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An Ongoing Challenge: Safe and Respectful Treatment for LGBTs

June 30, 2013
by Michael Shelton
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The top treatment considerations for LGBTs, regardless of changing laws

The Supreme Court handed down two decisive victories to LGBTs on June 26, and, not surprisingly, there are many who are dissatisfied with the Court’s decisions.  While it does seem that the United States has crossed a threshold in regards to LGBT recognition, approval, and support, let us not forget that millions of Americans are not so supportive and even antipathetic to these societal changes.

While researching my books “Gay Men and Substance Abuse” and  “Family Pride: What LGBT Families Should Know about Navigating Home, School, and Safety in Their Neighborhoods” I interviewed LGBTs who reported a backlash in their local communities.  Some felt that in the present climate - in which so much LGBT progress is evident – the need to hunker down and maintain a low profile has never been so necessary.  As addiction professionals we cannot blithely assume that LGBT progress has necessarily occurred in our treatment facilities.  Our colleagues, administrators, support staff, facility staff, and, particularly, our patient population, may not be affirming of LGBTs.   Unless an agency or program was specifically created for LGBT substance abusers we cannot readily infer a facility’s readiness and willingness to accept this population, and the reality is that most LGBTs will receive treatment in general programs and not those specializing in LGBT-specific care.

How then do we begin to determine if a facility – even our own facility - is appropriate for LGBTs?  The National Institute on Drug Abuse formulated five essential questions families should ask when considering prospective treatment programs:[i]

  1. Does the program use treatments backed by scientific evidence?
  2. Does the program tailor treatment to the needs of each patient?
  3. Does the program adapt treatment as the patient's needs change?
  4. Is the duration of treatment sufficient?
  5. How do 12-step or similar recovery programs fit into drug addiction treatment?

These questions are a great starting point for LGBT substance abusers, but they elude concerns that many LGBTs and their loved ones espouse as essential, particularly those regarding safe and respectful treatment.  I propose then an additional question: Does the facility provide education to all clients regarding language and behaviors that show bias toward LGBT people?  Treatment facilities need to do more than ask clients to read an acknowledgment during orientation that disrespectful behavior is contraindicated; they instead need to clearly inform all prospective clients that:

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"NALGAP: The Association of Lesbian, Gay, Bisexual, Transgender Addiction Professionals and...