scannapieco et al. (2018) and Karakaya and Kutlu (2021) also noted the likelihood and the dangers associated with the discrimination and stigmatization that this minority sexual group faces throughout their life. They also found that the minority group is more likely to face discrimination and stigmatization, with Karakaya and Kutlu (2021) adding that this may lock them out from receiving important healthcare services.
According to the National Survey on Drug Use and Health (2018, as cited in National Institute on Drug Abuse, 2020), sexual minority adults report higher substance use patterns than heterosexual ones. In the previous year, 9 percent of sexual minority people aged 18 and older reported using opioids (including prescription opioid abuse and heroin use), compared to 3.8 percent of the general adult population. Furthermore, 9 percent of sexual minority individuals aged 26 and older reported misusing prescription opioids in the previous year, up from 6.4 percent in 2017.
Anderson (2018) posits that there is a systematic devaluation and oppression that is experienced from social stigma by LGBTQ+ individuals. White Hughto et al. (2015, as cited in Anderson, 2018) suggest an increase in psychological distress due to stress and discrimination sprouting from social stigma. In this regard, stigma and discrimination are therefore found as key propellants of a more stressful living within the LGBTQ+ group. This status, in turn, pushes these sexual minority individuals to have an increased prevalence of substance use and abuse.
That said, it is a general consensus that the increased prevalence of abuse of substances within the LGBTQ+ group is likely to be a combination of factors like social stigma and discrimination. The increased substance abuse is linked to high levels of discrimination and social stigma. Demant et al. (2018) consider substance abuse by LGBTQ+ individuals as a mechanism of coping with their stressors like stigma and discrimination within the environment that are associated with their statuses as members of the sexual minority group. The LGBTQ+ group is more sensitive to the negative impacts of stigmatization and discrimination compared to their heterosexual peers, alluding to their higher risk of substance abuse (Demant et al., 2018).
Violence and harassment are also among the stressors that significantly bring about substance abuse within the LGBTQ+ community. Medley et al. (2016) and Ackermann (2019) both agree that individuals who identify as LGBTQ+ are at very high risk of undergoing harassment and violence in their lives. The sexual minority groups are at greater risks of being harassed as well as undergoing other stressors like violence in the workplace, at home, in hotel rooms, among others, as compared to the heterosexual group who are the sexual majority population (Medley et al., 2016). These stressors are mostly inflicted on them by the majority sexual group, who in most cases happen to be their family members, friends, and relatives. These stressors significantly render the LGBTQ+ group at greater risks of substance use and abuse as well as mental disorders.
Rosner et al. (2021) support that violence and harassment are key drivers of substance abuse among lesbians, gay, bisexual, transgender, and queer/questioning individuals. They add that these stressors are attributed to the high levels of mental distress witnessed among this sexual minority group. This is a major challenge because it is always hard for individuals to come to terms with violence and harassment meted on them by their friends, employers, relatives, and others in society. As a result, in a society where they receive unequal treatment, and others violate their rights, the LGBTQ+ individuals feel isolated and struggle to survive alongside the others from the ‘the straight’ majority group. Therefore, they indulge in substance abuse to compensate for their isolated statuses in society and as a means to escape from the harsh realities of their stressors within their environments.
The substance abuse disparities between the sexual minority and the sexual majority are attributed to the violence and harassment inflicted on the minority group. According to Demant et al. (2018), the sexual minority group tends to use substances as a means to cope with the many forms of violence and harassment committed against them in society. The current literature shows that LGBTQ+ people are at high risks of experiencing physical and verbal violence at home, the workplace, and even in stores, among other places (Demant et al., 2018). The current literature is in consensus that the atrocious acts like violence and harassment, accompanied by discrimination and stigmatization, in a society highly perceived as heteronormative render the minority group highly exposed to substance abuse.
Nevertheless, the findings are also in consensus that substance use usually is the case when the minority group wants to avoid or cope with the negative impacts of the stressors resulting from living in a heterosexual environment.
A number of LGBTQ+ youth in the foster care system suffer intimidation, violence, and discrimination from the individuals entrusted with their care and support (Scannapieco et al., 2018). According to McCann et al. (2013, as cited in Karakaya & Kutlu, 2021), 47 percent of the participants admitted to being subjected to verbal violence and 19 percent to physical violence due to their LGBT identification. Another survey of 402 transgender people in the United States found that 56 percent had faced verbal harassment, 37 percent had faced employment discrimination, and 19 percent had faced physical violence. (Karakaya & Kutlu, 2021). Therefore, the findings from studies show clearly that the likelihood of substance abuse among the LGBTQ+ group is higher than their heterosexual peers due to verbal harassment and physical violence committed against them.
Lack of support for the sexual minority individuals also contributes to the higher rate of abuse of substances within the group (Ackermann, 2019). Owing to the fact that they are often faced with rejection and discrimination from friends, family members, their employers, among others, these individuals tend to choose to remain silent about their sexual orientations with the intention of avoiding discrimination and any other forms of violence they are likely to face.
In research conducted by Karakaya and Kutlu (2021), the participant stated that they never sorted or delayed seeking health care support due to the fear that they were likely to face negative attitudes from the health care workers. This is a contributing factor to the individuals’ lack of needed support and presents danger when it comes to their health and life in general. This finding is consistent with the argument of Anderson (2018) that a lack of care that is culturally sensitive is a common complaint within the group which may be the reason why cause the individuals to be reluctant to seek treatment and examinations. Therefore, the current literature is in consensus that the kind of life that comes from these statuses the individuals find so lonely and full of anxiety. In turn, they live a stressful life and seek refuge in substance abuse.
Finally, LGBTQ+ culture and lifestyle is another risk factor that exposes individuals to substance abuse compared to their heterosexual counterparts. Demant et al. (2018) state that in the research they conducted on a group of young sexual minority people, they found that there are many factors considered to be deep-rooted in the LGBTQ+ lifestyle and culture that may increase their rate of substance abuse, such as the key role played by use of substance when socializing and peer pressure in the group.
LGBT communities are highly centralized in licensed venues such as bars, clubs, or LGBT-specific parties where use of substance is a norm. This can be linked with the high consumption of substances like alcohol and other illicit substances because that forms part of the ‘bar culture’ where substance use is vital for socialization in those environments.
Demant et al. (2018) found that substance use in the community, particularly with the bar setting, parties, and nightclubs, peer pressure is also a key contributor to the higher substance abuse within the LGBTQ+ group compared to the heterosexual group. Within the minority sexual group, substance use is considered a necessity and makes one belong to the LGBT sexual minorities. In this regard, the strong influence to drink and engage in abuse of substances is generally higher within the minority group.
Conclusion
Substance abuse within LGBTQ+ individuals is an important issue and is increasing in occurrence due to several contributing factors. This paper aimed to discuss the various contributing factors such as stigmatization and discrimination, violence and harassment, lack of support, and peer pressure witnessed within the LGBTQ+ culture and lifestyle to increase understanding of this controversial group. The reviewed literature suggests that there is a higher substance abuse within the LGBTQ+ group as compared with the heterosexual peers. This increased substance abuse is linked with high levels of discrimination, stigma, lack of support, and the general lifestyle the members of this group lead in environments where alcohol and other substances are a regular occurrence. Therefore, based on the current evidence, it is concluded that there is a higher rate of substance abuse in the sexual minority group due to the above contributing risk factors compared with the heterosexual group.
References:
Ackermann, K. (2019, September 10). Why substance abuse is higher within the LGBTQ Community. American Addiction Centers. Retrieved September 14, 2021, from https://americanaddictioncenters.org/lgbtqiapk-addiction/why-substance-abuse-ishigher-within-the-lgbtq-community.
Anderson, S. (2018, March 26). Mental health disparities in the LGBT community: The role of stigma. Handle Proxy. Retrieved September 13, 2021, from http://hdl.handle.net/10755/624005.
Demant, D., Hides, L., White, K. M., & Kavanagh, D. J. (2018, September 27). LGBT communities and substance use in QUEENSLAND, Australia: Perceptions of young people and community stakeholders. PLOS ONE. Retrieved September 14, 2021, from https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0204730.
Karakaya, S., & Kutlu, F. Y. (2021). LGBT individuals’ opinions about their health care experiences: A qualitative research study. Journal of nursing management, 29(1), 24-31. DOI: 10.1111/jonm.13199
Medley, G., Lipari, R.N., Bose, J., Cribb, D.S., Kroutil, L.A., &McHenry, G.. (2016). Sexual Orientation and Estimates of Adult Substance Use and Mental Health: Results from the 2015 National Survey on Drug Use and Health. https://www.samhsa.gov/data/sites/default/files/NSDUH-SexualOrientation-2015/NSDUH-SexualOrientation-2015/NSDUH-SexualOrientation-2015.htm
National Institute on Drug Abuse. (2020, August 25). Substance use and suds in lgbtq* populations. National Institute on Drug Abuse. Retrieved September 13, 2021, from https://www.drugabuse.gov/drug-topics/substance-use-suds-in-lgbtq-populations.
Rosner, B., Neicun, J., Yang, J. C., & Roman-Urrestarazu, A. (2021). Substance use among sexual minorities in the US–Linked to inequalities and unmet need for mental health treatment? Results from the National Survey on Drug Use and Health (NSDUH). Journal of Psychiatric Research, 135, 107-118.
Scannapieco, M., Painter, K. R., & Blau, G. (2018). A comparison of lgbtq youth and heterosexual youth in the child welfare system: Mental health and substance abuse occurrence and outcomes. Children and Youth Services Review, 91. https://doi.org/10.1016/j.childyouth.2018.05.016