“There’s always so much stress for me at this time of year – and everyone’s pushing drinks.”

This is a statement from a gay male therapy client who is also in recovery from drug and alcohol addiction. He continued, “I don’t feel particularly strong right now, and it would be easy to just say ‘screw it’ and grab a drink off the tray.”  

He didn’t grab that first drink, mostly because of his strong commitment to his recovery program and the personal support he’d cultivated around staying sober. But his situation is a good reminder of something we may not pay enough attention to.

In general, the holidays are much more stressful than any other time of year. LGBT persons have their own particular set of stressors, and remembering some helpful tips can help make the holiday season easier.

But there’s one thing that we would do well to remember and be aware of:

LGBT persons are much more likely to abuse alcohol and drugs than the general population.

Stay with me here.

Maybe it’s the stress of being different that makes us want to self-medicate to feel better. Could it be a way to drive away the suspicion of judgment we fear from those closest to us? Maybe it’s the constant struggle to secure rights, respect and dignity that make it so easy to reach for something to relax. Maybe it’s the higher amount of depression we have as a community. Maybe it’s the culture of bars that seem(ed) to be our only support- and the dogged pursuit of the LGBT dollar by alcohol and tobacco companies. Maybe it’s the simple feeling of comfort and relaxation that became a driving need. Maybe it’s the stress of keeping secrets.

Maybe it’s all of the above.

Whatever the reason, the reality is this:

LGBT persons are 3-5 times more likely to abuse substances, less likely to abstain and more likely to continue heavy use later in life than the general population (NALGAP, 2002).

To be clear: this is not a consequence of sexual/personal identity, but of society’s response or reaction to it, often leaving us reaching for something to help cope with the confusion and pain. And because many of us cope in this way, often in the company of our peers – perspective is often a hard thing to come by.

And because, for many of us, carrying the dual secrets/shames of being a sexual minority and having a problem with substance abuse/addiction is so difficult and even scary, we find it hard to talk about – much less deal with.

To help facilitate some perspective and discussion, allow me to offer the following distinction between abuse and addiction:

Substance Abuse: Using a substance in an abusive manner, esp. in ways that may be (temporarily) harmful, impairing, or disabling. Not all people who abuse substances are addicts.

Substance Addiction: Compulsive use of a substance characterized by four elements:

1. Loss of control- (non-rational compulsion) The user has no ability to deny the compulsion
2. Continued use despite adverse consequences- the addict uses even though they know it causes problems
3. Cravings- intense psychological preoccupation with getting and using the substance
4. Denial- distortion of perception, unable to see the risks and consequences of use

Because a person doesn’t have to use drugs or drink alcohol every day to have a problem, it’s often difficult to recognize the signs of drug and alcohol addiction. This checklist of common alcohol and drug abuse symptoms can help you identify the signs of addiction, determine if yourself, a friend or loved one is having a problem with addiction, and if additional help is needed.

Please remember that even if a person shows any of the following signs and symptoms, it does not necessarily mean that they have a drug or alcohol addiction. The presence of some of these symptoms could relate to stress, depression or other problems that may or may not be related to substance abuse.

General signs and symptoms of addiction/consistent abuse:

• Observable signs of deteriorating personal hygiene
• Multiple physical symptoms and complaints
• Accidents
• Personality and behavioral changes
• Many drug prescriptions for self and family
• Frequent emotional crises
• Behavior excused by family and friends
• Activities involving drinking alcohol are a priority
• Arguments/violent outbursts
• Sexual problems
• Extramarital affairs
• Withdrawal from and fragmentation of family
• Neglect of children
• Abnormal, illegal, anti-social actions of children
• Separation or divorce
• Unexplained absences from home

Medical and Physical Signs:

• Observable decline in physical health
• Signs of weight change
• Pupils either dilated or constricted; face flushed/bloated
• Emergency-room treatments such as drug or alcohol overdose, unexplained injuries, symptoms of migraine headaches, auto accidents
• Claims of having been “mugged” but without witnesses
• Inability to focus and track in a conversation
• Signs of shakiness, tremors of hands
• Slurred speech
• Unsteady gait
• Constant runny nose
• Nausea, vomiting, diarrhea

Observed by Friends and Community

• Noticeable signs of becoming personally isolated
• Embarrassing behavior
• Driving while under the influence of alcohol or a drug
• Legal problems
• Neglect of social commitments
• Unpredictable behavior such as inappropriate spending

Workplace Signs

• Signs of workaholic behavior
• Disorganized schedule
• Decreased workload or workload intolerance
• Signs of poor work performance
• Alcohol on breath with attempts to cover with mints or mouthwash
• Frequent unexplained absences or prolonged breaks
• Tardiness or leaving work early
• Withdrawal from professional committees or organizations
• Defensive if questioned or confronted
• Poor judgment
• Observed occurrences of drug or alcohol intoxication, drowsiness or hypersensitivity during work hours
• Deadlines barely met or missed altogether
• Frequent job changes or relocation
• Avoiding supervisor or other co-workers

The good news: There is a lot of help for LGBT people who want it. Recovery programs, addiction centers, therapists, hospitals, churches and even workplaces can be sources of help and support. Online groups are even available for those who have difficulty talking face to face about their fears and possible problems.

But remember, the best way to have perspective is to be aware.

Be aware of your own habits and behaviors around substances. Be aware of the habits of your friends and social groups. Do we need to gather with alcohol in order to have fun? Do we insist others have a drink? Do we make it difficult for them to refuse? Are we sensitive to (or even aware of) those in recovery?

Be aware that you, your friends and (chosen) family may be more susceptible to addiction than you thought.

And, maybe, with that increased awareness, we can make the holidays – and our community – a whole lot healthier.