Addiction: counseling, treatment, prevention

counseling treatment prevention for web.jpg

It is a well-documented fact that the LGBT community struggles with addiction at a much higher rate than other populations. Studies report rates of 20-30% compared to 9% in the general population. This means, when compared to the average American walking around, members of the LGBT community are a 2 to 3 times more likely to struggle with substance abuse.

The LGBT community struggles up to 200% more with tobacco use. When it comes to alcohol, LGBT people have a rate of 25% compared to 5–10% in the general population. Men who have sex with men are 3.5 times more likely to use marijuana than those who do not have sex with other men. They are 12.5 times more likely to use amphetamines and 9.5 times more likely to use heroine. These numbers are overwhelming evidence that the LGBT community faces a huge crisis in the face of addiction and treatment needs.

Several factors contribute to the increased rates of use, abuse, and addiction among the LGBT community, and most of us do not need to be reminded of the reasons. We have all have struggled with the social factors contributing to these higher risks, but I would like to address some of them:

Early Childhood Experiences—From early in our childhoods, many members of our community experience rejection by society, friends, and, most importantly, family. Rejection and lack of supports at an early age has a detrimental impact on coping and adapting to stressors, acquiring stability and achieving a healthy lifestyle. The LGBT community also faces higher rates for sexual abuse.

Need to Belong—Even the most accepted member of the community can recognize the early perceptions of “being different and not being like everyone else.” While this is not completely unique to our community, it is extremely marginalizing and isolating. This isolation and marginalization pulls at our human need to be part of something and find our tribe. So to fit in and find others who accept us, we tend to turn to social lubricants like drugs and alcohol in higher rates.

Stress Management—Another social and internal stressor for the community stems from coming out and integrating our sexualities and gender identities. The anxieties of maintaining our secret of being gay, lesbian, bisexual or transgender contribute greatly to our need to find ways to cope. Drugs and alcohol provide this in an unhealthy, but functional, outlet.

Now that the problem has been clarified, let’s explore prevention and treatment. Prevention of substance abuse and addiction can come in the form of healthy choices, positive support systems, counseling and many other forms. Treatment, on the other hand, is more difficult and complex due to the nature of addiction and human behavior.

The LGBT community needs to have prevention and treatment specifically targeting the unique needs of the community. Research shows that, for the LGBT community, parental acceptance and support can often be a huge factor in the prevention of criminal behaviors, addictions, and contracting HIV. However, accepting a child’s desire to show a little flare, or dress/behave in ways that are not in line with gender norms can be very difficult for some parents to manage.

counseling treatment prevention Johnathan 3.jpegIt is generally my belief that parents (no matter how healthy or unhealthy they present) are doing the best they can in the moment. This does not excuse them from maltreatment, abuse, neglect, nor does it praise them for doing well either. It is simply to state the premise that they are doing the best they can in the moment. With that said, as adults, it becomes our responsibility to manage ourselves and take the steps needed to heal, grow, improve, and own our problems, wounds, and lives.

With any luck, we have escaped childhood and adolescence without any serious wounds, traumatic events or harmful effects. However, I believe that this is not a very realistic expectation for most in the LGBT community. It is far more likely that many among our ranks have experienced traumatic events and internalized anxieties and negative thinking that significantly affect our behaviors and development.

These factors can lead to sexual addictions, in addition to substance use to numb our daily struggle with our past. This is not to say that everyone in the community struggles with addictions. The numbers show this is not the case. However, how many of us arrive at adulthood with unhealthy thoughts, feelings, and behaviors?

Our need to be part of something and belong to a group of similar people, again, is a human need. In our community, we all start out isolated and wary of the world around us. When we begin to reach out, we often receive ridicule, punishment, and judgment, contributing more damage to who we are trying to become. Eventually, many of us find some method of making friends and begin creating our tribe to rely on. If lucky, we find a great and supportive healthy group of friends.

Stress can be a common issue for anyone and is not unique to our community. However, we do have unique stressors that other communities do not have. In the LGBT community, stress can come from family, guilt, our workplace, our faith, our own behaviors, and fears and anxieties. Stress is a very common reason for seeking counseling and can be the beginning of a great exploration of our desire to achieve a healthy and happy life.

Now let’s turn to the concept of counseling and treatment. Some counselors, including myself, prefer to separate these two concepts. Treatment focuses on addressing a specific psychiatric disorder or mental health condition, such as depression/anxiety, addiction, or traumatic experiences.

Many view cost as a barrier to treatment, but it typically leads to a diagnosis, allowing the client rely on insurance to help pay for treatment over a long period of time to resolve the underlying problems and hopefully to begin to manage symptoms and possibly eliminate them.

Alternatively, counseling focuses on exploring a client’s history, thinking and emotional processing, or behavioral expressions. Common reasons for seeking counseling include relationship issues, a desire to replace unhealthy behaviors, or needing to build skills for stress management. In the case of counseling, too, insurance can often offset costs, and there is less of a need to have a diagnosis in order to bill insurances. Frequently, counseling does lead to out of pocket payments and can range in price but can be affordable.

If someone is struggling with addiction or factors contributing to addiction such as depression/anxiety or trauma, treatment can begin very early and prevent the expense of hospital stays and lengthy treatment. Through early recognition and intervention, addiction can be prevented. Addiction responds best to treatment, however, when the person is ready to make the changes and address the causes. Treatment in the addictions community is quite readily available and ranges from support groups, Alcoholics Anonymous meetings, or outpatient counseling to treatment centers across the country and inpatient hospitals.


Johnathan Johnson, LPC/MHSP is the CEO/President of New Directions Counseling & Consulting in Nashville. He has been a member of the Nashville community for 6 years, has over 15 years of experience and has been licensed as a professional counselor since 2007.