LGBT Drug Treatment Blog

GLBT Issues Regarding Addiction Treatment

Problems with drug addiction and alcoholism are from a combination of personal, relational and societal pressures. For lesbian, gays and bisexuals who live outside of the heterosexual norm, these pressures may be even greater.

There are dinctive risks that the gay, lesbian bisexual encounter due to their sexual preference. Some of these risks can be:

* using alcohol or drugs to ease and enjoy sex
* internalizing homophobic attitudes which lower self esteem and produce shame
* relying on the bar scene to develop their social network

It is well documented that gay and lesbian drug addiction is much higher than their heterosexual counterparts. The blessing is that their are now gay addiction treatment programs, lesbian alcohol treatment programs and gay and lesbian drug rehabs which allow this population the same comfortability in addiction treatment as any heterosexual.

The use of crystal methamphetamine by men who have sex with men (MSM) increases the risk of HIV transmission and can cause complications in those who are already HIV-positive, according to an article in the March 15 issue of Clinical Infectious Diseases, now available online. Highly popular with young people who frequent dance clubs, crystal meth and its cousin “Ecstasy” both induce a feeling of elation and alertness. This sense of well-being is dangerous, though, as it lessens inhibitions and can lead to unprotected sex with multiple partners.From the Clinical Infectious Diseases :Crystal methamphetamine use increases HIV risk

The use of crystal methamphetamine by men who have sex with men (MSM) increases the risk of HIV transmission and can cause complications in those who are already HIV-positive, according to an article in the March 15 issue of Clinical Infectious Diseases, now available online.
Highly popular with young people who frequent dance clubs, crystal meth and its cousin “Ecstasy” both induce a feeling of elation and alertness. This sense of well-being is dangerous, though, as it lessens inhibitions and can lead to unprotected sex with multiple partners. HIV rates are high among methamphetamine users, putting younger MSM at an increased risk for infection.

Meth-induced lapses in judgment leading to promiscuous sexual behavior make users more likely to contract HIV, but the drug itself could also increase the risk “because it may suppress a part of your immune system that’s important in fighting off HIV,” said Dr. Antonio Urbina, lead author of the study. Furthermore, he said, meth and its analogs, such as “Ecstasy,” can be fatal when mixed with certain antiretroviral treatment (ART). In addition, HIV-positive meth users on HIV medications are missing more doses and are likely contributing to the spread of drug-resistant strains of HIV, said Dr. Urbina.

Among HIV-positive patients not receiving ART, meth use may increase the risk of developing HIV dementia, a condition associated with reduced motor and verbal skills. Methamphetamine decreases dopamine transporter levels, causing symptoms akin to those of Parkinson’s disease, and when combined with HIV’s toxic effects on the brain, “there’s an overlap in neurotoxicity between methamphetamine and HIV,” said Dr. Urbina. “That’s potentially the most serious side effect.”

Getting the word out to young people about the risks of meth use may be difficult. “I really think there’s a lack of information about the catastrophic risks of methamphetamine use, particularly in young MSMs,” said Dr. Urbina, especially since adolescents and young adults “tend to be risk-takers.” The risk of having unsafe sex, and thus the risk of contracting HIV “is far greater [with methamphetamine use] than with marijuana or alcohol,” Dr. Urbina added. “We need to create an environment of awareness that this drug is not one to experiment with.”

Data on Gay, Lesbian, Bisexual, and Transgendered Youth

According to the Massachusetts Youth Risk Behavior Survey GLBTQ are significantly more likely than their peers to face threats, attempt suicide, and take risks. Risk behaviors among GLBTQ youth are directly related to the violence and harassment they often face. However, the work of programs that create safety in schools and communities throughout Massachusetts and an increasing cultural acceptance of GLBT people have contributed to significant improvements in the lives of GLBT youth.

Read the bad news

Read the good news

The Bad News

The most common thing we feel is isolation. We often feel like we’re all alone, especially because there is so little information available and so few places to meet other Gay Lesbian Bisexual Transgender Questioning (GLBTQ) youth.
We are three times as likely as our straight peers to vomit or use laxatives to control our weight. Though eating disorders are more common among females, among Gay Lesbian Bisexual students eating disorders are more common among males.
Nearly one in three of us have used cocaine at least once - compared to one in fourteen heterosexual students who have used cocaine. We are also more than three times more likely to be daily smokers of cigarettes.
We are three times more likely than my heterosexual peers to contract an STD.
We are three times more likely to have been pregnant or to have gotten someone pregnant.
Many of us get kicked out of our homes, and some of us end up on the street. Between 20-40% of homeless youth identify as gay, lesbian, bisexual, or transgendered.
Though we never intended to, many of us survive on the street by exchanging sex for money, food, or shelter. Seventy-three percent of kids on the street engage in survival sex.
We are more than twice as likely as our heterosexual classmates to skip school because we don’t feel safe. Approximately 28% of us drop out of school altogether.
In the past year, one in five gay, lesbian, and bisexual students have been threatened or injured with a weapon at school.
One in three of us have attempted suicide in the past year. Among those of us who have experienced ongoing harassment or violence at school 89% of us will attempt suicide.
Suicide is the leading cause of death among gay, lesbian, and bisexual youth.
Read the good news

In Massachusetts we have formed GSAs (Gay Straight Alliances) in record numbers. In 1993, there were 3 GSAs in our state; as of 2001 there were over 200.
We have organized the Gay/Straight Youth Pride March in Boston every year since 1995. In 2002, more than 5000 youth and supporters attended from all over Massachusetts and New England.
More and more GLBT youth are coming out publicly, providing us with important role models. Kerry Ashforth of Plymouth, MA was named one of “20 teens who changed the world” by People Magazine for her work in supporting GSAs around the country. Jess Dugan, an openly transgendered student at Cambridge Rindge and Latin was crowned Prom King in 2003. Corey Johnson, captain of the Masconomet High School football team, came out to his coaches and teammates to rousing support, and is now speaking out in schools and communities nationwide.
The state network of Alliances of Gay, Lesbian, Bisexual and Transgender Youth (AGLYs) has expanded from three groups in 1992 to 17 groups in 2003 and serves as a national model for a number of states working to support GLBT youth.
Since the formation of the Governor’s Commission on Gay and Lesbian Youth in 1992, there has been a 45% decline in violence against GLBT youth.
Training for educators and human service providers has made a big difference in how we are treated in schools and communities. GLB students in schools where faculty has been trained in suicide and violence prevention for GLB youth are twice as likely as students in other schools to report feeling supported by teachers and counselors.
Our rate of injection drug use has dropped precipitously since 1995.
Our rate of eating disorders dropped 10 percentage points between 1995 and 2001, even as the rate among heterosexual students remained stable.
Between 1999 and 2001, our rates of STDs dropped more than five percentage points.
Suicide attempts among GLB youth dropped 13 percentage points between 1997 and 2001.
Sources

The 2001 Massachusetts Youth Risk Behavior Survey
Advocates for Youth
The Boston Alliance of GLBT Youth
*Some data does not include transgendered youth because the Massachusetts Youth Risk Behavior Survey does not ask about gender identity.

There has not been alot of research on lesbians and alcoholism or drug addiction, os it is difficult to describe the issues they face. However, current studies suggest that on the average lesbians are more likely to use alcohol than other women, use other drugs in conjunction with alcohol at a higher rate, report higher rates of drug abuse and continue drinking at a higher rate as they grow older. It onl stands to rason that a higher percentage of lesbians enter alcohol rehab than other women. For this reason and the accompanying issues, lesbian alcohol rehabs have had to be designed.

Methamphetamine Treatment as HIV Prevention

For about a decade in California, the drug most tightly linked with HIV infection in Gay Bisexual Men has been crystal methamphetamine. The drug conveys a sense of heightened sexuality in the short term and is associated with risky sexual behaviors and extremely high rates of HIV infection in those seeking treatment. Sixty percent of the participants in Dr. Shoptaw’s study reported HIV-positive status, a prevalence much higher than his group has observed among GBM seeking treatment for cocaine (30 percent), alcohol (15 percent), or heroin (5 percent) abuse.

“The reductions in risky sexual behavior in this study exceeded those observed in HIV prevention trials among Gay BBisexual Men. We conclude that treatment for crystal meth abuse fits into a comprehensive HIV prevention strategy,” says Dr. Shoptaw. The findings have already made an impact: These data helped policymakers at the California Office of AIDS decide to allocate $3 million for programs that address methamphetamine abuse among GBM.

Methamphetamine and the Blues

The researchers were not surprised by the high percentage of their study participants who reported depression symptoms at the beginning of the study. Gay Bisexual Men are three times as likely as heterosexual men to have clinical depression.

Crystal Methamphetamine abusers often say they take the drug to kick the blues, but results from the current study suggest that continuing abuse may serve to relieve low moods related to stimulant withdrawal rather than alleviate underlying chronic depression.

When they analyzed the temporal link between crystal methamphetamine abuse and depression, Dr. Shoptaw and his colleagues found that a urine sample indicating abuse of the drug within the past 5 days strongly predicted high BDI scores and abstinence strongly predicted low scores. In contrast, BDI scores did not predict episodes of future methamphetamine abuse, which is what would be expected if the men were abusing the drug to alleviate depression. “Meth abusers probably remember feeling better after taking the drug, but this perception may not match the physiology of long-term stimulant abuse,” says Dr. James Peck, a member of the research team who led the analysis of the depression data.

Treatment Curbs Methamphetamine Abuse Among Gay and Bisexual Men Research Findings
Vol. 20, No. 4 (March 2006)

By Lori Whitten, NIDA NOTES Staff Writer

Behavioral therapy can help gay and bisexual men (GBM) reduce methamphetamine abuse and risky sexual behaviors and sustain these gains for 1 year, NIDA-funded researchers report. By the end of a 16-week trial of four different behavioral therapies, study participants’ stimulant-positive urine samples fell 31 percent, and their number of past-month sexual partners fell more than 50 percent—outcomes that regressed little at the followup visits. Symptoms of depression also improved.

Benefits of Behavioral Therapy Persist Up to One Year

Although all interventions were effective, participants who received contingency management (CM), cognitive-behavioral therapy (CBT) and CM, or culturally tailored Gay CBT (GCBT) submitted fewer stimulant-positive urine samples during treatment, compared with those in standard CBT.

Dr. Steven Shoptaw and colleagues at the University of California, Los Angeles and the Friends Research Institute recruited 263 methamphetamine-addicted GBM throughout Los Angeles County, particularly in Hollywood, where HIV prevalence is especially high. Of these, 162 completed the requirements for entering the treatment phase of the study, which were to attend six assessments and participate in at least two of four group sessions on abstinence skills during a 2-week “baseline period.” Men who met the requirements reported less severity and shorter duration of methamphetamine abuse than those who did not, despite having abused methamphetamine for 5 years and having spent $293 on the drug in the past month, on average. Half had engaged in unprotected anal intercourse (UAI) with someone other than their primary partner in the past month, and 84 percent of these men linked the behavior to methamphetamine abuse. Most participants (73 percent) reported symptoms of depression, with about 30 percent describing these as moderate to severe.

The researchers randomly assigned each patient to one of four behavioral therapies: cognitive-behavioral therapy (CBT), contingency management (CM), CBT+CM, or Gay CBT (GCBT). In CBT, participants analyzed situations and emotions linked with relapse, practiced ways to manage craving and thoughts about drug abuse, and discussed healthy behaviors in group sessions. In CM, participants received vouchers redeemable for groceries, transportation, and clothing if they submitted stimulant-negative urine samples. GCBT addressed standard CBT issues—including relapse, craving, and healthy behaviors—using specific examples from gay cultural events and environments. For example, they compared the experience of owning up to a drug problem with the experience of acknowledging sexual orientation by “coming out.” All four interventions were offered three times a week for 4 months.

Problems in our community’

Confronting issues like drug use, risky sexual behavior and depression among gay men often involves sensitive topics — judgment, limiting sexual liberation, attempting to appear “normal” to mainstream society — and Cox knows that plenty of gay activists tackling issues like these have been maligned as moralistic assimilationists.

“I’m not anti-partying in the traditional sense,” Cox said. “I think the point is not that we don’t have a good time. It’s that when we see something is not working, we need to stop.

“Well being is about gay men building lives they value so much that they won’t want to put them at risk,” Cox said.

Robert Weiss, clinical director of the Sexual Recovery Institute in Los Angeles, agreed that calling attention to underlying crises among gay men is at times intimidating.

“I think it’s very, very difficult for those of us in the field of mental health and substance abuse to talk about the problems in our community,” said Weiss, who is also the author of “Cruise Control: Understanding Sex Addiction in Gay Men.”

“It’s hard for us because there’s a lot of sensitivity to being positive about the community,” he said.

Nevertheless, Weiss notes that multiple studies show higher rates of substance abuse among gay men than the general population, and adds, “I have no doubt in my mind that there is more acting out in other addictive ways,” such as sexually.

But determining whether depression leads gay men to act out sexually, or whether an abundance of sexual activity creates a depressing set of circumstances, is as difficult as answering whether a chicken or egg comes first, Weiss said.

“If you spend three to four hours a week, five nights a week online looking for sex, then the weekends in a bathhouse, you’re not going to feel so good,” Weiss said. “The behavior itself is very isolating, alienating and leaves people feeling hopeless.

“I have certainly seen men who appeared quite depressed, but once they stopped acting out and gained some sense of hope that they can live differently, then they’re not as depressed.”

Depression, sex addiction linked in gay men: report (Gay)
Gay experts call for honest dialogue on touchy subjects

By RYAN LEE
Friday, September 15, 2006

Mental health issues were long viewed as either/or: someone either was, or wasn’t depressed.

But in recent years, mental health experts have paid more attention to the various gradations of depression, and some gay health advocates say it’s time people recognized how even moderate levels of depression can significantly impact behavior.

A new report compiled by the Medius Institute for Gay Men’s Health — a small, New York-based organization founded in June 2005 — suggests that because gay men have higher rates of depression than the general population, they also are more likely to engage in high-risk behavior associated with depression, including unsafe sex and drug use.

“It would be an oversimplification to say that depression ‘causes’ the risky behavior,” according to the report, “Living on the Edge: Gay Men, Depression & Risk-Taking,” written by Spencer Cox, Medius founder and executive director.

“Instead, it appears that in gay men, multiple epidemics — such as depression, drug abuse, violence, childhood sexual abuse and HIV — interact to increase risk for one another,” Cox wrote.

Depression — along with milder mood disorders like dysthymia — should not be viewed as the latest “crisis-of-the-month” for gay men, but rather as “a background risk modulator” that subconsciously influences a range of behaviors, Cox said.

Cox compiled the Medius report by searching medical databases for already-existing studies on depression among gay men and other populations, as well as through interviews with mental health and sex researchers and service providers.

Cox estimated that he reviewed and analyzed about 300 different studies, from sources as varied as the Centers for Disease Control & Prevention and National Institutes of Health, to the Gay Urban Men’s Health Study.

Among the previous findings Cox highlighted in his overview was that gay men were more likely than heterosexual men and lesbians to experience depression, and that depression in younger gay men was associated with increases in risk-taking behavior, such as not wearing a condom.

“What makes the gay experience [with depression] unique is the high levels of depression — roughly one-in-five gay men experience depressive symptoms,” said Cox, noting that the rate for the general population is less than half of that. “So, it’s like everything is louder for us, everything is bigger when we’re talking about depression and mental illness in gay men.”

The result of that amplification, according to Cox, is a culture where scores of gay men engage in drug use and high-risk sexual behavior to cope with unseen depression, oblivious to the toll their self-destructive habits are taking on their well being.

“The normalization of a lot of those things makes it very hard to see what’s happening — everybody you know is doing a bump of cocaine on the dance floor, so go ahead,” Cox said. “I do think it’s very hard for people to say, ‘I’m very confused, and I need help.’

“We need to make it OK to say, ‘You need help, get help,’” he added.

Fergie tells gay fans to quit drugs

Tuesday, 19th September 2006, 12:08

LIFE STYLE EXTRA (UK) - Black Eyed Peas singer Fergie has warned the gay community to stop taking drugs.

The 31-year-old singer, who has just released her first solo single ‘London Bridge, issued the stern advice to homosexuals who are regulars on the club scene and take ecstasy, insisting the substance only leads to harder drugs.

Fergie, who overcame an addiction to crystal meth, told gay magazine HX: “In my experience, ecstasy leads to crystal meth, and I just think that people don’t know how addictive that drug is. It’s so cunning because it’s such a fun drug at first. You lose weight and look great for a while, but I don’t care if it takes six months or five years, it will creep up on you. Do’t be fooled and think you’re special.”

Fergie has also slammed the growing number of blogs on the internet - a subject she tackles in her song ‘Pedestal’ on her new album ‘The Dutchess’.

She said: “I just think, ‘Wow, I’ve worked so hard for this, but what are you people doing other than sitting there behind your computers and talking s**t about people?’

“If people don’t like me, fine, but don’t criticise people if you’re not getting off you’re a** and doing something about your own life.”

Alcohol Treatment Programs have been available for the hetersexual population for many years. There have even been addiction treatment programs for eating disorders, sex addiction and compulsive gambling, but what happened to specialized treatment for the lesbian alcoholic.

Historically, they were forced to fit into these other addiction programs, similar to having to “fit in” with the rest of the heterosexual world. Fitting in with the rest of the world is easier. In alcohol treatment programs, honesty in the key and one is only going to expose themselves if they feel safe enough to do so. It is easy to understand why a lesbian, who has been judged and faced prejudice on a regular basis in the heterosexual world, would choose not to expose themselves just because they are in alcohol treatment.

After all of the challenges lesbians and gays have had to face with regards to addiction and alcohol treatment, it is comforting to know that alcohol treatment or alcoholism treatment for lesbians is availalbe. Most of the lesbian alcohol treatment programs are a component within a program, but they allow the lesbian to feel comfortable, safe and provide them the environment in which to promote honesty. Lesbian alcohol treatment, like gay alcohol treatment, has finially “come out of the closet”, but still has a ways to go.

It may be difficult to find quality, effective lesbian or gay alcohol treatment programs on your own, so yo might want to call Recovery Connection a nationally recognized, free referral service or go to their websit at www.recoveryconnection.org.