Related Health Issues

Once a client begins to address his or her substance abuse problem, he or she may face a variety of additional health problems, some of which may be due to poor self-care. Lesbian, gay, bisexual, and transgender (LGBT) people in recovery have similar health concerns and face many of the same physical and mental health crises as anyone else in recovery. This chapter provides a brief introduction to some of the health problems facing LGBT individuals as they begin their recovery from substance abuse. Health assessments and interventions for substance-using LGBT clients should include the same components as those for other clients and some additional components that are unique to or more common among LGBT individuals.

Many people who abuse substances have co-occurring mental health disorders, such as affective disorders, eating disorders, or other psychiatric illnesses. Substance abuse clouds judgment and contributes to hazardous behaviors that can lead to illness, such as HIV/AIDS, sexually transmitted diseases (STDs), hepatitis, and injuries. People who abuse substances may have neglected their health and nutrition and may smoke cigarettes. Some may have been the victims of domestic violence or hate crimes resulting in posttraumatic stress disorder. When considering these factors, providers of substance abuse treatment for LGBT clients should, as with any client, screen for other health problems—for possible co-occurring mental disorders, poor nutrition, poor dental care, liver disease, STDs, HIV/AIDS, violence, sexual abuse, and incest. In this way, substance abuse treatment providers can assist their LGBT clients in accessing appropriate medical care and treatment for their health and mental health concerns.

The abuse of alcohol and other mood-altering substances can also affect the treatment of HIV/AIDS. For example, substance abuse and its associated mental impairments can interfere with clients’ ability to comply with very complicated medicine regimens. Strict adherence is crucial to the effectiveness of the powerful new medications used to combat HIV. Substance abuse also affects clients’ ability to take their medication properly.