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

DNA Magazine - - CONTENTS - By Vanessa McQuar­rie

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.

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