Why Do Gay Men Sometimes Struggle with Substance Abuse?

3 min read · 2 sections

Research investigating prevalence rates for substance abuse in the LGBT community is not extensive; however, the bulk of it indicates that the rate of substance abuse is estimated to be between 20 percent and 30 percent, or higher, in gay and transgender people compared to about 9 percent in the general population.

  • The rate of alcohol abuse in gay and transgender individuals may be as high as 25 percent compared to 5–10 percent in the general population.
  • The use of tobacco products is significantly higher in gay individuals than in heterosexuals; some studies suggest 200 percent higher.
  • Gay men are far more likely to use amphetamines than heterosexual man (as much as 12 times more likely).
  • Gay men are nearly 10 times more likely to use heroin than heterosexual men.

There are most likely numerous reasons that account for the increased risk for gay men to abuse substances compared to heterosexual men. The American Psychiatric Association (APA) and the National Institute on Drug Abuse (NIDA) list numerous risk factors associated with an increased probability to abuse drugs or alcohol. These include:

Issues with Cultural Competency in the Healthcare System

Gay men may be hesitant to utilize healthcare services that can assist them in identifying and treating issues with substance abuse because they have significant experience with healthcare professionals who are unaware of the specific needs of this group, or there may be outright hostility and/or discrimination directed at them.

The discrimination associated with being gay may lead to overall negative expectations of the healthcare system. As a result, gay men may delay getting treatment for substance abuse, or they may not disclose their sexual preferences or relationship issues with treatment providers.


Specific types of clubs or bars have been traditional meeting places for gay men to feel safe while socializing with others. In these locations, drinking and smoking remain acceptable and often popular. As a result, gay men will often associate socializing with others who share their sexual preference with drinking, smoking, and using other drugs.

According to the American Cancer Society, tobacco companies traditionally advertise in magazines aimed at gay and transgender individuals. The use of advertising in other venues that are frequented by gay men for alcohol and tobacco has also been an issue of concern for this group.

The experience of stress, perceived abuse, stereotyping, and targeted efforts at marketing directed at gay men may be exacerbated by potential issues with:

There is no simple solution for these issues. The National Association of Lesbian and Gay Addiction Professionals suggests that the use of public education, public awareness, and legislation are the keys to preventing the increased risk of substance abuse in gay individuals. This would include:

The literature suggests that the increase in substance abuse in individuals who are not heterosexual in their orientation, compared to heterosexual individuals, is primarily the result of environmental factors that can be addressed by society. There is no reason to believe that the increase in substance abuse that occurs among LGBT individuals is due to any type of specific genetic factor. Therefore, the increased risk of these individuals to develop substance abuse issues can be addressed and minimized with proper steps by federal, state, and local governments.

Although no amount of legislation will change the attitudes of some individuals regarding those with different lifestyles, legislation can ensure that public discrimination that can lead to an increase in stress in gay men and others in the LGBT community is minimized. This could significantly decrease the risk of substance abuse issues in this demographic.

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