Abstract
This chapter examines some of the unique challenges and opportunities in both research and clinical practice with gay, lesbian, and bisexual individuals experiencing problematic use of addictive substances. It begins with a brief overview of the concept of sexual orientation and some of the challenges facing individuals who do not identify as heterosexual. The chapter then addresses the prevalence of substance misuse and abuse in the gay, lesbian, and bisexual population, some of the unique problems they experience, and the complexity of making accurate assessments in research with this population. The chapter concludes with a discussion of affirmative clinical practice in responding to the treatment needs of gay, lesbian, and bisexual clients.
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References
Amadio DM (2006) Internalized heterosexism, alcohol use, and alcohol-related problems among lesbians and gay men. Addict Behav 31:1153–1162
Amadio DM, Chung YB (2004) Internalized homophobia and substance use among lesbian, gay, and bisexual persons. J Gay Lesbian Social Services 17:83–101
Anderson SC (1996) Substance abuse and dependency in gay men and lesbians. J Gay Lesbian Social Services 5:59–76
Autrey PK (2005) Drug use. In: Sears JT (ed) Youth, education, and sexualities: an international encyclopedia, vol. 1. Greenwood, Westport, CT
Barbara A (2002) Substance abuse treatment with lesbian, gay, and bisexual people: a qualitative study of service providers. J Gay Lesbian Social Services 14:1–17
Beatty RL, Geckle MO, Huggins J et al (1999) Gay men, lesbians, and bisexuals. In: McCrady BS, Epstein EE (eds) Addictions: a comprehensive guidebook. Oxford, New York
Berrill KT (1992) Anti-gay violence and victimization in the United States: an overview. In: Herek GM, Berrill KT (eds) Hate crimes: confronting violence against lesbians and gay men. Sage, Newbury Park, CA
Bloomfield K (1993) A comparison of alcohol consumption between lesbians and heterosexual women in an urban population. Drug Alcohol Depend 33:257–269
Borden A (2007) The history of gay people in alcoholics anonymous from the beginning. Haworth, New York
Brooks VR (1981) Minority stress and lesbian women. Lexington Books, Lexington, MA
Brown T (2002) A proposed model of bisexual identity development that elaborates on experiential differences of women and men. J Bisexuality 2:67–91
Burgard SA, Cochran SD, Mays VM (2005) Alcohol and tobacco use patterns among heterosexually and homosexually experienced California women. Drug Alcohol Depend 77:61–70
Bux DA Jr (1996) The epidemiology of problem drinking in gay men and lesbians: a critical review. Clin Psychol Rev 16:277–298
Cabaj RP (1997) Gays, lesbians, and bisexuals. In: Lowinson JH, Ruiz P, Millman RB et al (eds) Substance abuse: a comprehensive textbook, 3rd edn. Williams and Wilkins, Baltimore, MD
Cass VC (1979) Homosexual identity formation: a theoretical model. J Homosex 4:219–235
Cass VC (1984) Homosexual identity formation: testing a theoretical model. J Sex Res 20:143–167
Cass V (1996) Sexual orientation identity formation: a Western phenomenon. In: Cabaj RP, Stein TS (eds) Textbook of homosexuality and mental health. American Psychiatric, Washington, DC
Cheng Z (2003) Issues and standards in counseling lesbians and gay men with substance abuse concerns. J Mental Health Counseling 25:323–336
Chernin J, Holder JM, Chandler C (1997) Measurement and evaluation in counseling and development 30:88–90
Chung YB, Szymanksi DM (2006) Racial and sexual identities of Asian American gay men. J LGBT Issues Counseling 1:67–93
Cochran BN, Cauce AM (2006) Characteristics of lesbian, gay, bisexual, and transgender individuals entering substance abuse treatment. J Subst Abuse Treat 30:135–146.
Cochran BN, Peavy KM, Robohm JS (2007) Do specialized services exist for LGBT individuals seeking treatment for substance misuse? A study of available treatment programs. Subst Use Misuse 42:161–176
Cochran SD, Keenan C, Schober C et al (2000) Estimates of alcohol use and clinical treatment needs among homosexually active men and women in the U.S. population. J Consult Clin Psychol 68:1062–1071
Cochran SD, Mays VM (2000) Relation between psychiatric syndromes and behaviorally defined sexual orientation in a sample of the US population. Am J Epidemiol 151:516–523
Cochran SD, Mays VM (2006) Estimating prevalence of mental and substance using disorders among lesbians and gay men from existing national data. In: Omoto AM, Kurtzman HS (eds) Sexual orientation and mental health: examining identity and development in lesbian, gay, and bisexual people. American Psychological Association, Washington, DC
Cochran SD, Mays VM, Alegria M et al (2007) Mental health and substance use disorders among Latino and Asian American lesbian, gay, and bisexual adults. J Consult Clin Psychol 75:785–794
Cochran SD, Sullivan JG, Mays VM (2003) Prevalence of mental disorders, psychological distress, and mental health service use among lesbian, gay, and bisexual adults in the United States [Electronic version]. J Consult Clin Psychol 71:53–61
Coleman E (1982) Developmental stages of the coming-out process. Am Behav Scientist 25:469–482
Craft EM, Mulvey KP (2001) Addressing lesbian, gay, bisexual, and transgender issues from the inside: one federal agency’s approach. Am J Public Health 91:889–891
Dean L, Meyer IH, Robinson K et al (2000) Lesbian, gay, bisexual, and transgender health: findings and concerns. J Gay Lesbian Med Assoc 4:101–151
Diamant AL, Wold C, Spritzer K et al (2000) Health behaviors, health status, and access to and use of health care: a population-based study of lesbian, bisexual, and heterosexual women. Arch Family Med 9:1043–1051
Diamond LM (2006) What we got wrong about sexual identity development: unexpected findings from a longitudinal study of young women. In: Omoto AM, Kurtzman HS (eds) Sexual orientation and mental health: examining identity and development in lesbian, gay, and bisexual people. American Psychological Association, Washington, DC
Diamond LM (2008) Sexual fluidity: understanding women’s love and desire. Harvard University, Cambridge MA
DiPlacido J (1998) Minority stress among lesbians, gay men, and bisexuals: a consequence of heterosexism, homophobia, and stigmatization. In: Herek GM (ed) Psychological perspectives on lesbian and gay issues: vol. 4. Stigma and sexual orientation: understanding prejudice against lesbians, gay men, and bisexuals. Sage, Thousand Oaks, CA
Drabble L, Midanik LT, Trocki K (2005) Reports of alcohol consumption and alcohol-related problems among homosexual, bisexual, and heterosexual respondents: results from the 2000 national alcohol survey. J Stud Alcohol 66:111–120
Drabble L, Trocki K (2005) Alcohol consumption, alcohol-related problems, and other substance use among lesbian and bisexual women. J Lesbian Stud 9:19–30
Drabble L, Underhill BL (2002) Effective intervention and treatment for lesbians. In: Straussner SLA, Brown S (eds) The handbook of addiction treatment for women: theory and practice. Jossey-Bass, San Francisco
Eliason MJ (2000) Substance abuse counselor’s attitudes regarding lesbian, gay, bisexual, and transgendered clients. J Subst Abuse 12:311–328
Eliason MJ, Hughes T (2004) Treatment counselor’s attitudes about lesbian, gay, bisexual, and transgendered clients: urban vs. rural settings. Subst Use Misuse 39:625–644
Evans K, Sullivan JM (2001) Dual diagnosis: counseling the mentally ill substance abuser, 2nd edn. Guilford, New York
Fassinger RE (1991) The hidden minority: issues and challenges in working with lesbian women and gay men. Counseling Psychologist 19:157–176
Fassinger RE, Miller BA (1996) Validation of an inclusive model of sexual identity formation on a sample of gay men. J Homosex 32:53–78
Fiefield L (1975) On my way to nowhere, alienated, isolated, and drunk: an analysis of gay alcohol abuse and evaluation of alcoholism rehabilitation services for the Los Angeles Gay Community. The Gay Community Services Center, Los Angeles
Garnets LD, Herek GM, Levy B (2003) Violence and victimization of lesbians and gay men: mental health consequences. In: Garnets LD, Kimmel DC (Eds) Psychological perspectives on lesbian, gay, and bisexual experiences, 2nd edn. Columbia University, New York
Gay and Lesbian Medical Association (2006) Breaking the grip: treating crystal methamphetamine addiction among gay and bisexual men. Gay and Lesbian Medical Association, San Francisco
Gay and Lesbian Medical Association and LGBT Health Experts (2001) Healthy people 2010: companion document for lesbian, gay, bisexual, and transgender (LGBT) health. Gay and Lesbian Medical Association, San Francisco
Gilman SE, Cochran SD, Mays VM et al (2001) Risk of psychiatric disorders among individuals reporting same-sex sexual partners in the National Comorbidity Survey. Am J Public Health 91:933–939
Gonsiorek JC, Rudolph JR (1991) Homosexual identity: coming out and other developmental events. In: Gonsiorek JC, Weinrich DC (eds) Homosexuality: research implications for public policy. Sage, Newbury Park, CA
Gruskin EP, Hart S, Gordon N et al (2001) Patterns of cigarette smoking and alcohol use among lesbians and bisexual women enrolled in a large health maintenance organization. Am J Public Health 91:976–979
Guss JR (2000) Sex like you can’t even imagine: “Crystal,” crack, and gay men. In: Guss JR, Drescher J (eds) Addictions in the gay and lesbian community. Haworth Medical, New York
Haddock G, Zanna MP (1998) Authoritarianism, values, and the favorability and structure of anti-gay attitudes. In: Herek GM (ed) Psychological perspectives on lesbian and gay issues: vol. 4. Stigma and sexual orientation: understanding prejudice against lesbians, gay men, and bisexuals. Sage, Thousand Oaks, CA
Halkitis P N, Parsons JT, Stirratt MJ (2001) A double epidemic: crystal methamphetamine drug use in relation to HIV transmission among gay men. J Homosex 41:17–35
Hall JM (1993) What really worked? A case analysis and discussion of confrontational intervention for substance abuse in marginalized women. Arch Psychiatr Nurs 7:322–327
Hellman RE, Stanton M, Lee J et al (1989) Treatment of homosexual alcoholics in government-funded agencies: provider training and attitudes. Hospital Community Psychiatry 40:1163–1168
Herek GM (1989) Hate crimes against lesbians and gay men: issues for research and policy. Am Psychol 44:948–955
Herek GM (1991) Stigma, prejudice, and violence against lesbians and gay men. In: Gonsiorek JC, Weinrich JD (eds) Homosexuality: research implications for public policy. Sage, Newbury Park, CA
Herek GM (1996) Heterosexism and homophobia. In: Cabaj RJ, Stein TS (eds) Textbook of homosexuality and mental health. American Psychiatric, Washington, DC
Herek GM (2003) The psychology of sexual prejudice. In: Garnets LD, Kimmel DC (eds) Psychological perspectives on lesbian, gay, and bisexual experiences, 2nd edn. Columbia University, New York
Herek GM, Gillis JR, Cogan JC et al (1997) Hate crime victimization among lesbian, gay, and bisexual adults: prevalence, psychological correlates, and methodological issues. J Interpers Violence 12:195–215
Herek GM, Gillis JR, Cogan JC (1999) Psychological sequelae of hate-crime victimization among lesbian, gay, and bisexual adults. J Consult Clin Psychol 67:945–951
Hicks D (2000) The importance of specialized treatment programs for lesbian and gay patients. In: Guss JR, Drescher J (eds) Addictions in the gay and lesbian community. Haworth Medical, New York
Hughes TL (2003) Lesbians’ drinking patterns: beyond the data. Subst Use Misuse 38:1739–1758
Hughes TL, Eliason M (2002) Substance use and abuse in lesbian, gay, bisexual, and transgender populations. J Prim Prev 22:263–298
Hughes TL, Wilsnak SC (1997) Use of alcohol among lesbians: research and clinical implications. Am J Orthopsychiatry 67:20–36
Hughes TL, Wilsnack SC, Szalacha L et al (2006) Age and racial/ethnic differences in drinking and drinking-related problems in a community sample of lesbians. J Stud Alcohol 67:579–590
Human Rights Campaign (nd) A decade of violence: hate crimes based on sexual orientation. Retrieved 10 June 2006 from http://www.hrc.org
Human Rights Campaign (nd) A chronology of hate crimes: 1998–2002. Retrieved 10 June 2006 from http://www.hrc.org
Isrealstam S (1988) Knowledge and opinions of alcohol intervention workers in Ontario, Canada, regarding issues affecting male gays and lesbians: parts I and II. Int J Addict 23:227–252
Jorm AF, Korten AE, Rodgers B et al (2002) Sexual orientation and mental health: results from a community survey of young and middle-aged adults. Br J Psychiatry 180:423–427
Kocet MM, Larson L (2005) Substance abuse, addiction, and depression in the gay community. Presentation at the 2005 Annual Conference of the American Counseling Association, Atlanta, GA
Lewis CE, Saghir MT, Robins E (1982) Drinking patterns in homosexual and heterosexual women. J Clin Psychiatry 43:277
Lewis RJ, Derlega VJ, Clarke, EG et al (2006) Stigma consciousness, social constraints, and lesbian well-being. J Counseling Psychol 53:48–56
Lewis RJ, Derlega VJ, Griffin JL et al (2003) Stressors for gay men and lesbians: life stress, gay-related stress, stigma consciousness, and depressive symptoms. J Soc Clin Psychol 22:716–729
Mansergh G, Colfax GN, Marks G et al (2001) The Circuit party men’s health survey: findings and implications for gay and bisexual men. Am J Public Health 91:953–958
Matthews CR (2007) Affirmative lesbian, gay, and bisexual counseling with all clients. In: Bieschke KJ, Perez RM, DeBord KA (eds) Handbook of counseling and psychotherapy with lesbian, gay, bisexual, and transgender clients, 2nd edn. American Psychological Association, Washington, DC
Matthews CR, Bieschke KJ (2001) Adapting the ethnocultural assessment to gay and lesbian clients: the sexual orientation enculturation assessment. J Humanistic Educ Develop 40:58–73
Matthews CR, Lease SH (2000) Focus on the lesbian, gay, and bisexual family. In: Perez RM, DeBord KA, Bieschke KJ (eds) Handbook of counseling and therapy with lesbians, gays, and bisexuals. American Psychological Association, Washington, DC
Matthews CR, Lorah P, Fenton J (2005) Toward a grounded theory of lesbians’ recovery from addiction. J Lesbian Stud 9:57–68
Matthews CR, Lorah P, Fenton J (2006) Treatment experiences of gays and lesbians in recovery from addiction: a qualitative inquiry. J Mental Health Counseling 28:111–132
Matthews CR, Selvidge MMD (2005) Lesbian, gay, and bisexual clients’ experiences in treatment for addiction. J Lesbian Stud 9:79–90
Matthews CR, Selvidge MMD, Fisher K (2005) Addiction counselors’ attitudes and behaviors toward gay, lesbian, and bisexual clients. J Counseling Develop 83:57–65
Mattison AM, Ross MW, Wolfson T et al (2001) Circuit party attendance, club drug use, and unsafe sex in gay men. J Subst Abuse 13:119–126
Mays VM, Cochran SD (2001) Mental health correlates of perceived discrimination among lesbian, gay, and bisexual adults in the United States. Am J Public Health 91:1869–1876
McCarn SR, Fassinger RE (1996) Revisioning sexual minority identity formation: a new model of lesbian identity and its implications for counseling and research. Counseling Psychologist 24:508–534
McDowell D (2000) Gay men, lesbians and substances of abuse and the “club and circuit party scene”: what clinicians should know. In: Guss JR, Drescher J (eds) Addictions in the gay and lesbian community. Haworth Medical, New York
McKirnan DJ, Peterson PL (1989) Alcohol and drug use among homosexual men and women: epidemiology and population characteristics. Addict Behav 14:545–553
McKirnan DJ, Peterson PL (1989) Psychosocial and cultural factors in alcohol and drug abuse: an analysis of a homosexual community. Addict Behav 14:555–563
Meyer IH (1995) Minority stress and mental health in gay men. J Health Soc Behav 36:38–56
Meyer IH (2003) Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations. Psychol Bull 129:674–697
Milliger C, Young M (1990) Perceived acceptance and social isolation among recovering homosexual alcoholics. Int J Addict 25:947–955
Morgenstern J, Irwin TW, Wainberg, ML et al (2007) A randomized controlled trial of goal choice interventions for alcohol use disorders among men who have sex with men. J Consult Clin Psychol 75:72–84
O’Hanlan KA, Cabaj RP, Schatz B, Lock, J et al (1997) A review of the medical consequences of homophobia with suggestions for resolution. J Gay Lesbian Med Assoc 1:25–39
Ohnishi H, Ibrahim FA, Grzegorek JL (2006) Intersections of identities: counseling lesbian, gay, bisexual, and transgender Asian-Americans. J LGBT Issues Counseling 1:77–94
Orenstein A (2001) Substance use among gay and lesbian adolescents. J Homosex 41:1–15
Paul JP, Stall R, Bloomfield KA (1991) Gay and alcoholic: epidemiologic and clinical issues. Alcohol Health Res World 15:151–160
Potter-Efron R (2002) Shame, guilt, and alcoholism: treatment issues in clinical practice, 2nd edn. Haworth, New York
Ratner EF (1993) Treatment issues for chemically dependent lesbians and gay men. In: Garnets LD, Kimmel DC (eds) Psychological perspectives on lesbian and gay male experiences. Columbia University, New York
Reynolds AL (2003) Counseling issues for lesbian and bisexual women. In: Kopala M, Keitel M (eds) Handbook of Counseling Women. Sage, Thousand Oaks, CA
Rivers I, D’Augelli AR (2001) The victimization of gay, lesbian, and bisexual youths. In: D’Augelli AR, Patterson CJ (eds) Lesbian, gay, and bisexual identities and youth: psychological perspectives. Oxford University, New York
Rosario M, Hunter J, Gwadz M (1997) Exploration of substance use among lesbian, gay, and bisexual youth: prevalence and correlates. J Adolesc Res 12:454–476
Ross MW, Mattison AM, Franklin DR Jr (2003) Club drugs and sex on drugs are associated with different motivations for gay circuit party attendance in men. Subst Use Misuse 38:1173–1183
Russell GM (2000) Voted out: the psychological consequences of ant-gay politics. New York University, New York
Saghir MT, Robins E (1973) Male and female homosexuality: a comprehensive investigation. Williams and Wilkins, Baltimore
Savin-Williams RC (2007) The new gay teenager. Harvard University, Cambridge, MA
Skinner WF (1994) The prevalence and demographic predictors of illicit and licit drug use among lesbians and gay men. Am J Public Health 84:1307–1310
Skinner WF, Otis MD (1996) Drug and alcohol use among lesbian and gay people in a southern U.S. sample: epidemiological, comparative, and methodological findings from the Trilogy Project. J Homosex 30:59–92
Sophie J (1986) A critical examination of stage theories of lesbian identity development. J Homosex 12:39–51
Stall R, Wiley J (1988) A comparison of alcohol and drug use problems of homosexual and hetersosexual men: the San Francisco men’s health study. Drug Alcohol Depend 22:63–73
Substance Abuse and Mental Health Services Administration (2001) A provider’s introduction to substance abuse treatment for lesbian, gay, bisexual, and transgender individuals. (DHHS Publication No. SMA 03-3819). Substance Abuse and Mental Health Services Administration, Rockville, MD
Sue DW, Arredondo PA, McDavis RJ (1992) Multicultural competencies and standards: a call to the profession. J Counseling Develop 20:64–68
Szymanski DM, Kashubeck-West S, Meyer J (2008) Internalized heterosexism: a historical and theoretical overview. Counseling Psychologist 36:510–524
Trocki KF, Drabble L, Midanik L (2005) Use of heavier drinking contexts among heterosexuals, homosexuals, and bisexuals: results from a national household probability study. J Stud Alcohol 66:105–110
Troiden RR (1979) Becoming homosexual: a model of gay identity acquisition. Psychiatry 42:362–373
Weber GN (2008) Using to numb the pain: substance use and abuse among lesbian, gay, and bisexual individuals. J Mental Health Counseling 30:31–48
Weinberg TS (1994) Gay men, drinking, and alcoholism. Southern Illinois University, Carbondale, IL
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Matthews, C.R. (2010). Gays, Lesbians, and Bisexuals. In: Johnson, B. (eds) Addiction Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0338-9_68
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