George is an accountant at a prestigious law firm, but he struggles daily with his mental health. As a person who identifies as bisexual, George is constantly anxious and afraid to be open about his sexuality, especially among his socially conservative work colleagues. George’s family is also very strict and traditional, which has caused him to remain secretive about his identity for many years. The inner torment and shame that George experiences daily eventually sends him into a deep depression where he self-medicates with anti-anxiety medications and alcohol.

While the above story is fictional, it is an example of how some individuals in the LGTBQ+ community end up abusing substances. Many people face daily struggles and find it difficult to cope, whether it’s due to discrimination or inner suffering. George’s example is just one of many where people turn to drugs and alcohol to cope with stress and feelings of fear, anxiety, depression, and inadequacy.

However, there is hope and treatment available that meets the unique needs of this community.

Prevalence and Causes of Addiction Among the LGBTQ+ Community

  • According to the Substance Abuse and Mental Health Administration (SAMHSA), 20% to 30% of LGBTQ+ people misuse substances, compared with 9% of the general population.
  • 1% of LGBTQ+ adults are estimated to have used illicit drugs in 2015, compared to 17.1% of heterosexual adults.
  • 25% of LGBTQ+ people abuse alcohol, compared with 5% to 10% of heterosexual adults.
  • The Centers for Disease Control and Prevention (CDC) report that 1 in 4 LGBTQ+ individuals smoke tobacco, compared with 1 in 6 among heterosexual individuals.
  • According to research at the University of Michigan, people who identify as lesbian or gay are more than twice as likely to have a severe alcohol or tobacco use disorder, compared with people who identify as heterosexual.
  • The same study revealed that people who identify as bisexual are three times as likely to have an alcohol or tobacco use disorder.

Substances Commonly Abused by Members of the LGBTQ+ Community

People in the LGBTQ+ community are known to abuse a range of substances. Below are the most common.


Tobacco use amongst the LGBTQ community is 200% higher than those in the heterosexual population. While the reason for this statistic is complex, some of it is due to the stress and anxiety that many in this community experience. High tobacco use can also be linked to aggressive advertising campaigns that have been targeted at LGBTQ individuals over the last 25 years.

Whatever the reasons, though, high tobacco use leaves many individuals at risk of health complications, such as cancer and cardiovascular disease. Sadly, the CDC reports that around 30,000 LGBTQ+ individuals die each year from tobacco-related diseases.


Alcohol is another highly abused substance among the LGBTQ+ community. An estimated 20% to 25% of individuals abuse the drug, compared with 5% to 10% in the heterosexual community. High stress levels and anxiety due to societal stigma can cause many individuals to turn to alcohol to cope. Another contributing factor is that the strong sense of safety and community provided by gay bars can promote heavy drinking among the LGBTQ+ community.


Stimulants such as prescription amphetamines (Adderall) or other illicit drugs like cocaine and crystal meth are another problem drug in the LGBTQ+ community. Amphetamines produce energizing and euphoric qualities, and they are frequently used in the gay club and party scene. Recent studies indicate that gay men are 12.2 times more likely to use stimulants than their heterosexual peers.

While amphetamine use is somewhat normalized among the club and party scene, these drugs can be highly addictive. When used in excess or at high doses for long periods, they can lead to cardiovascular problems, overdoses, or seizures.


Heroin is a dangerous drug that is also highly addictive. This drug can be smoked, snorted, or injected, creating a euphoric rush for the individual. Heroin use is common among the LGBTQ+ community: some studies indicate that gay men, for example, are 9.5 times more likely to use heroin than heterosexual men. While reasons for use are complicated, many individuals in the LGBTQ+ community turn to heroin to deal with experiences of discrimination, stigma, and homophobia.

Co-Occurring Disorders Among LGBTQ+

Substance abuse rarely occurs in isolation. Many people who develop an addiction also have underlying mental health conditions, such as anxiety and depression. For the LGBTQ+ community, in particular, many of these individuals have had to hide their sexuality out of fear of persecution.

This can lead to mental health problems of their own, as a person is hiding a core part of who they are. Even those who are open about their sexuality may live in fear of being discriminated against. All these factors can lead many individuals to develop mental health issues.

Some of the common co-occurring conditions among the LGBTQ+ community include:

  • Major depressive disorder (MDD)
  • Generalized anxiety disorder (GAD)
  • Post-traumatic stress disorder (PTSD)
  • Suicide attempts or self-harm tendencies

In addition to these emotional or psychological afflictions, some LGBTQ+ individuals also experience physical health issues connected to their sexuality. These can include:

  • Compulsive sexual behavior
  • Sex addiction
  • Sexual dysfunction
  • Sex or HIV-related anxiety
  • Sexual abuse or assault

Since many individuals who identify as LGBTQ+ have underlying physical and/or mental health conditions, treatment programs should focus on dual diagnosis or co-occurring disorders. This allows for the highest chance of long-term recovery.

Causes of Substance Abuse

There are several reasons why people in the LGBTQ+ community abuse substances. While not all individuals will develop an addiction, there are still risks involved. Some of the primary causes of substance abuse include:

  • Discrimination and societal stigma.
  • Lack of support (or rejection) from family and friends.
  • Being targeted with bullying, hate crimes, abuse, threats, public humiliation, or ridicule.
  • Employment issues, such as being fired.
  • Internalized homophobia, self-hatred, or shame.
  • Fears of being targeted for discrimination or abuse.
  • Marginalization or social prejudice.

Recognizing the Signs of Substance Abuse

One of the ways to prevent the cycle of addiction is to educate yourself about substance abuse. If you or someone you know is having issues with drugs and alcohol, below are some key signs of addiction to watch out for:

  • Tolerance: when your body is used to a substance and requires larger amounts to achieve the desired effects.
  • Withdrawal: if you experience symptoms such as nausea, tremors, nervousness, cold sweats, or agitation when you stop using drugs or alcohol.
  • Remorse: if your drug use has made you feel guilty or sad, even though you are taking the substance to feel better.
  • Relapse: if you try to stop taking the drug but find yourself going back to it due to intense cravings or withdrawal symptoms.

Other signs of addiction and/or substance abuse are:

  • A decline in personal appearance.
  • Withdrawal from friends or family.
  • Diminished enjoyment or participation in activities.
  • Lying about substance use.
  • Spending a lot of time recovering from the effects of substances.
  • Exhibiting a need to drink or use drugs to cope or feel “normal.”
  • Mood swings.
  • Physical signs like chronic bloodshot eyes, excessive drowsiness (e.g., depressants), hyperactivity (e.g., stimulants), poor concentration, memory issues.
  • Continuing to use substances despite any negative consequences.
  • Legal troubles such as arrests, accidents, or DWIs.

Specialized Treatment and Support for Members of the LGBTQ+ Community

LGBTQ+ individuals have access to a range of treatment options, many of which are specialized for the lesbian, gay, bisexual, transgender, and queer communities. These can be found in traditional rehab facilities, as well as in centers that cater exclusively to this population. Because the needs of LGBTQ+ people are unique and specific, it can be comforting to know that there are programs where you can feel safe and accepted.

In terms of what they offer, many programs provide treatment for substance abuse while focusing on issues that are specific to the LGBTQ+ community. There is often an emphasis on evidence-based therapy and individual and group therapy sessions. Along with therapy, many programs also provide special sessions that address issues such as discrimination/rejection, depression, anxiety, coming out, etc. Many of the staff in these programs are also from the LGBTQ+ community.

However, like standard drug rehab facilities, there is no blanket approach to LGBTQ+ rehab. Centers will differ from one to the next and their programs will also vary in length and intensity. Some programs may also be categorized by sexual orientation, while others provide for a wider range of gender identities.

Finding an LGBTQ+-Specific Treatment Program

In the U.S., there are hundreds of drug and alcohol rehab facilities that also cater to the needs of the LGBTQ+ community. Many of these centers help individuals with co-occurring mental health conditions alongside treatment for substance abuse. Some of the program options to look out for include:

  • Residential or inpatient treatment
  • Intensive outpatient programs
  • Regular outpatient programs
  • Partial hospitalization programs
  • Sober living
  • Sexual health programs

Like most traditional rehab programs, treatment usually begins with a detox program followed by inpatient, outpatient, and/or residency at a sober living facility. This will vary depending on your individual needs.


If you or a loved one are struggling with substance abuse, you are not alone. Treatment and support are readily available. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment.

You can also find a list of treatment centers near you on our website to help get you on the path to recovery.

Key Sources

Boyd, C., Veliz, P., Stephenson, R. Hughes, T., & Esteban McCabe, S. (2019). Severity of Alcohol, Tobacco, and Drug Use Disorders Among Sexual Minority Individuals and Their “Not Sure” Counterparts. LGBT Health. 6(1).

Centers for Disease Control and Prevention. (2016). Gay and Bisexual Men’s Health: Substance Use.

National Institute on Drug Abuse (NIDA). (2019). Substance Use and SUDs in LGBTQ* Populations.

Substance Abuse and Mental Health Services Administration (SAMHSA). Lesbian, Gay, Bisexual, and Transgender (LGBT).

Medical Disclaimer

At, we are dedicated to helping people recover from problematic substance use and associated mental health disorders. If you or a loved one are struggling with addiction to drugs or alcohol, you are not alone. Information on treatment and support options is readily available through the National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-4357. To further assist you along the path to recovery, the treatment center locator on our website allows you to easily find rehabilitation programs and services in your local area.

We provide our readers with factual, evidence-based content concerning the causes and nature of addiction, as well as available treatment options. However, this informative content is intended for educational purposes only. It is by no means a substitute for professional medical advice, diagnosis, or treatment. With regard to any addiction-related health concerns, you should always seek the guidance of a qualified, registered physician who is licensed to practice medicine in your particular jurisdiction. You should never avoid or delay seeking professional health care advice or services based on information obtained from our website. Our authors, editors, medical reviewers, website developers, and parent company do not assume any liability, obligation, or responsibility for any loss, damage, or adverse consequences alleged to have happened directly or indirectly as a result of the material presented on