Drugs and Diversity:
Lesbian, gay, bisexual and transgender
(LGBT) communities
Learning from the evidence

The extent and nature of drug use
This review is part of a wider programme of work undertaken by the UKDPC and associated problems
to provide an overview of the differing needs and challenges associated with Implications for policy and practice drug use among diverse minority communities within the UK. By bringing together a variety of evidence in one place we are seeking to encourage a broader view of the evidence and its implications, and to Drug treatment and
stimulate debate about how to respond to the varying patterns of use of prevention programmes
different communities. Implications for policy and practice The government, local partnerships & commissioners and service providers have sought to address the challenges of a range of diverse groups over the years. This review has not sought to evaluate the impact these have made Interaction with the police and
but rather to describe what is known about the current situation, to stimulate criminal justice system
much-needed discussion of the issues, highlight gaps and to identify new Implications for policy and practice areas for action.
It is important to note that lesbian, gay, bisexual and transgender (LGBT) people are not a homogeneous group but the published evidence often fails to distinguish between sub-groups or has a very narrow focus as one particualr group. In particular, it should be noted that most of the evidence available in this review relates to gay men only. It was a common finding for all the reviews conducted as part of this project that the evidence was extremely limited and often of poor quality. Therefore the findings, although the best available, should be interpreted with caution. The full review on which this briefing is based: • The Impact of Drugs on Different Minority Groups: A Review of the UK Literature Part 2: Lesbian, Gay, Bisexual and Transgender Communities • Available at: Prevalence of last year drug use by sexuality, people aged 16 to 59 years, BCS 2007/08-08/09
The extent and nature of drug use
and associated problems
Implications for policy and practice
• Given the comparatively higher rates of drug use
among LGBT communities, government policy • Drug use among LGBT groups is higher than among and local commissioners need to address the their heterosexual counterparts, irrespective of gender needs of this group. The focus on problem heroin or the different age distribution in the populations. and crack use may have worked against this and • Gay men report higher overall rates of use of drugs any new drug strategies need to explicitly than lesbian women, largely due to higher rates of recognise LGBT needs.
stimulant use, particularly amyl nitrite (‘poppers'). • As ‘early adopters' of new drugs LGBT • Cannabis is the most commonly used drug among communities may provide early warning of ‘new' lesbian women, with prevalence rates similar to those or emerging patterns of use and associated reported for gay men.
problems; appropriate data-gathering • ‘Recreational' drug use is comparatively high among mechanisms are required to identify issues early.
LGBT groups, which may lead to use of new drugs before they are widespread in the general population.
• LGBT people, particularly gay men, may also be at risk of misusing other drugs, such as steroids and Viagra. Further information is needed about: • Some types of drug use may be associated with risky • how and when LGBT drug use causes problems sexual behaviour, including exposure to HIV infection.
and the overlap with alcohol use; • Strong links have been reported between Viagra use • the patterns and extent of drug use among and sexual risk, with Viagra used to counteract different groups and associated problems within negative physical effects of other stimulant drugs.
the LGBT community; • In addition to erectile dysfunction and sexually • the contexts in which drug use takes place and transmitted infections, stimulant drugs have been the reasons for use and the range of risk reported to impact on physical health, including behaviours in order to inform prevention and cardiovascular problems. harm reduction service provision.
• A study of gay men who used steroids highlighted The inclusion of a question on sexual orientation in a wide range of associated physical and mental the British Crime Survey (BCS) provides analysis opportunities; other national surveys could follow this lead. Longitudinal studies of pathways in and out of drug use are also needed.
Drug treatment and
Implications for policy and practice
• There is a need to review how self help groups, including those concerned with substance • Specific services for LGBT people have been developed, misuse can be developed, focusing on including ‘self-referral' services (ie drop-in centres) community venues, community networks and and out-reach provision in a range of settings (such how innovative social media approaches can as nightclubs).
be used to improve outcomes.
• Evidence is limited but suggests awareness and • Both LGBT-specific and mainstream services uptake of drug services are low given drug use levels need to adapt to dealing with a wider variety of in the population. substances and the on-going emergence of new • Barriers to uptake include: drugs; this has implications for local commissioning the absence of perceived problematic use; and resourcing, as well as the development of perceptions that ‘mainstream' drug services appropriate care.
do not cater for the most commonly used drugs • LGBT people can be found everywhere and, (such as GHB) within the community or understand except in some urban areas, specialist LGBT the specific needs of LGBT people; services are not likely to be sustainable. distance to specialist services in rural areas. Mainstream services need to provide appropriate • Mainstream services often use a traditional definition help and support and have staff with the of family that does not include same sex relationships knowledge and skills developed to deliver and may unwittingly stigmatise or discriminate improved services for LGBT groups. against family members of LGBT service users.
• The introduction of a ‘kite-mark' system for • Good practice in drug treatment is generally seen services demonstrating good practice could by the LGBT community to be non-judgmental and improve LGBT people's confidence in services.
empowering, focused on the specific needs of the group. • Other services providing care (ie sexual health • It is also characterised by provision of information and and mental health), need greater knowledge and support on wider health and emotional well-being understanding of LGBT specific substance use needs of LGBT people. issues, to facilitate targeted prevention or • Several studies suggested innovative ways of referral to drug services as necessary.
delivering information about drugs and services through community networks and other outlets like entertainment venues and making general use of LGBT services.
Further information is needed about: • Given the psychological harms and sexual risk • effective treatment models and pathways for behaviours associated with drug use, joint working some of the drugs commonly used by LGBT groups; between mental health and substance misuse • the barriers to access to services, in particular services, and more consideration of substance use among different LGBT groups and geographical in sexual health services have been highlighted as necessary.
Collection of data on sexuality in routine data collection from services is necessary to understand the extent to which services cater for LGBT people and their needs.
Interaction with the police and
Implications for policy and practice
criminal justice system (CJS)
• The expansion of the number of new drugs that are controlled through the Misuse of Drugs Act • There is little evidence regarding the interaction has the potential to criminalise and increasingly between the LGBT community, the police and CJS marginalise many LGBT people because of their in respect of drug problems. greater use and early adoption of new substances.
• One study suggests the provision of drug treatment in prison is the main focus of interaction with the CJS; indeed that it may be the main source of drug treatment for gay men.
Further information is needed about: • Some evidence suggests that many LGBT users obtain • The extent and nature of LGBT people's drugs from within the community; as they do not interaction with the Police and criminal justice purchase from outside dealers, they may not view the system in relation to drugs; activity as being ‘criminal'.
• Experiences of LGBT people's interaction with • Historically poor relations between LGBT groups and the police and CJS in relation to drugs (both in the police in relation to other associated issues (ie the community and custodial settings); domestic violence, personal safety, and discrimination) • The potential role of the police in signposting may also present a barrier to interaction; proactive and providing access to drug treatment and police initiatives may be required to overcome distrust.
support for LGBT groups.
Funding for this review was provided by the Home Office.
The background review for this briefing was undertaken for the UK Drug
Policy Commission by the Office of Public Management.
The UK Drug Policy Commission is an independent, non-aligned and time
limited charitable body set up with funding from the Esmée Fairbairn
UK Drug Policy Commission (UKDPC), July 2010. ISBN 978-1-906246-16-7
Foundation to enhance political and public understanding of the effectiveness The full version of this briefing, and the accomanying full reports, are of policies aimed at dealing with the harms caused by illegal drugs.
available at



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