Why queers experience increased risk of substance abuse, regional resources that can help

Jaime Lazich


Being queer is a liberatory experience. We reject norms handed down to us through our power to construct our own lives, selves, bodies, families and communities. Such flagrant displays of freedom threaten power structures that depend on the status quo. Driven by fear of dismantlement, those in power move to silence disruptors at any cost. So the world tries to convince us that we do not exist, or that we do not deserve basic rights, much less a thriving sense of belonging. This psychic friction manifests in a litany of hardships: from family rejection to high unemployment rates, housing instability to bullying. It takes a toll. Self-creation and radical acceptance are all well and good, but the ugly ire of prejudice and discrimination can still cause trauma, resource scarcity, and an internalized phobia of ourselves. If you are LGBTQ+ and struggling with addiction there are many places that can help – in Kentucky, the tri-state area, and online.

Minority stress and substance abuse

The stress stemming from adversity can lead to self-medication with drugs and alcohol. On top of that, gay bars have more than solidified themselves as communal safe havens for queer and trans folks, tethering an already vulnerable population to a booze-fueled habitat. Louisville is making moves to incorporate more sober spaces for queers but Kentucky’s LGBTQ+ scene continues to revolve heavily around the consumption of alcohol. 

Queers run a higher risk of substance abuse, and in seeking help must also grapple with a very heterocentric healthcare system. Navigating recovery while LGBTQ+ comes with a unique set of challenges. Contending with our healthcare system as a queer or trans person is exhausting at best, potentially lethal at worst. Many practitioners do not have the sensitivity or knowledge necessary to properly interface with LGBTQ+ patients, much less treat or diagnose us, which leads to queer and trans folk having to educate practitioners on how to do their job. 

Entering into a rehab program can be particularly challenging if you’re LGBTQ+: trans participants in residential facilities can be placed in housing that doesn’t align with their gender; queer and trans folks can become the target of bullying from cishet participants; trans and non-binary individuals can be misgendered or deadnamed; intake paperwork generally doesn’t reflect the names, orientations, markers or descriptors that LGBTQ+ folks use.

The blatant discrimination and endless microaggressions make for nothing short of a living hell, which can cause LGBTQ+ participants to not seek any further help, or discontinue treatment altogether. These outcomes have potentially devastating side effects when the completion of a substance abuse program greatly impacts one’s success at achieving long-term sobriety.

The benefits of queer-centric programming

Who knew, inclusivity actually matters: rehab programs that are tailored for LGBTQ+ participants have been shown to result in better outcomes. When queers feel like they can be their authentic selves they are more likely to complete treatment, feel good about it, and feel supported throughout the process. But there is much work to be done: the prevalence of specialized programs for queer and trans folks decreased from 2014 to 2018. In a more recent study from 2020 it was found that there was still a dearth of programming. Many rehab centers claim to have an inclusive program when in reality none exists. For the purposes of this article I followed up with a list of providers in Kentucky that purported to have LGBTQ-centered treatment, only to find that no initiative was in place (if there ever was to begin with).

 There’s much beauty to be found in the self-determination of being queer and trans. Giving the finger to the status quo and forging on to build our own narrative is bold and joyous. But there is only so much creation that we are capable of in a world that is actively causing us harm. We need help. We need systems of support that reflect back our humanity, our unique stasis. We need interdependence and understanding from people who carry the same cross-section of identities, values and beliefs. 

Connecting through online meetings

Bringing queer-focused treatment into the fold is so necessary – it allows the community to see itself. A sense of collective and peer support is vital for queers at the beginning stages of rehab, as well as later on in recovery. The era of COVID popularized meeting virtually – a boon to queer and trans folk looking for community that may be sparse where they live. Attending LGBTQ+ meetings might be geographically impossible for some but virtual meetings offer a way in for those looking for solidarity. 

Choosing a rehab facility

Numerous factors come into play when selecting a rehab program. It’s important to do research to find out what will be the best fit for you. Enlist the help of a physician, therapist or healthcare provider if possible. They can assist in finding a facility to help with addiction as well as other co-occurring issues. Research where the facilities are, what insurance they take, if they offer any additional services or amenities, and what kind of certifications or accreditations they may have. Read reviews and seek out testimonials from former participants. 

LGBTQ+ resources for those struggling with addiction


Robert Alexander Center: LGBTQ-affirming inpatient and outpatient services

Brightview Health: intensive LGBTQ+ outpatient program

Center for Addiction Treatment: LGBTQ-affirming inpatient and outpatient services

Sober Housing

Bright Outlook Recovery: LGBTQ+ housing

New Foundations Recovery: allows trans participants to choose their own housing

B. Riley House: LGTBQ+ housing in Cleveland, OH


GLAST: peer support meetings, free HIV testing

Gay and Sober KY: in person and online meetings

Gay and Sober: daily online meetings

Addiction No More: in person meetings, listed at bottom of page

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