Abstract
In this chapter, we explore the use of substances amongst sexual minorities and the interplay with their mental health for those for whom it becomes problematic. After considering the nomenclature and prevalence of such use, and possible influences within this, we discuss the importance of culturally sensitive practice and specific therapeutic and ethical considerations we must take within this work.
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References
Abdulrahim, D., Whitely, C., & Bowden-Jones, O. (2016). Club drug use among Lesbian, Gay, Bisexual and Trans (LGBT) people. Novel Psychoactive Treatment UK Network (NEPTUNE)
ACON. (2013). Health outcomes strategy 2013–2018: Alcohol and other drugs.
Anderson, S. C. (2009). Substance use disorders in lesbian, gay, bisexual, and transgender clients: Assessment and treatment. Columbia University Press.
Aldridge, A. (2020). Intoxicating the ‘charmed circle’: Constructions of deviance and normativity by people who combine drugs and sex. Criminology & Criminal Justice, 20(5), 564–576. https://doi.org/10.1177/1748895820937332
Balsam, K. F., Martell, C. R., & Safren, S. A. (2006). Affirmative cognitive-behavioral therapy with lesbian, gay, and bisexual people. In P. A. Hays & G. Y. Iwamasa (Eds.), Culturally responsive cognitive-behavioral therapy: Assessment, practice, and supervision (pp. 223–243). American Psychological Association.
Beam, J. (2008). In the life: A black gay anthology. RedBone Press.
Becker, J. B., McClellan, M. L., & Reed, B. G. (2017). Sex differences, gender and addiction: Sex, Gender, and Addiction. Journal of Neuroscience Research, 95(1–2), 136–147. https://doi.org/10.1002/jnr.23963
Barbara, A. M. (2002). Substance abuse treatment with lesbian, gay and bisexual people: A qualitative study of service providers. Journal of Gay & Lesbian Social Services, 14(4), 1–17.
Bourne, A., Reid, D., Hickson, F., Rueda, S. T., & Weatherburn, P. (2014). Drug use in sexual settings among study: Gay and bisexual men in Lambeth, Southwark & Lewisham (p. 3). Sigma Research, London School of Hygiene & Tropical Medicine.
British Psychological Society. (2019). Guidelines for psychologists working with gender, sexuality and relationship diversity. https://www.bps.org.uk/news-and-policy/guidelines-psychologists-working-gender-sexuality-and-relationship-diversity
Brooks, K. D., Bowleg, L., & Quina, K. (2009). Minority sexual status among minorities. In S. Loue (Ed.), Sexualities and identities of minority women (pp. 41–63). Springer. https://doi.org/10.1007/978-0-387-75657-8_3
Burckell, L. A., & Goldfried, M. R. (2006). Therapist qualities preferred by sexual-minority individuals. Psychotherapy: Theory, Research, Practice, Training, 43(1), 32–49. https://doi.org/10.1037/0033-3204.43.1.32
Cabaj, R. P. (2014). Substance use issues among gay, lesbian, bisexual, and transgender people . In Textbook of substance abuse treatment (pp. 707–721). American Psychiatric Association.
Cave, J., Ismail, S., Liccardo, R., Rabinovich, L., Rubin, J., & Weed, K. (2009). Tackling problem drug use (TR-795-NAO; p. 76). UK National Audit Office. www.nao.org.uk/wp-content/uploads/2010/03/0910297_reviews.pdf
Cochran, B. N., Peavy, K. M., & Robohm, J. S. (2007). Do specialized services exist for LGBT individuals seeking treatment for substance misuse? A study of available treatment programs. Substance Use & Misuse, 42(1), 161–176.
Corliss, H. L., Rosario, M., Wypij, D., Wylie, S. A., Frazier, A. L., & Austin, S. B. (2010). Sexual orientation and drug use in a longitudinal cohort study of U.S. adolescents. Addictive Behaviors, 35(5), 517–521. https://doi.org/10.1016/j.addbeh.2009.12.019
Dorn-Medeiros, C. M., & Doyle, C. (2018). Alcohol as coping: Internalized homophobia and heterosexism’s role in alcohol use among lesbians. Journal of LGBT Issues in Counseling, 12(3), 142–157. https://doi.org/10.1080/15538605.2018.1488230
Drabble, L., & Eliason, M. J. (2012). Substance use disorders treatment for sexual minority women. Journal of LGBT Issues in Counseling, 6(4), 274–292. https://doi.org/10.1080/15538605.2012.726150
Drescher, J. (2015). Out of DSM: Depathologizing homosexuality. Behavioral Sciences, 5(4), 565–575.
Edmundson, C., Heinsbroek, E., Glass, R., Hope, V., Mohammed, H., White, M., & Desai, M. (2018). Sexualised drug use in the United Kingdom (UK): A review of the literature. International Journal of Drug Policy, 55, 131–148. https://doi.org/10.1016/j.drugpo.2018.02.002
Eliason, M. J., & Schope, R. (2001). Does “don’t ask don’t tell” apply to health care? Lesbian, gay, and bisexual people’s disclosure to health care providers. Journal of the Gay and Lesbian Medical Association, 5(4), 125–134.
Elmquist, J., Shorey, R. C., Anderson, S. E., & Stuart, G. L. (2017). A preliminary investigation of the relationship between dispositional mindfulness and eating disorder symptoms among men in residential substance use treatment. Addiction Research & Theory, 25(1), 67–73. https://doi.org/10.1080/16066359.2016.1198475
Emslie, C., Lennox, J., & Ireland, L. (2015). The social context of LGBT people’s drinking in Scotland (p. 28). Glasgow Caledonian University.
Enkema, M. C., Hallgren, K. A., Neilson, E. C., Bowen, S., Bird, E. R., & Larimer, M. E. (2020). Disrupting the path to craving: Acting without awareness mediates the link between negative affect and craving. Psychology of Addictive Behaviors, 34(5), 620–627. https://doi.org/10.1037/adb0000565
European Monitoring Centre for Drugs and Drug Addiction. (2018). European drug report 2018: Trends and developments. Publications Office. https://doi.org/10.2810/800331
Evans, K. (2019). The psychological roots of chemsex and how understanding the full picture can help us create meaningful support. Drugs and Alcohol Today, 19(1), 36–41. https://doi.org/10.1108/DAT-10-2018-0062
Flentje, A., Livingston, N. A., Roley, J., & Sorensen, J. L. (2015). Mental and physical health needs of lesbian, gay, and bisexual clients in substance abuse treatment. Journal of Substance Abuse Treatment, 58, 78–83. https://doi.org/10.1016/j.jsat.2015.06.022
Gilbert, P. (1998). What is shame? Some core issues and controversies. In Shame: Interpersonal behavior, psychopathology, and culture (pp. 3–38). Oxford University Press.
Global Commission on Drug Policy. (2017). The world drug perception problem: Countering prejudices about people who use drugs (Report 2017).
Gonzalez, J. M., Alegría, M., Prihoda, T. J., Copeland, L. A., & Zeber, J. E. (2011). How the relationship of attitudes toward mental health treatment and service use differs by age, gender, ethnicity/race and education. Social Psychiatry and Psychiatric Epidemiology, 46(1), 45–57. https://doi.org/10.1007/s00127-009-0168-4
Harm Reduction International. (2021). Chemsex and harm reduction for gay men and other men who have sex with men (p. 8) [Briefing Note]. Harm Reduction International.
Hegazi, A., Lee, M., Whittaker, W., Green, S., Simms, R., Cutts, R., Nagington, M., Nathan, B., & Pakianathan, M. (2017). Chemsex and the city: Sexualised substance use in gay bisexual and other men who have sex with men attending sexual health clinics. International Journal of STD & AIDS, 28(4), 362–366. https://doi.org/10.1177/0956462416651229
Hicks, D. (2000). The importance of specialized treatment programs for lesbian and gay patients. Journal of Gay & Lesbian Psychotherapy, 3(3–4), 81–94.
Hodson, K., Meads, C., & Bewley, S. (2017). Lesbian and bisexual women’s likelihood of becoming pregnant: a systematic review and meta‐analysis. BJOG: An International Journal of Obstetrics & Gynaecology, 124(3), 393–402.
Hoff, B., Freeman, D., & Wang, D. (2020). Mindfulness-based chemsex recovery (Annual Report). Spectra.
Institute of Medicine. (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding (Vol. 49). The National Academies Press. https://doi.org/10.5860/CHOICE.49-2699
Irons, C., & Lad, S. (2014). Using compassion focused therapy to work with shame and self-criticism in complex trauma. Australian Clinical Psychologist, 3(1), 47–54.
Jayne, M., & Williams, A. (2020). Faith-based alcohol treatment in England and Wales: New evidence for policy and practice. Health & Place, 66, 102457. https://doi.org/10.1016/j.healthplace.2020.102457
Jeffery, M. K., & Tweed, A. E. (2014). Clinician self-disclosure or clinician self-concealment? Lesbian, gay and bisexual mental health practitioners’ experiences of disclosure in therapeutic relationships. Counselling and Psychotherapy Research, 1–8. https://doi.org/10.1080/14733145.2013.871307
Kandall, S. (1999). Substance and Shadow: Women and Addiction in the United States. Harvard University Press.
Kunelaki, R. (2019). What is sober sex and how to achieve it? Drugs and Alcohol Today, 19(1), 29–35. https://doi.org/10.1108/DAT-11-2018-0064
Ma, R., & Perera, S. (2016). Safer ‘chemsex’: GPs’ role in harm reduction for emerging forms of recreational drug use. British Journal of General Practice, 66(642), 4–5.
Maxwell, S., Shahmanesh, M., & Gafos, M. (2019). Chemsex behaviours among men who have sex with men: A systematic review of the literature. International Journal of Drug Policy, 63, 74–89. https://doi.org/10.1016/j.drugpo.2018.11.014
Mayer, K. H., Bradford, J. B., Makadon, H. J., Stall, R., Goldhammer, H., & Landers, S. (2008). Sexual and gender minority health: What we know and what needs to be done. American Journal of Public Health, 98(6), 989–995. https://doi.org/10.2105/AJPH.2007.127811
McCellan, M. (2017). Lady lushes: Gender, alcoholism, and medicine in modern America. Rutgers University Press.
McGeough, B. (2021). A systematic review of substance use treatments for sexual minority women. Journal of Gay & Lesbian Social Services, 33(2), 180–210. https://doi.org/10.1080/10538720.2021.1875346
Medley, G., Lipari, R. N., Bose, J., Cribb, D. S., Kroutil, L. A., & McHenry, G. (2015). Sexual orientation and estimates of adult substance use and mental health: results from the 2015 National Survey on Drug Use and Health. 54.
Mericle, A. A., de Guzman, R., Hemberg, J., Yette, E., Drabble, L., & Trocki, K. (2018). Delivering LGBT-sensitive substance use treatment to sexual minority women. Journal of Gay & Lesbian Social Services, 30(4), 393–408. https://doi.org/10.1080/10538720.2018.1512435
Meyer, I. H. (2003). Minority stress and mental health in gay men. In L. D. Garnets & D. C. Kimmel (Eds.), Psychological perspectives on lesbian, gay, and bisexual experiences (2nd ed.). (2003-00760-026; pp. 699–731). Columbia University Press. http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-00760-026&site=ehost-live
Miller-Lloyd, L., Landry, J., Macmadu, A., Allard, I., & Waxman, M. (2020). Barriers to healthcare for people who inject drugs: A survey at a syringe exchange program. Substance Use & Misuse, 55(6), 896–899. https://doi.org/10.1080/10826084.2019.1710207
Moncrief, M. (2014). Out of your mind: Improving provision of drug & alcohol treatment for lesbian, gay, bisexual & trans people. London Friend.
Neisen, J. H. (1997). An inpatient psychoeducational group model for gay men and lesbians with alcohol and drug abuse problems. In Chemical dependency treatment: Innovative group approaches (pp. 37–51). Routledge
Nutt, D. J., King, L. A., & Phillips, L. D. (2010). Drug harms in the UK: A multicriteria decision analysis. The Lancet, 376(9752), 1558–1565. https://doi.org/10.1016/S0140-6736(10)61462-6
Office for Health Improvement & Disparities. (2021). Adult substance misuse treatment statistics 2020 to 2021: Report. Office for Health Improvement & Disparities. https://www.gov.uk/government/statistics/substance-misuse-treatment-for-adults-statistics-2020-to-2021/adult-substance-misuse-treatment-statistics-2020-to-2021-report
Office of National Statistics (ONS). (2018). Adult drinking habits in Great Britain: 2017. Office of National Statistics (ONS). https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/drugusealcoholandsmoking/bulletins/opinionsandlifestylesurveyadultdrinkinghabitsingreatbritain/2017
Pachankis, J. E. (2014). Uncovering clinical principles and techniques to address minority stress, mental health, and related health risks among gay and bisexual men. Clinical Psychology: Science and Practice, 21(4), 313.
Pachankis, J. E., Hatzenbuehler, M. L., Rendina, H. J., Safren, S. A., & Parsons, J. T. (2015). LGB-affirmative cognitive-behavioral therapy for young adult gay and bisexual men: A randomized controlled trial of a transdiagnostic minority stress approach. Journal of Consulting and Clinical Psychology, 83(5), 875–889. https://doi.org/10.1037/ccp0000037
Pachankis, J. E., & Safren, S. A. (2019). Handbook of evidence-based mental health practice with sexual and gender minorities. Oxford University Press. https://doi.org/10.1093/med-psych/9780190669300.001.0001
Pennay, A., McNair, R., Hughes, T. L., Leonard, W., Brown, R., & Lubman, D. I. (2018). Improving alcohol and mental health treatment for lesbian, bisexual and queer women: Identity matters. Australian and New Zealand Journal of Public Health, 42(1), 35–42. https://doi.org/10.1111/1753-6405.12739
Pienaar, K., Murphy, D. A., Race, K., & Lea, T. (2018). Problematising LGBTIQ drug use, governing sexuality and gender: A critical analysis of LGBTIQ health policy in Australia. International Journal of Drug Policy, 55, 187–194. https://doi.org/10.1016/j.drugpo.2018.01.008
Pitman, A., Marston, L., Lewis, G., Semlyen, J., McManus, S., & King, M. (2021). The mental health of lesbian, gay, and bisexual adults compared with heterosexual adults: Results of two nationally representative English household probability samples. Psychological Medicine, 1–10.
Platteau, T., Herrijgers, C., & de Wit, J. (2020). Digital chemsex support and care: The potential of just-in-time adaptive interventions. International Journal of Drug Policy, 85, 102927. https://doi.org/10.1016/j.drugpo.2020.102927
Platteau, T., Pebody, R., Dunbar, N., Lebacq, T., & Collins, B. (2019). The problematic chemsex journey: A resource for prevention and harm reduction. Drugs and Alcohol Today, 19(1), 49–54.
Rosińska, M., Gios, L., Nöstlinger, C., Vanden Berghe, W., Marcus, U., Schink, S., Sherriff, N., Jones, A.-M., Folch, C., Dias, S., Velicko, I., & Mirandola, M. (2018). Prevalence of drug use during sex amongst MSM in Europe: Results from a multi-site bio-behavioural survey. International Journal of Drug Policy, 55, 231–241. https://doi.org/10.1016/j.drugpo.2018.01.002
Sagar-Ouriaghli, I., Godfrey, E., Bridge, L., Meade, L., & Brown, J. S. L. (2019). Improving mental health service utilization among men: A systematic review and synthesis of behavior change techniques within interventions targeting help-seeking. American Journal of Men’s Health, 13(3), 155798831985700. https://doi.org/10.1177/1557988319857009
SAMHSA: Substance Abuse and Mental Health Services Administration. (2001). Summary of findings from the 2000 National Household Survey on Drug Abuse. NHSDA Series H-13, DHHS Publication No (SMA) 01-3549. Office of Applied Studies.
Santoro, P., Rodríguez, R., Morales, P., Morano, A., & Morán, M. (2020). One “chemsex” or many? Types of chemsex sessions among gay and other men who have sex with men in Madrid, Spain: Findings from a qualitative study. International Journal of Drug Policy, 82, 102790. https://doi.org/10.1016/j.drugpo.2020.102790
Schlag, A. K. (2020). Percentages of problem drug use and their implications for policy making: A review of the literature. Drug Science, Policy and Law, 6, 205032452090454. https://doi.org/10.1177/2050324520904540
Schulz, C. T., Glatt, E. M., & Stamates, A. L. (2022). Risk factors associated with alcohol and drug use among bisexual women: A literature review. Experimental and Clinical Psychopharmacology, 30(5), 740–749. https://doi.org/10.1037/pha0000480
Seitz, N.-N., Lochbühler, K., Atzendorf, J., Rauschert, C., Pfeiffer-Gerschel, T., & Kraus, L. (2019). Trends in substance use and related disorders. Deutsches Aerzteblatt Online. https://doi.org/10.3238/arztebl.2019.0585
Senreich, E. (2010). Differences in outcomes, completion rates, and perceptions of treatment between white, black, and Hispanic LGBT clients in substance abuse programs. Journal of Gay & Lesbian Mental Health, 14(3), 176–200. https://doi.org/10.1080/19359701003784675
Senreich, E. (2012). Lesbian, gay, and bisexual clients in a substance abuse treatment program serving a mostly black and Hispanic population. Journal of LGBT Issues in Counseling, 6(4), 310–336. https://doi.org/10.1080/15538605.2012.730474
Shahab, L., Brown, J., Hagger-Johnson, G., Michie, S., Semlyen, J., West, R., & Meads, C. (2017). Sexual orientation identity and tobacco and hazardous alcohol use: Findings from a cross-sectional English population survey. BMJ Open, 7(10), e015058. https://doi.org/10.1136/bmjopen-2016-015058
Smalley, K. B., Warren, J. C., & Barefoot, K. N. (2018). LGBT health: Meeting the needs of gender and sexual minorities. Springer Publishing Company. http://0-search.ebscohost.com.catalogue.libraries.london.ac.uk/login.aspx?direct=true&db=psyh&AN=2017-36752-000&site=ehost-live
Smith, V., & Tasker, F. (2018). Gay men’s chemsex survival stories. Sexual Health, 15(2), 116–122. https://doi.org/10.1071/SH17122
Stevens, M. B. (2016). Social workers’ experiences related to online dating: A descriptive study (Masters Thesis). Smith College, Northampton, MA.
Stuart, D. (2013). Sexualised drug use by MSM: Background, current status and response. HIV Nursing, 13(1), 6–10.
Tervalon, M., & Murray-García, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117–125. https://doi.org/10.1353/hpu.2010.0233
Todd, M. (2016). Straight jacket—How to be gay and happy. Transworld Digital.
Torres, T. S., Bastos, L. S., Kamel, L., Bezerra, D. R. B., Fernandes, N. M., Moreira, R. I., Garner, A., Veloso, V. G., Grinsztejn, B., & De Boni, R. B. (2020). Do men who have sex with men who report alcohol and illicit drug use before/during sex (chemsex) present moderate/high risk for substance use disorders? Drug and Alcohol Dependence, 209, 107908. https://doi.org/10.1016/j.drugalcdep.2020.107908
Unhjem, L., Hoss, L., Roberts, B., & VanderTuin, S. (2021). Swipe right for… my therapist? Ethical considerations for therapists using dating apps. Contemporary Family Therapy, 43(2), 177–188. https://doi.org/10.1007/s10591-020-09561-7
United Nations Office on Drugs and Crime [UNODC]. (2019). World Drug Report 2019 (pp. 1–56).
Wang, P. S., Lane, M., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005). Twelve-month use of mental health services in the United States: Results from the national comorbidity survey replication. Archives of General Psychiatry, 62(6), 629. https://doi.org/10.1001/archpsyc.62.6.629
West, R., & Brown, J. (2013). Theory of addiction (2nd ed.). Wiley.
Williams, H., Varney, D. J., Taylor, J., Durr, P., & Elan-Cane, C. (2010). The lesbian, gay, bisexual and trans public health outcomes framework companion document (p. 57). Public Health England.
Women and Equalities Committee. (2019). Health and social care and LGBT communities. House of Commons.
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Rolt, M., Margetts, A. (2023). Addressing Substance Abuse. In: Semlyen, J., Rohleder, P. (eds) Sexual Minorities and Mental Health. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-031-37438-8_15
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