Addiction, folks like to say, doesn't discriminate. But in reality, people from marginalized communities often do face unique mental health challenges, including substance-related ones. It's no secret that poverty, discrimination, isolation and trauma can undermine a person's well-being. Many members of the LGBTQ+ community are all too familiar with the experience.
The good news is that treatment centers, recovery communities and mental health advocates have been stepping up to meet the needs of the LGBTQ+ community. And individuals who might have struggled to find help in the past are now connecting with resources that make them "feel comfortable and confident and be focused on their treatment," said Anne-Marie Esposito, chief operating officer of Malvern Behavioral Health in Philadelphia.
It may be Pride Month now, but recovery is every day. So we wanted to share what recovery looks like in the LGBTQ+ community today—and what changes the past few years have brought.
'Sobriety Doesn't Always Make the List': Addiction, Mental Health and the LGBTQ+ Community
The most recent data from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) shows that lesbian, gay and bisexual individuals grapple with significantly higher rates of substance use disorders than their heterosexual counterparts. In 2021, 34% of bisexual adults, 31% of gay adults and 25% of lesbian adults reported substance use disorders in the past year, compared to 17% of the overall adult population. Rates of mental health issues were elevated as well.
What stressors in the community help explain this? "We have had, more often than I would like, kids who were disconnected from their family of origin, and that's a pretty painful thing," said Esposito, referring to young adults but citing a too-common experience across all ages. Malvern opened an inpatient psychiatric program tailored to patients in the LGBTQ+ community in March 2023.
"So what do drugs and alcohol do? They help us cope with things … that become so painful that it's just easier to use or to drink, because that makes you feel better in the moment." Some patients in Malvern's new Wisteria Program lack basics of stability like housing and safe environments. Addiction isn't always their most urgent concern. (The National Alliance on Mental Illness provides a comprehensive list of resources for individuals in the LGBTQ+ community seeking help.)
But, of course, many LGBTQ+ community members deal with substance use and mental health issues related to problems that can strain anyone's emotional well-being—employment stress, relationship difficulties. "It can be anything from not feeling accepted and loved by the people that created them all the way to jobs and breakups," said Esposito.
'Here I Am and This Is What I Need': LGBTQ+, Sober and Proud
The more heartening story of the past few years is that treatment, care, support and even sober lifestyle options for the LGBTQ+ recovery community have improved in noteworthy ways. In some cases, the treatment programs that focus on the community, like Malvern's Wisteria, are new. In others, the resources existed, but they're becoming more accessible to more people.
What's the difference-maker in this care and these resources? It's largely a matter of safety, comfort and sensitivity toward the needs and identities of patients. In the past, "there was not a feeling of safety of coming to inpatient [treatment]," said Esposito. "Some clients are looking for a place where 'I can focus on my anxiety, my depression, my substance use—and not have to have people asking me questions that are not appropriate.'"
Esposito identified two other major recent breakthroughs. The first is the explosion of digital recovery communities and virtual support groups during the COVID pandemic. "In the world of COVID, zip codes didn't matter, so you could find support groups all over the place. I think that has really lifted the barrier for folks in recovery, to really be able to reach out and connect with people that they can relate to," said Esposito.
The other big development is the rise of young adults in recovery or seeking mental health services. About one-third of Malvern's young adult program identifies as LGBTQ+. "Now we have this younger generation, and they're demanding the resources that they need for wellness. So we've got this young adult group that's like, 'Hey, here I am and this is what I need, and I deserve to have it.'"
Treatment programs empower people from all backgrounds to go back out into the world and live sober. In most successful recoveries, sober socializing and community connections continue. The very recent movement toward creating sober bars and cafes is one way that people who live substance-free are moving sober social life forward, and many, many of these spaces are LGBTQ-owned or proactive about providing affirming, inclusive hangouts for everyone.
"What I'm seeing is a rise in people just wanting to go to a safe space that has delicious drinks and an opportunity to connect authentically with other people," said Laura Silverman, founder of Zero Proof Nation, a platform that spotlights and promotes sober bars and nonalcoholic drinks. "They want to go to a place where they're more present. We need these sober social spaces so that people can have a safe place to go."
There are plenty of other sober activities and gatherings out there today as well, and members of the LGBTQ+ recovery community can choose among options that are more specific to them or that serve the broader sober community.
From the early stages of treatment to the longer journey of a fulfilling, drug-free life, the resources and opportunities for those who are LGBTQ+ and sober are expanding and improving—which should be a source of hope and pride for everyone.