The Need for Specialized Substance Abuse Treatment for Gay Men in the United States

Substance misuse and abuse is a global public health issue that affects sexual minority populations at a higher rate than the heterosexual population. Many popular gay socialization strategies include gay bars and chemsex, or sexualized drug use, in which substance use is common in both. The Minority Stress Model provides an explanation as to how stigma embedded in a society and within a person can act as a stressor and manifest into a substance abuse disorder. This stigma acts for many as a barrier to seeking healthcare out of fear of discrimination, causing many to hide their identity when seeking treatment. This same fear is present in traditional substance abuse treatment programs, where gay men may be afraid to be vulnerable in front of heterosexual peers. Specialized substance abuse treatment services for gay men attempt to increase the likelihood of seeking treatment as well as optimize treatment outcomes. The most important aspects to specializing these programs include consideration of the treatment environment, providing counselors with cultural competency training, and addressing areas in treatment that may be unique points of stress in a gay man’s life. Barriers to accessing existing programs include geographic location, agencies not completely adapting programs for gay patients, and cost. Although, possible solutions, mainly involving telehealth to promote treatment alliances, are available