People that identify to be in the LGBTQIA+ community can experience higher levels of alcohol and drug use than those not in this population. This is often due to the unique challenges and situations that those within this community encounter in their lives.
These factors are well-understood, and addressing them directly during addiction rehab can help make treatment more effective.
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Why those identifying to be within the LGBTQIA+ community more likely to experience addiction?
Higher rates of alcohol and drug addiction in the LGBTQIA+ community is partly explained by ‘minority stress theory’. This was first described by researcher Ilan Meyer in 2003 as the psychological weight of belonging to a group that faces discrimination.
Minority stress accumulates from years of a person hiding part of who they are and worrying about how people will react. The stress of this often leads to mental health challenges and increases the likelihood of turning to alcohol or drugs to cope. .
Research published in association with BeLonG To found that 50% of those in the LGBTQIA+ community aged 14 to 18 showed severe symptoms of depression, and 66% showed severe symptoms of anxiety.
Those figures cover the community as a whole, but transgender and gender non-conforming people experience even higher rates of mental health challenges. The same BeLonG To research found that 64% of the wider LGBTI+ community reported suicidal thoughts compared to 82% in trans/gender non-conforming individuals.
When intrusive thoughts become this severe, drinking and drug use can increase to as a coping strategy. This greatly increases the risk of addiction.
The impact of discrimination, rejection and identity concealment
The negative experiences those in the LGBTQIA+ community face in Ireland are documented. According to a large-scale EU-wide survey by the European Union Agency for Fundamental Rights:
- 37% experienced harassment in the year before the survey
- 11% had been physically attacked in the five years before it, and
- 59% avoided holding hands with a same-sex partner in public
The reaction from friends and family can also vary extensively; many are supportive, but this isn’t always the case.
Shame comes from growing up in a world that has not always made it easy for people, that identify to be LGBTQIA in Ireland, to show their authentic selves.
Alcohol and drugs can become a way of managing these feelings when nothing else is working. Understanding that connection is central to understanding LGBTQIA+ and addiction.
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Alcohol and drug use in LGBTQIA+ communities in Ireland
Whilst, at Smarmore Castle, we don’t use the term “abuse” to discuss people’s experience with substance use, we have here because that’s how it’s often described in studies and literature.
Research consistently shows that rates of drug and alcohol abuse are higher in LGBTAIQ+ communities, including in Ireland.
Alcohol addiction and LGBTQIA+ social life are closely linked. Some people’s social lives involve going to bars and clubs, where drinking is the norm and there’s pressure to join in.
When someone is drinking a lot on a regular basis, alcohol dependency can develop gradually, without a clear moment when it starts. The link between drug addiction and LGBTQIA+ communities follows a similar pattern.
GHB, chemsex and the LGBTQIA+ community
GHB, or gamma-hydroxybutyrate, is a depressant that usually comes as a clear, odourless liquid. It’s a common “club drug” which produces feelings of relaxation and lowers inhibition.
What makes GHB dangerous is how little separates a recreational dose from an overdose. Batch strength varies, and mixing GHB with alcohol is common at parties and bars.
GHB overdose can cause seizures, loss of consciousness, and cardiac arrest. If you think someone has overdosed on GHB, call 112 or 999 immediately.
Chemsex refers to sex involving specific drugs, usually within gay and bisexual male social scenes. The prevalence of chemsex is hard to measure accurately and studies give different figures. However, one study of 632 Irish men via gay dating platforms found that 6% had used chemsex drugs in the last year.
GHB is one of the drugs most commonly used this way, alongside crystal methamphetamine, ketamine, and mephedrone.
At Smarmore Castle, GHB detox is always medically supervised. A doctor monitors patients throughout, manages any complications as they arise, and keeps them as safe and comfortable as possible.
LGBTQIA+ addiction and co-occurring mental health conditions
Many of those within the LGBTQIA+ can live with a dual diagnosis. This means a co-occurring substance use disorder and a mental health condition.
The Mental Health Foundation notes that:
- Every one in two people in the LGBTIQ+ community had experienced depression
- Three in five had experienced anxiety
- One in eight aged 18 to 24 had attempted to end their life
The substance use and the mental health condition usually feed each other in both directions. Drinking or using drugs can worsen depression and anxiety. Depression and anxiety make it harder to stop.
A large systematic review across 123 studies and 31 countries found mean prevalence rates of 35% for depressive disorders and 34% for anxiety disorders in LGBTIQ+ populations. The same review found that where societal acceptance was higher, rates of depression and anxiety were lower.
At Smarmore Castle, both conditions are assessed and treated within the same programme rather than referred separately. If only the substance use gets treated, recovery is less likely to last.
“It takes more courage to admit, you know, that you’re not as strong as everyone is saying or thinking that you are, and that actually makes you stronger too. That was the difference this time. I was able to just come out and say I need to do this, I want to get my maintenance and all that sort of stuff, and it was part of that just being willing to do whatever it takes you know. Being suggested to say look, ‘I’m not okay, but I will be alright, I’ll get through this just give me a little bit of space, you know.’ What I could describe… it’s totally different for everyone. We say all the time in the fellowships, you can’t describe it, just come on and do it, give it a go and experience it for yourself.”
— Anthony Deegan, former patient and Recovery Advocate
Signs that it might be time to seek help
- You use alcohol or drugs to feel comfortable in social situations.
- Your use goes up when things connected to your identity feel difficult. This might include a difficult coming out, tension with family, discrimination, or not feeling safe being open about who you are.
- You use GHB or other substances as part of sex and find it hard to stop or imagine sex without them.
- Alcohol or drugs have become your main way of managing low mood or anxiety, particularly in situations connected to your identity.
- People in your life have expressed concern.
- You’re hiding how much you’re using.
If any of this sounds familiar, it might be time to talk to someone.
How does LGBTQIA+-inclusive addiction treatment work at Smarmore Castle?
At Smarmore Castle, every patient gets an individual treatment plan. It’s developed with your focal therapist in the first week of our Foundation Programme.
For LGBTQIA+ patients, that plan includes how experiences connected to your identity need to be addressed in treatment. As part of our residential community, you’ll take part in education sessions and individual and group therapy.
You can read more about private rehab in Ireland and what to expect from treatment.
Recovery is not always straightforward, and setbacks are a common part of many people’s experiences. We provide continuing care as part of our treatment programmes to ensure our support is still there when you leave. The evidence shows that longer-term support like this leads to better outcomes.
Our addiction assessment is a free, confidential starting point. There’s no pressure to make any decisions.
If someone you know is in the LGBTQIA+ community and needs help with addiction
Watching someone you know go through this is hard. You may feel uncertain about what to do or worried about saying the wrong thing.
When the individual identifies to be within the LGBTQIA+ community, there are sometimes other considerations to be careful about. You may not know how open they are about their identity with others, or how to start the conversation without overstepping.
Let them know you’re there without putting pressure on them. Don’t make decisions on their behalf, and don’t share information about their identity or substance use without their permission.
Your own wellbeing is important too. Family therapy is part of the treatment programme at Smarmore Castle, and our team is here to support you as well. You don’t have to wait until they’ve decided anything before you call us.
Additional resources
- TENI
- GLEN
- ShoutOut
- ReachOut
- SpunOut
- Greenbow LGBT Society of Ireland
- Irish Pink Adoptions
- Belongto.org
Frequently asked questions about LGBTQIA+ addiction treatment in Ireland
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What support organisations specialise in addiction help for those in the LGBTQIA+ community, in Ireland?
Several organisations in Ireland offer support specifically for those in the LGBTQIA+ community. BeLonG To focuses on young people aged 14 to 23, covering mental health and identity. TENI supports transgender and gender non-conforming people specifically. SpunOut offers straightforward information on mental health and substance use for young people.
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Are there online addiction recovery programmes tailored for LGBTQIA+ individuals?
Dedicated online programmes with genuine LGBTQIA+ expertise are limited, though some peer support groups run LGBTQIA+ specific meetings online. For people who’ve already completed a residential programme, remote continuing care is available through Smarmore Castle. If you’d like to talk through what would suit you, get in touch.
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Where can I find LGBTQIA+-friendly addiction counsellors in Dublin?
Access to LGBTQIA+ affirming addiction counsellors in Ireland is more limited than it should be, and provision in Dublin is uneven. The Irish Association for Counselling and Psychotherapy runs a therapist directory.
You can search it by specialism, including LGBTQ+ affirmative practice. Smarmore Castle has experience working with LGBTQIA+ patients, and our addiction assessment is free and confidential.
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Is there a link between trauma and LGBTQIA+ identity and addiction?
Yes. Many have experienced trauma and this often contributes to mental health difficulties and substance use. At Smarmore Castle, addressing the link between trauma and addiction is part of treatment from the start.
