LGBT Drug Rehab


LGBT drug rehab programs address unique issues that influence addiction treatment for sexual minorities, such as stigma, discrimination, family rejection, homophobia, social alienation, and violence based on gender identity and sexual orientation (NIDA, 2017). Despite advancements in recent years regarding social acceptance and equal treatment of sexual minorities, a higher prevalence of mental and physical health risks still exists among LGBT individuals, especially among LGBT older adults who have experienced much of the discrimination, hate-violence and stigma associated with their sexual identity prior to the increasing LGBT acceptance and inclusion (Yarns, Abrams, Meeks & Sewell, 2016).

Culturally responsive LGBT drug rehab treatment centers are devoted to all aspects of sexual minority health, not only targeting the environmental stressors that lead to higher rates of mental distress and substance use disorders, but also providing LGBT-focused interventions for each age group. Given the evolving landscape of minority stress, it’s important to understand the developmental, social and contextual factors that account for the disparities across age groups.

Do younger LGBT members experience less minority stress than older LGBT adults?

Previous research has suggested that younger LGBT generations experience less minority stress, but a new study examining age group differences with respect to substance use reveals that substance use disparities were not systematically smaller in younger age groups (Schuler, Stein & Collins, 2019).

Younger generations today have witnessed changes that the older generations never expected to see, such as openly gay politicians, same-sex marriages and positive portrayals of LGBT characters in the media (Institute of Medicine, 2011). Today’s younger age cohorts have more access to online information about LGBT resources that were not available to older generations. As the push for LGBT rights and equal treatment continues, minority stress has only taken on different forms in today’s society than it did in yesteryear. One of the most prominent forms of discrimination based on sexual orientation nowadays is cyberbullying on social media platforms such as Facebook. Studies link cyberbullying with violence, offense and drug use, and among minority groups who are affected by bullying and cyberbullying, sexual minorities were found to be the most vulnerable to victimization (Llorent, Ortega-Ruiz & Zych, 2016). The Gay, Lesbian & Straight Education Network (GLSEN) released a report on LGBT experiences with online harassment. Their study, Out Online, found that 27% of respondents did not feel safe online, and 42% of LGBT youth experienced cyberbullying, compared to 15% of non-LGBT youth.

The environmental context for older LGBT adults was much more limiting, which influenced the timing of some life events such as the coming out process. Compared to younger generations, the timing of one’s self-disclosure for older LGBT adults occurred in later in life. For today’s youth, the average age of self-identification as lesbian or gay is 16.7 for males and 16 years for girls (Institute of Medicine, 2011), whereas the average age of self-disclosure for older LGBT adults was 28, which indicates that many adults in previous decades have waited a substantial amount of time to come out (Fredriksen Goldsen, Bryan, Jen, Goldsen, Kim & Muraco, 2017).

Does age make a difference in substance use among LGBT individuals?

There have been mixed results about the impact of age on substance use among sexual minorities (Green & Feinstein, 2011). Generally speaking, age has been a protective factor against substance abuse for the general population, but among LGBT individuals, age doesn’t appear to have a significant impact on substance use among younger and older generations. For example, younger sexual minority women reported more alcohol and drug-related problems than heterosexual women, but these differences were not significant for older sexual minority women. If LGBT individuals reduced their substance use as they aged, researchers would have observed those differences (Green & Feinstein, 2011).

Estimates of LGBT age groups seeking drug rehab treatment

In 2015, the National Survey on Drug Use and Health (NSDUH) added two questions on sexual identity and sexual attraction. In addition to comparing sexual minorities’ estimates for substance use and mental health issues to those of sexual majority members, the survey also compared estimates within LGBT subgroups by sex and age. The survey identified respondents as needing drug rehab treatment if they had a substance use disorder (SUD) in the past year or if they received drug treatment at a specialty facility in the past year. The survey sample consisted of 1.7 million sexual minority adults, and the findings are categorized by age groups as follows:

• Of the 1.7 million sexual minority adults, 659,000 young adults ranged from ages 18 to 25, and 1 million adults were aged 26 or older
• Of the 659,000 sexual minority young adults who needed drug rehab, 486,000 needed treatment for alcohol use disorder and 389,000 needed treatment for illicit drug use
• Of the 1 million sexual minority adults aged 26 and older, 717,000 needed treatment for alcohol use, and 492,000 needed drug rehab treatment for illicit drug use

The survey collected data on two types of treatment received: those who received “any” substance use treatment or those who received substance use treatment at a specialty facility. Any substance use treatment is described as drug rehab at any location, which includes hospitals, outpatient/inpatient rehab facilities, mental health centers, emergency rooms, private clinics, jails/prisons, or self-help groups such as Alcoholics Anonymous or Narcotics Anonymous. Substance use treatment at a specialty facility doesn’t necessarily mean a specialty facility for LGBT drug rehab, but rather, it refers to a broader category of specialized facilities such as inpatient treatment (only) at a hospital, drug rehab facility, or mental health. The findings revealed that approximately 340,000 sexual minority adults aged 18 and older received any substance use treatment, and about 254,000 sexual minority adults received drug rehab at a specialty facility.

The availability of LGBT drug rehab programs at any substance use treatment facility is limited. While research shows that sexual minority adults were more likely to seek substance use treatment than their sexual majority counterparts, of all treatment programs purported to provide specialized LGBT drug rehab programs in the United States and Puerto Rico, only 7.4% reported to actually provide such specialized services.

What do sexual minority clients want out of LGBT drug rehab programs?

Rowan and colleagues (2013) conducted a study to find out what lesbians and gay men value in culturally specific drug rehab treatment programs. The research sample consisted of 40 former clients and clinical staff members, and three themes emerged from the study: (1) a separate treatment unit or facility; (2) safe and supportive therapeutic communities, and (3) specific client-centered treatment approaches.

The need for gender-based, anti-stigma policies in existing addiction treatment centers was demonstrated in a separate study of gender diverse individuals who provided recommendations for LGBT drug rehab treatment programs (Lyons et al., 2015). Often excluded from research, this transgender subgroup within the LGBT community experiences more stigma than other sexual minority peers; compared to lesbian, gay, bisexual, and heterosexual clients, transgender individuals are less likely to complete addiction treatment in mixed gender treatment facilities. In this qualitative study, researchers found that positive client experiences were associated with treatment settings where transgender persons felt understood and respected.


1 Fredriksen-Goldsen, K. I., Bryan, A. E., Jen, S., Goldsen, J., Kim, H. J., & Muraco, A. (2017). The Unfolding of LGBT Lives: Key Events Associated With Health and Well-being in Later Life. The Gerontologist, 57(suppl 1), S15–S29. doi:10.1093/geront/gnw185

2 Green, K. E., & Feinstein, B. A. (2011). Substance use in lesbian, gay, and bisexual populations: an update on empirical research and implications for treatment. Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 26(2), 265–278. doi:10.1037/a0025424

3 Institute of Medicine (US) Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities. The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. Washington (DC): National Academies Press (US); 2011. 4, Childhood/Adolescence. Available from:

4 Llorent, V. J., Ortega-Ruiz, R., & Zych, I. (2016). Bullying and Cyberbullying in Minorities: Are They More Vulnerable than the Majority Group?. Frontiers in psychology, 7, 1507. doi:10.3389/fpsyg.2016.01507

5 NIDA. (2017, September 5). Substance Use and SUDs in LGBT Populations. Retrieved from on 2019, April 29

6 Schuler MS, Stein BD & Collins RL. (2019). Differences in substance use disparities across age groups in a national cross-sectional survey of lesbian, gay and bisexual adults. LGBT Health, 6(2):68-76. doi: 10.1089/lgbt.2018.0125. Epub 2019 Feb 8.

7 Yarns BC, Abrams JM, Meeks TW & Sewell DD. (2016). The mental health of older LGBT adults. Current psychiatry reports, 18(6). doi: 10.1007/s11920-016-0697-y

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