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Handbook of LGBT Elders pp 473–490Cite as

Substance Use Disorders Intervention with LGBT Elders

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Abstract

Substance use disorders (SUDs) and mental health problems frequently co-occur. SUDs are one of the most common psychiatric diagnoses in older adults. The purpose of this chapter is to discuss SUDs among LGBT elders. Information is presented on the scope of SUDs, prevalence and patterns of use, SUDs and aging comorbidity, assessment, diagnosis, and treatment of LGBT elders. This chapter provides the reader with a baseline for understanding issues that impact and influence LGBT elders’ substance use. There is no suggestion that LGBT status is synonymous with addiction or mental illness disorders. Thus, the chapter explores the extent to which SUDs exist among LGBT elders.

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Author information

Authors and Affiliations

  1. University of Kentucky, Lexington, USA

    Debra A. Harley & Michael T. Hancock

Authors
  1. Debra A. Harley
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  2. Michael T. Hancock
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Corresponding author

Correspondence to Debra A. Harley .

Editor information

Editors and Affiliations

  1. University of Kentucky, Lexington, Kentucky, USA

    Debra A. Harley

  2. University of Kentucky, Lexington, Kentucky, USA

    Pamela B. Teaster

Appendices

Learning Exercises

Self-Check Exercises

  1. 1.

    What are some unique characteristics of LGBT elders who abuse substances?

  2. 2.

    What is the most commonly abused substance by elders?

  3. 3.

    Why is it difficult to estimate the number of LGBT elders with SUDs?

  4. 4.

    How difficult is it for LGBT elders to find AA groups that are specific to their needs?

  5. 5.

    What roles do gay bars play in the lives of LGBT persons?

Experiential Assignments

  1. 1.

    Interview an LGBT elder to determine what his or her specific needs would be in a support group (e.g., AA) designed specifically of LGBT elders.

  2. 2.

    Interview a substance abuse counselor, social worker, or medical professional/nurse to explore his or her knowledge about meeting the unique needs of a LGBT elder with SUDs and a mental health disorder.

  3. 3.

    Develop a manual on substance abuse and mental health resources in you local town or city region for LGBT elders.

Multiple-Choice Questions

  1. 1.

    Which type of treatment options is recommended first for elders with SUDs?

    1. (a)

      Least costly

    2. (b)

      Most comprehensive

    3. (c)

      Least intensive

    4. (d)

      Multilevel

  2. 2.

    Which type of medication is the elderly most likely to receive that has misuse and abuse potential?

    1. (a)

      Psychoactive

    2. (b)

      Diuretic

    3. (c)

      Inhalants

    4. (d)

      Anti-coagulant

  3. (3)

    What is the purpose of a substance abuse screening is to do which of the following?

    1. (a)

      Identify a treatment protocol

    2. (b)

      Identify at-risk behavior

    3. (c)

      Make a diagnosis

    4. (d)

      Determine the existence of a family history of substance abuse

  4. 4.

    Which of the following is how comorbitity of substance abuse and mental illness be defined and treated?

    1. (a)

      Both as secondary conditions

    2. (b)

      One as a primary and the other as a secondary condition

    3. (c)

      Both as primary conditions

    4. (d)

      One as a primary condition and the other as a symptom

  5. 5.

    Which of the following usually result in iatrogenic stress?

    1. (a)

      Overprescribing of medication

    2. (b)

      Ignoring that alcohol is also a toxic drug

    3. (c)

      Failing to take into account the way the elderly metabolize medications

    4. (d)

      All of the above

    5. (e)

      None of the above

  6. 6.

    How are LGBT persons viewed if they do not reveal their sexual orientation or gender identity while in treatment?

    1. (a)

      Secretive

    2. (b)

      Introverted

    3. (c)

      Selfish

    4. (d)

      Untruthful

  7. 7.

    Which of the following is ignored as a growing concern of LGBT elders in substance abuse treatment?

    1. (a)

      HIV

    2. (b)

      Dementia

    3. (c)

      Illicit drugs

    4. (d)

      Substance-specific syndrome

  8. 8.

    Why are LGBT elders with comorbidities less likely to seek treatment?

    1. (a)

      More medical problems than younger people

    2. (b)

      Internalized stereotypes

    3. (c)

      Religious reasons

    4. (d)

      Legally cannot be questioned about substance use

  9. 9.

    What is a unique challenge of residential substance abuse treatment that is specific to transgender adults?

    1. (a)

      Age at which they come out

    2. (b)

      Post-reassignment surgery status

    3. (c)

      Pre-reassigned surgery status

    4. (d)

      Unwillingness to provide information

  10. 10.

    How many “yes” responses to questions on the CAGE or SMAR-G are indicative of a substance abuse problem?

    1. (a)

      One

    2. (b)

      Two

    3. (c)

      Three

    4. (d)

      All

Key

  • 1-C

  • 2-A

  • 3-B

  • 4-C

  • 5-D

  • 6-D

  • 7-A

  • 8-B

  • 9-C

  • 10-B

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Harley, D.A., Hancock, M.T. (2016). Substance Use Disorders Intervention with LGBT Elders. In: Harley, D., Teaster, P. (eds) Handbook of LGBT Elders. Springer, Cham. https://doi.org/10.1007/978-3-319-03623-6_24

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  • DOI: https://doi.org/10.1007/978-3-319-03623-6_24

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