Lesbian, gay, bisexual, transgender, and queer (LGBTQ) people have higher rates of risky substance use and substance use disorders (SUDs) as compared to the general population [1-4]. These disparities exist across multiple substance categories including tobacco, alcohol, cannabis, and cocaine. Furthermore, some substances (e.g., crystal methamphetamine) are used within a particular cultural context by a subset of the LGBTQ population. For transgender people receiving gender-affirming treatments, substance use can also have important interactions with these treatments, further increasing the relevance of identifying substance use in this patient population . Minority stress theory (MST) is one conceptual framework for understanding such disparities and posits that individuals from marginalized and/or stigmatized groups experience a unique type of stress that is additive to general stress . Numerous studies have linked MST constructs (i.e., discrimination, prejudice, stigma) to increased risk for substance use and SUDs among LGBTQ people. Clinicians can incorporate such knowledge into clinical practice to tailor treatment in a patient-centered, culturally-responsive manner.
**This content was captured at the 2019 APA Annual Meeting and may reference information from various sources and terminology from previous editions of the DSM.
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Medley, G., et al. (2016). "Sexual orientation and estimates of adult substance use and mental health: results from the 2015 National Survey of Drug Use and Health." Retrieved January 29, 2020, from https://www.samhsa.gov/data/sites/default/files/NSDUH-SexualOrientation-2015/NSDUH-SexualOrientation-2015/NSDUH-SexualOrientation-2015.htm
Lee, S. J. (2015). Addiction and Lesbian, Gay, Bisexual and Transgender (LGBT) Issues. In Textbook of Addiction Treatment: International Perspectives (pp. 2139-2164). Springer Milan.
- Summarize the epidemiology of substance use and substance use disorders (SUDs) among lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals.
- Describe minority stress theory and how this conceptual framework helps explain substance use related disparities among LGBTQ people.
- Discuss the differences in substance use among LGBTQ individuals by sexual orientation, gender identity, race/ethnicity, and degree of urbanicity/rurality.
- Identify strategies for incorporating knowledge of unique factors in substance use among LGBTQ individuals (e.g., internalized stigma, discrimination, family rejection) into clinical practice.
- Recognize clinical situations where specialist referral and/or consultation would be appropriate.
Estimated Time to Complete
Estimated Duration: 60 minutes
Begin Date: June 1, 2020
End Date: June 1, 2023
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Faculty and Planner Disclosures
- Petros Levounis, M.D., M.A., Chair, Department of Psychiatry, Rutgers- New Jersey Medical School. Reports no financial relationships with commercial interests.
- Faye Chao, M.D.., Unit Chief, Inpatient Addiction Services, Mt. Sinai Roosevelt Hospital. Reports no financial relationships with commercial interests.
- Jeremy Kidd, M.D., MPH., Addiction Psychiatry Fellow, Department of Psychiatry, Columbia University New York State Psychiatric Institute. Reports no financial relationships with commercial interests.
- Brian Hurley, M.D., M.B.A, DFASAM, Director of Addiction Medicine, Los Angeles County Department of Health Services. Reports no financial relationships with commercial interests.
- Tristan Gorrindo, M.D., Director of Education, American Psychiatric Association. Reports no financial relationships with commercial interests.
- Katie Putnam, Membership Development Specialist, American Psychiatric Association. Reports no financial relationships with commercial interests.
- Ally Brown, Senior Program Manager, Online Learning, American Psychiatric Association. Reports no financial relationships with commercial interests.
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