ADDICTIONS: WHAT LIES BENEATH?

In our continuing series on addiction, we look at treatment options – with an emphasis on support services tailored to the queer community.

In our continuing series, we look at treatment options tailored to the LGBT community.

OVER the past few issues of DNA, we’ve acknowledged that substance use is higher in the LGBTQI community than in the general community. We’ve learned that while most in the community consume alcohol and other drugs, and some participate in chemsex safely, others become substance abusers or addicts.

There can be many reasons why people become addicted to certain behaviours and substances. Neurology and physiology play a part. Psychologically, childhood trauma can be a causal factor, and homophobia and associated problems relating to “minority stress” can have a big impact, too.

What has also become apparent over this series of articles is that people can often tell when it’s time to get help (for themselves or someone close to them).

Thirdly, we’ve found that while there’s help available, mainstream services aren’t always a good fit for the LGBT community.

Genevieve Whitlam, Associate Director of Clinical And Client Services at ACON, an LGBTQI community health service based in New South Wales, says talking to a counsellor about treatment options can be helpful. (ACON offers free counselling in NSW). “There are many types of treatment programs available and making decisions about which is best for you can be daunting,” says Whitlam.

Broadly, treatment options include contacting an information/advice line; entering a detox program (residential or as an out-patient) or a residential rehab program; undergoing counselling/therapy; or joining a support or therapy group (such as a 12-step program or SMART recovery group).

Simon Ruth, CEO of Thorne Harbour Health, an LGBTQI community health service based in Victoria, says there isn’t one path for everybody. “You just have to find a program that meets your needs. There’s always hope,” he says.

GPs are usually a good starting point for advice on treatment, which can also include prescription medicines to stop you drinking alcohol and options to reduce drug intake, like replacing heroin with methadone.

Simon Ruth also suggests calling a queer helpline to talk things over, especially if you aren’t in a major city, where most drug and alcohol and LGBTQI health services are located. QLife operates nationally, while others are state-based.

Melbourne creative Craig Ingrey, who discussed his drug and alcohol addiction in part two of this series (DNA #226), achieved sobriety by talking to a GP and therapist. He warns people not to expect others to be there to support them during recovery, especially in the queer community. “There’s a lot of fair-weather friendships. If you pull back and you’re cut off, that’s just the way it is,” says Ingrey. “That sounds tough, but it is from experience.”

Ingrey recovered in Perth, away from what he calls the “back alleys and bed-knobs” scene. He says the hiatus made a big difference. “My self-imposed isolation from queer culture and pubs and clubs was really, really important at that time. I didn’t have anybody trying to lure me back in.”

The Touchbase website (for details see breakout box), which was produced by Thorne Harbour Health and other community organisations, advises people to start seeing less of the friends they use alcohol and drugs with. “You might feel guilty about that, but ultimately you’ve got to put yourself first in that instance,” says Nic Holas from The Institute Of

Many in a Touchbase video.

Bill O’Loughlin of Harm Minimisation Victoria recommends people find new friends if, for example, they want to cut down on their drug use and their social circle consists of drug users and dealers. His advice is to “carefully manage” who you interact with using “a slow and careful and very deliberate process” of elimination.

Ruth says the information and advice on the Touchbase website was created because we in the LGBTQI community find it difficult to talk about substance abuse. “We aren’t good at those intimate conversations. We don’t know how to talk to each other if we are struggling with drugs and alcohol. We need to get better.”

Jacob Thomas, an activist who discussed how they became addicted to work and was abusing alcohol in DNA #226, says that, on occasion, peer pressure has caused them to feel unsafe in the queer community.

“I’ve stopped going out to clubs or parties as much as I did… I got burnt from expectations and pressures to drink too much, stay out until the sun came up, and consume drugs I didn’t want,” says Jacob.

Thomas says we all have a responsibility to keep our party spaces inclusive. “We get to set the standard of how we get to be treated, and how we treat each other. Community is vital, and it should be shame-free on all counts.”

In a similar vein, just as we shouldn’t shame those who don’t want to use drugs and alcohol anymore, we shouldn’t shame those who do for past transgressions either.

Ingrey says there was a time when he felt ashamed of things that happened when he was drinking. Thinking about the people he loved and had hurt helped him to see things more clearly as he got sober. “Reconciliations happened, and addictions went falling by the wayside. I felt like I was important and wanted and part of a family and could move on to the next chapter.”

He’s quick to add that people who are considering treatment need to do it for themselves, not others, and should pursue it in their own way. “You’ve really got to do it yourself. Follow your bliss.”

Timing is also important. “If it is not the right time, it’s not the right time.” If it is the right time, “do it and don’t look back; keep looking forward”.

While recovery is all about looking forward, good treatment programs ask participants to question why they are using drugs and alcohol and for many, the answers will be found in their childhood.

Stu Fenton, an Australian therapist and clinician based at Resort 12, a residential rehab facility for LGBTQI clients in Thailand, believes that in most cases where addiction or mental health issues are present in adults, that person has experienced some degree of trauma in childhood.

“I don’t mean the traditional definition of trauma such as a major car accident or a death. Most trauma are things that we don’t traditionally identify as such,” says Stu.

Any sort of abuse (physical, emotional, sexual) or neglect at the hands of family is, of course, likely to cause a child trauma. Fenton’s model is even broader, defining trauma as stemming from “anything that is less than nurturing” in the childhood home.

LGBTQI children may experience further trauma if their family is homophobic and/or if they are bullied and stigmatised at school because they are different.

Such trauma can have a big impact because young children don’t have strong boundaries to protect themselves or the resilience needed to rationalise what’s happening. “They don’t have the mental capacity to self-support, self-soothe or self-regulate.”

In rehab, Fenton begins to teach clients how to do now what they couldn’t do then – set boundaries, communicate non-violently, be authentic and better able to cope. “Most people come in defended and guarded, with a blurry view of their lives because of drugs and alcohol.”

Working with counsellors and supportive peers, they start to make the connection between trauma and addictions and drop their guard. Dysfunctional coping mechanisms and blind spots emerge, and they gain a deeper level of self-awareness. “These discoveries are often revelations and epiphanies a person can only uncover once the addiction is contained,” Fenton says.

“Therapy reveals the mysteries that lie beneath the addiction.”

Therapy reveals the mysteries that lie beneath the addiction… a person can only uncover these revelations once the addiction is contained,”

– Stu Fenton.