SDF seeks to raise awareness and understanding of substance use and related issues and improve both the prevention of, and the response to, problem substance use in Scotland.
We are committed to working with partners at all levels to address the health inequalities faced by LGBTQI+ people around substance use and health. Throughout this work SDF is keen to include LGBTQI+ people and their perspectives to work with partners to raise awareness and understanding of specific substance use cultures and improve both the prevention of, and the response to, problem substance use in amongst LGBTQI+ people in Scotland.
SDF’s work is grounded in the evidence base and an understanding of the root causes of problem substance use and the experience of people affected. In terms of SDF LGBTI+ work it may be useful to share some of this perspective and insight.
LGBTQI+ is an umbrella term for lesbian, gay, bi-sexual, transgender, queer, intersex & others. These perspectives are useful to people planning and delivering services as well as the community itself in developing means to be engaged and empowered in dealing with planners and providers within and outwith the community. Individual people who happen to be LGBTQI+ should be treated as individuals with their own perspectives and issues.
Approaches to good health
Health literacy involves understanding what personal actions and behaviours can promote good mental and physical health including accessing support. If people are to enjoy better health, an environment which allows people to have this knowledge and have the motivation, resources and power to take such actions are also required. The provision of high quality, accessible and acceptable services is key. All of this can be developed through joint work which includes the LGBTQI+ community.
LGBTQI+ communities as health promoting communities
Like people in other communities, many LGBTQI+ people live healthy and happy lives and use alcohol and other drugs in ways that do not raise concerns for individuals or other people.
LGBTQI+ communities can offer health-positive resources to people that are protective against problem substance use including a sense of belonging, opportunities for connection and friendship within safe spaces, as well as opportunities to develop and share good health literacy among peers. These same resources can support and promote recovery in people who develop a substance use problem.
LGBTQI+ communities and health inequalities
LGBTQI+ communities also experience some significant health inequalities.
LGBTQI+ people are at higher than average risk of harms relating to substance use, poor mental health, some physical health problems and are at higher risk of experiencing homelessness.
Gay, bisexual, men who have sex with men and trans women are at a higher risk of HIV and viral hepatitis transmission.
These health problems are not an inevitable consequence of a person’s sexuality or gender identity. These issues arise in the context of social, cultural, and environmental factors, including discrimination, stigma, homophobia and transphobia as well as hetero/cis-sexism.
Many LGBTQI+ people experience trauma around their sexuality or gender identity. This is a common experience, especially in childhood, adolescence and early adulthood, when people can be particularly vulnerable. This increases the risk of poor mental health, physical illness and the likelihood of problematic substance use.
Social attitudes towards LGBTQI+ people as well as the way they are treated impacts on the effectiveness of health interventions in terms of prevention, treatment and support including in the realm of substance use. There is an evident need to address stigma, prejudice and misunderstanding around these communities. SDF works with others to address these issues and is keen to build on this work.