Growing up queer—whether you’re out or not—often comes with childhood trauma. From direct bullying and abuse to feeling uncomfortable being out—with an entire government policy called “Don’t Ask, Don’t Tell”—nearly every queer person has a story about a traumatic event in their childhood.
But those stories aren’t just stories. They’re also defined as ACEs—adverse childhood experiences—and the more you have, the more likely you are to develop chronic medical and mental health issues in adulthood.
And many people—no matter the number of ACEs they experience—use substances to cope, according to MetroHealth Pride Network counseling psychologist Sarah Benuska, PhD, MS.
“The use of substances as a way to cope is not unusual for human beings,” says Benuska. “But people in the queer community have so much more going against us: possible trauma, lack of supports, mental health issues and valid distrust of the healthcare system.”
Overlapping variables, more substance abuse
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), members of the queer community are more likely to use and abuse nicotine, alcohol and other drugs than heterosexual and/or cisgender people.
Overlapping variables cause the disparity while also making it more difficult to find effective treatment.
“The overlapping variables of mental health issues—depression, anxiety, PTSD—along with a lack of safe support sources, and a higher prevalence of things like being under- or unemployed or being unhoused or experiencing housing instability makes the queer community more vulnerable to lean on substances to cope,” says Benuska. “Because the community historically has had few positive and/or more negative experiences in the healthcare system, it might be easier for some to cope with their stress using substances rather than seeking treatment found with a healthcare provider.”
While many people turn to substances periodically to cope, Benuska advocates for every person to develop a toolbox of coping mechanisms to deal with life’s hardships.
“Substance use in and of itself isn’t necessarily a problem from a mental health perspective,” says Benuska. “But if it’s the only coping strategy you’re using, then it’s probably not a good idea nor sufficient.”
Benuska advises paying attention to yourself by prioritizing a range of self-care needs and tools including social support and self-compassion. By reaching out to feel a connection with another person, reframing negative self-talk, or finding new sources of joy, you can develop a variety of healthy coping/self-care strategies. Keep in mind that strategies may need to change as you age, or based on what you’re going through.
“Being a human is an ongoing process of adaptation, you’re always going to be moving into or away from periods of stress and wellbeing,” says Benuska. “Paying attention to your needs based on what’s occurring in your life is not only realistic but recognizes when you might have the fortitude and capacity to, for example, start a new exercise regimen or when you need to pull back and slow down.”
“Substance use, for many, can get in the way of fully taking the best care of yourself, and especially so when it turns into abuse. It is critical to identify when it turns into abuse and what you can do.”
When to seek treatment
Benuska recommends tuning in to four key metrics when deciding if treatment might be right for you.
- It’s not working. If using drugs or alcohol is causing issues in your relationships or causing you to feel poorly too often, a mental health professional can help you find more productive coping strategies.
- Stopping is hard or painful. If you have side effects or unfavorable consequences in times that you’re not using a substance, it may be a sign that you need expert support.
- You stop moving forward. If you can’t get things done, can’t enjoy yourself and can’t move towards your goals, seek help.
- You’re not your best version of well. Benuska recommends first defining what health and well-being mean to you, and asking if a substance is standing in the way of that definition. If not, seeking support may be key to getting there.
“If you’re not sure, come talk to us,” advises Benuska. A good provider will help you identify your goals for health and well-being and celebrate when you reach them.”
Seeking Care at MetroHealth and in Cincinnati
One of the things that sets the MetroHealth Pride Network apart, according to Benuska, is the staff awareness of the lived experiences of the queer community.
“We care specifically about the LGBTQ+ community,” says Benuska. “We’re not here because we fell into it—we chose this work.”
The MetroHealth Pride Network focuses on trauma-informed care, which for Benuska means being person-centered and person-first. That means treating people with humility, honesty, respect and care.
“It’s about an approach and attitude beyond the treatment,” says Benuska. “It’s about recognizing people are human before anything else.”
Seeing an affirming and trauma-informed medical provider is critical in treating substance-related issues. For example, some substance use disorders — including those involving opioids, nicotine and alcohol—benefit from medication-assisted treatment, which is available at MetroHealth alongside psychotherapeutic interventions.
“Overuse of certain substances can be deadly,” says Benuska. “But it can also be harmful to abruptly stop using after ongoing abuse. Seeking medical treatment is crucial if you are considering stopping using substances. Sometimes simply reducing use is the best next step. Regardless, you need a trained professional to guide you through that process to achieve a healthy outcome.”
Keep in mind that if previous treatment hasn’t worked for you, Benuska says to not give up.
“Treatment isn’t perfect,” says Benuska. “A lot of people who don’t find success the first, second or third time find success when they find the right treatment that works for them.”
With multiple treatments available, persistence is key. So is the team caring for you.
“Finding a care team that works for your specific needs and that is affirming is so important,” says Benuska. “Given what many LGBTQ+ folks have gone through, having a provider with expertise, who also listens and sees you is what you deserve.”
In Cincinnati, BrightView Health has a therapy group for LGBTQ+ individuals who and have substance use issues.
If you or someone you know needs help with a substance or alcohol use disorder, schedule an appointment online, or by calling BrightView at 833-510-4357 to take the first step.
This story was originally published by the Buckeye Flame and republished here with permission.
