The Pitiful State of LGBT Substance Abuse Treatment Availability

February 29, 2012
20 Comments
Recent studies indicate we can't get much worse.

It’s been more than a decade since the Substance Abuse and Mental Health Services Administration released “A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual and Transgender Individuals,” which recommended, “A commitment should be made at every level of the program, from the board of directors to the direct line staff, to design and deliver services in a manner sensitive to the needs of LGBT individuals” (p. 123).[i]   A 2009 study offers evidence as to the continued importance of this recommendation: 180 lesbian, gay, and bisexual participants were asked about their past substance abuse treatment experiences (both inpatient and outpatient), including overall satisfaction with their experiences, ability to be open about their sexuality in the program, and the amount of support they received from staff.   The author concluded that “LGBT specialized treatment was the only program treatment factor that was a statistically significant predictor of current abstinence” (p. 190).[ii]

How available is specialized treatment for LGBTs?  A 2007 study presents a chilling snapshot. The researchers made telephone contact with 854 substance abuse treatment agencies promoting themselves as having specialized programs for LGBTs in the National Survey of Substance Abuse Treatment Services.  Each facility was presented with the same question: ““Hi, I am calling because your agency is listed in the SAMHSA directory as one that provides special programs or groups for gays and lesbians, and I am interested specifically in what those programs are. Could you tell me more about them?” (p. 166)[iii]

The results?

·      Although all 854 agencies had indicated they provided LGBT-specific services, at the time of the phone contact 605 (70.8%) acknowledged no specialized programs existed.

·      Sixteen of the agencies (1.9%) reported they had offered those services in the past but no longer did so.

·      79 (9.3%) programs described themselves as “non-discriminating” (sample response: “We offer the same thing we offer straight people. . . we don’t discriminate.”) and 34 (4%) as “accepting” (sample response: “We don’t have special services for gays and lesbians, we just allow them in our groups.”).

·      Only 62 (7.3%) of agencies indicated specialized LGBT programming and almost half were in New York and California.

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Comments

Introduction

Hello Michael,

I have been following your work and wanted to introduce myself. I do a great deal of work with LGBTQ clients and am sensitive to many needs of the community in New York City.

My areas of expertise are addictions, anxiety, OCD, Trauma and PTSD. I am experienced in harm reduction, abstinence, non-12 step and 12 treatment.

I invite you to view my professional website at www.Empower-sws.com.

I am also on Linked In, Twitter, Google + and Facebook, but was unsuccessful in finding your profile address on any of these social media sites. (There are too many Michael Shelton's listed.)

I decided to take a chance and post on your blog hoping you will find this message.

My direct email is swspsychotherapy@gmail.com.

I hope to hear back from you soon.

Best,
Scott W. Stern

Sexual Orientation Should Not Matter

If someone is trying to better themselves by getting help for a problem. Why should it matter what their sexual orientation is. The fact that they are seeking help is all that should matter.

Pride Institute

I encourage your readers to discover and explore Pride Institute. Pride Institute is a 27 year old facility in Minnesota. It is the only facility in the United States that exclusively treats members of the LGBT community. (This is not an exaggeration) It's a really great place and the results are self evident...it does work. I have worked for the company as their Community Relations person for the East Coast for about a year now. I'm gay and happily sober 11 years. Please check them out.
The site is www.pride-institute.com . I can be reached for more detailed information at 646-316-4182.
Thank you.

LGBT treatment programs

We have created a Dual Diagnosis Outpatient Mental Health and Chemical Dependency Treatment program with specific programming in Saint Cloud, MN. We are one of 3 treatment programs in the state of Minnesota that have specific programs for LGBT individuals.

The Mental Health program is mainly focused on LGBT clients and over the past year has been slowly evolving into a gender clinic for individuals in transition.

The CD program runs specific programming for LGBT clients to deal with their addictions. The important reason, and very basic reason, for specific programming is the different issues that LGBT client have to deal with. For a majority, their sexual orientation/gender identity has had a large influence behind their use of chemicals. They have used chemicals to deal with their internalized homonegativity, negative messages from family, friends and society, harrassment and bullying that they have experienced, and the fear that they are "not normal." Those of use that work in this field know that many addicts use chemicals to avoid things, especially feelings.

Having a specific program, these clients can express themselves and feel safe to do so. They are able to talk about issues that they would never be able to in a "normal" treatment program. I have clients that have entered my program who have related past experience in programs that do not offer LGBT specific programming and talk about how they did not feel safe due to the other client's attitudes, they were told by the counselors not to divulge their sexual orientation in groups, and that sexual issues have no place in CD treatment. Many stated that when they graduated from these programs, they knew they would relapse because they were not able to deal with their core issues.

In short, those reasons are why it is so important to find our clients the appropriate program that they can get the help they need for their issues. To do anything less could be considered doing more harm to them then helping them.

is treatment different for lgbt

i am always confused by "special populations" treatment for addicted folks. What is the "real" difference if we understand that addiction is a brain disorder. do we have differnt cancer treatments for straight populations versus lgbt, and/or other populations?

it would be best for our treatment profession to focus on the one single unify and undeniable fact that our clients (all of them and their differences) has an addiction and need help.

reply to anonymous

The goal of treatment is recovery, long term abstinence from alcohol and/or drugs. To have the best chance of achieving this, LGBT clients may need additional help in finding the proper or LGBT specific resources. If staff isn't aware, or educated about the issues that LGBT individuals face when leaving treatment, how can the client have a decent shot at recovery? There are triggers specific to LGBT individuals.

You also have the unfortunate providers that will attempt to "fix" the sexuality, or are judgmental and unsupportive. It does happen. When this type of thing starts to happen, the LGBT client will most likely shut down...again making it difficult to achieve the goal.

Bottom line, professionals could actually cause treatment failures to LGBT clients with insufficient training and education.

Yes Treatment Needs to be "Different"

As a person in long term recovery for over 27 years and an addiction professional for 24 years it amazes me that with all the research supporting the overwhelming efficacy of gender specific and culturally specific addiction treatment services that this question even gets asked. It is obvious the individual writing this post has never heard of either "Person Centered Counseling" or "Recovery-Oriented Systems of Care". When the only tool you have in your toolbox is a hammer, you view the solution to every problem being a nail. There are many pathways to recovery and "one-size" addiction treatment services does not even come close to "fitting all".

LGBT Treatment for Adolecents

One of the things that I have noticed over the years is that there are very few LGBT programs for adults. There are even less programs for LGBT adolescents. In fact, to my knowledge, at least in the Northeast, where I am, there are NO LGBT programs for adolescents. We have one short term for LGBT adults, and that is it. That is by far too few programs to address the issues. As is seen in non-LGBT populations, there is a significant amount of substance use in the LGTB population that needs to be addressed. To sent someone who is LGTB to a gender specific program that does not address the issues that person faces opens the door for physical abuse of that individual, because of the homophobic fears of other's in the program. This needs to be addressed soon.

LGBT Treatment for Adolecents

One of the things that I have noticed over the years is that there are very few LGBT programs for adults. There are even less programs for LGBT adolescents. In fact, to my knowledge, at least in the Northeast, where I am, there are NO LGBT programs for adolescents. We have one short term for LGBT adults, and that is it. That is by far too few programs to address the issues. As is seen in non-LGBT populations, there is a significant amount of substance use in the LGTB population that needs to be addressed. To sent someone who is LGTB to a gender specific program that does not address the issues that person faces opens the door for physical abuse of that individual, because of the homophobic fears of other's in the program. This needs to be addressed soon.

LGBT substance abuse

What specifically needs to change within the treatment programs, so that LGBT feel more acknowledged? Are there standards of care for the population that are different from counseling populations in general? In our treatment program where I work in Alexandria,VA the staff are very sensitive to respecting LGBT clients, but sometimes the clients are not as sensitive and make rude and close-minded comments about anything having to do with LGBT.

It is about LGBT Responsive Programs

Clients can make rude and close minded comments towards anyone. Staff's job is to create a safe and accountable environment for everyone. If a client made a racist comment, would staff take steps to look at the comment and the effect of it on the group? Same with homophobic remarks. Staff's job is to create a safe environment for all by setting program standards and opportunities for learning at the same time maintaining a respectful and collaborative environment. Responsive programming includes discussions about oppression, racism, homophobia and how they effect people, addiction and recovery.

only one?

The only treatment center I know of that serves LGBT people is Pride Institute.

Why aren't leaders stepping up?

Several leading treatment centers are run by LGBT individuals but they don't have programs for LGBT clients. Why? They are in a position to really make a difference!!!

Treatment Centers

I would be willing to help develop a program for addiction /recovery.
I am a solo practitioner(MD) in Augusta , Ga. in a pain management clinic. I am board certified in PM@R. I am hoping to sit for the addiction boards in December.
Sincerely,
Bruce Tetalman,MD
btetalman@yahoo.com

Why Arent Leaders Stepping Up?

As a FTM transgender person who works as a Co-Occurring Counselor what I ahve observed is what I would call the homogenised effect within GLBT leader ship and those who are not GLBT. The perception is that TX needs are the same and they may be individualised if a GLBT person comes to Tx and will identify themselves as GLBT.
Daniel Norvell,ICADC,ICCDP

Gay Ghetto's in Southern California are Obsolete

My husband and I own and operate a group of outpatient addiction treatment programs in Los Angeles and Orange Counties. Being also sober and residents of oh so gay West Hollywood the times they have a changed- at least in Southern California.

Segregation is no longer fashionable here in sunny California. Gays and lesbians comprise up to forty percent of our clientele at some locations, such as our program in West Hollywood. As is common in most mutual support (including 12-step) recovery meetings, gays, lesbians, bisexuals and transpeople mix and play well together with their straight recovering compatriots.

No need to fear- recovery is alive and well in Southern California and most LGBT people are full and equal members of the larger society.

More focused on the G in LGBT?

It's my impression that for the LGBT services that are out there they are more focused on the "G" in LGBT, less so on the "L," and virtually nonexistent for the "B" and "T."

Sad state of affairs

What really amazes me is when you ask a gender-specific program how they address LGBT issues often they say, "It's not an issue." The reality is that it often IS an issue, but not something the program is comfortable addressing. In recovery people must be open and honest about themselves, and being in a recovery program where LGBT issues are not openly addressed and discussed does a disservice to everyone. I look forward to following this blog!

Why can't people see the difference in all individuals

As a provider, I find it difficult to understand why treatment providers and clinicians cannot treat the individual no matter what their lifestyles maybe. We as treatment providers and clinicians get caught up in terminology and not treatment strategies. I think a provider that looks at the individual as an individual can give the person affective treatment. After all, aren’t we supposed to treat the illness as well as the individual?

Why can't people see the difference in all individuals

As a provider, I find it difficult to understand why treatment providers and clinicians cannot treat the individual no matter what their lifestyles maybe. We as treatment providers and clinicians get caught up in terminology and not treatment strategies. I think a provider that looks at the individual as an individual can give the person affective treatment. After all, aren’t we supposed to treat the illness as well as the individual?