Webb Therapy Uncategorized Biopsychosocial factors influencing drug use in the LGBTQIA+ Community

Biopsychosocial factors influencing drug use in the LGBTQIA+ Community

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Psychological factors influencing drug use in Sydney’s gay community often stem from unique social and emotional challenges. Research highlights that stigma, discrimination, self-stigma, and internalised homophobia can lead to feelings of isolation, shame, and mental distress, which may increase vulnerability to substance use.

Additionally, the normalisation of partying in certain social settings, such as bars and clubs, has historically been a way for subcultural populations of LGBTQ+ individuals to connect and find community. However, this environment can also contribute to higher rates of drug use. Emotional coping mechanisms, such as using substances to manage stress or trauma, are also significant factors.

The biopsychosocial model provides a comprehensive framework for understanding alcohol and other drug dependency in the LGBTIA+ community. Here’s a breakdown of the factors:

  1. Biological Factors:
    • Genetic predisposition plays a role, with some individuals being more vulnerable to chemical dependency due to inherited traits.
    • Neurobiological changes caused by substance use can alter brain function, making it very challenging to reduce or stop using substances despite the negative consequences occurring in the individual’s life.
  2. Psychological Factors:
    • Trauma, such as adverse childhood experiences, peer bullying, neglect, authoritarian child rearing, seemingly innocuous societal messages, and/or discrimination, can lead to emotional distress and substance use as a coping mechanism.
    • Internalised stigma, homophobia, or transphobia can exacerbate mental health issues like anxiety and depression, increasing the risk of substance use and potential physical and psychological dependency.
  3. Social Factors:
    • Experiences of ostracism, violence, or lack of acceptance and belonging can lead to isolation and substance use.
    • Social norms in certain LGBTQ+ spaces, such as bars or clubs, may normalise or encourage substance use.

This model underscores the importance of addressing all these interconnected factors in prevention and treatment efforts.

The Flux Study, also known as “Following Lives Undergoing Change,” is a longitudinal research project focusing on the lives of gay and bisexual men in Australia. Conducted by the Kirby Institute at UNSW Sydney, it examines various aspects of health, behaviour, and social factors, including drug use, sexual health, and the adoption of HIV prevention strategies like PrEP.

Key findings from the study include:

  • Recreational drug use is common among gay and bisexual men, with substances like marijuana, amyl nitrite (“poppers”), and party drugs being frequently used. However, dependency rates are relatively low.
  • Drug use is often linked to enhancing pleasurable experiences, including sexual enjoyment.
  • The study has provided insights into how men mitigate risks, such as using biomedical HIV prevention methods alongside drug use.

The Flux Study is a collaborative effort involving organisations like the National Drug and Alcohol Research Centre, ACON, and the Victorian AIDS Council. It aims to inform health interventions and support services tailored to the needs of this community.

The Flux Study has provided valuable insights into the health and behaviours of gay and bisexual men in Australia. Here are some key findings:

  • Drug Use: While recreational drug use is common, most participants reported infrequent use. Harm reduction strategies, such as not sharing injecting equipment, were widely practiced.
  • HIV Prevention: There was a significant increase in the uptake of HIV pre-exposure prophylaxis (PrEP), with usage rising from less than 1% in 2014 to about one-third of participants by 2017.
  • COVID-19 Impact: During the pandemic, participants reduced sexual contacts and adapted strategies to minimize risks in sexual contexts. Many also paused PrEP usage due to reduced sexual activity.
  • Mental Health: A notable proportion of participants reported mental health challenges, highlighting the need for targeted support services.

There are several support services available for addressing mental health challenges, particularly for the LGBTIA+ community in Australia. Here are some key options:

  1. QLife: A free, anonymous peer support and referral service for LGBTQ+ individuals. It operates via phone and webchat from 3 PM to midnight, 7 days a week. Phone: 1800 184 527. Their website provides a webchat service: QLife – Support and Referrals
  2. Beyond Blue: Offers 24/7 mental health support, including phone and online counselling. They also provide resources tailored to the LGBTQ+ community. Phone: 1300 22 4636. Click the following link to Beyond Blue’s Wellbeing Action Tool: beyond-blue-wellbeing-action-tool_dec_2024_updated.pdf
  3. Lifeline: A leading crisis support service available 24/7 for anyone in distress. They offer phone, text, and online counselling. Phone: 13 11 14
  4. Head to Health: Connects individuals to mental health resources, including helplines, apps, and digital programs. Medicare Mental Health is a free service that connects you with the mental health support that is right for you. Phone: 1800 595 212 or visit their website: Home | Medicare Mental Health
  5. WayAhead Directory: An online database to find local mental health services and resources. Phone: 1300 794 991
  6. NSW Mental Health Line: A 24/7 telephone service providing advice and recommendations for appropriate care. Phone: 1800 011 511

These services are designed to provide immediate support and guide individuals toward long-term mental health care.

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Polyvagal Theory and Trauma – Dr. Stephen PorgesPolyvagal Theory and Trauma – Dr. Stephen Porges

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Stephen Porges, psychiatry professor and researcher, on the polyvagal theory he developed to understand our reactions to trauma:

[Paraphrased] Polyvagal theory articulates three branches of the autonomic nervous system (ANS) that evolved from primitive vertebrates to mammals. First, there is a system known as ‘freeze’, which involves death feigning or immobilisation. Second, the ANS has a ‘fight or flight’ system, which is a mobilisation system. And third, with mammals, there is what Porges calls, a social engagement system (SES), which can detect features of safety, and actually communicate them to another. The SES may also be referred to by some as ‘rest and digest’, which Porges theory suggests is a function of the Vagus Nerve – the tenth cranial nerve, a very long and wandering nerve that begins at the medulla oblongata. When an individual experiences feelings of safety (within an SES state), the autonomic nervous system can support health restoration. In terms of dealing with a life threat, an ordinary person will most likely go into a feigning death, dissociative state of ‘freeze’.

Polyvagal theory in psychotherapy offers emotional co-regulation as an interactive process between therapist and client which engages the social engagement system of both therapist and client. Social engagement provides experiences of safety, trust, mutuality and reciprocity in which we are open to receiving another person, just as they are.

The following extract has been retrived from https://www.theguardian.com/society/2019/jun/02/stephen-porges-interview-survivors-are-blamed-polyvagal-theory-fight-flight-psychiatry-ace

Polyvagal theory has made inroads into medical and psycho-therapeutic treatment, but how should it inform how people treat each other?


“When we become a polyvagal-informed society, we’re functionally capable of listening to and witnessing other people’s experiences, we don’t evaluate them. Listening is part of co-regulation: we become connected to others and this is what I call our biological imperative. So when you become polyvagal-informed you have a better understanding of your evolutionary heritage as a mammal. We become aware of how our physiological state is manifested, in people’s voices and in their facial expression, posture and basic muscle tone. If there’s exuberance coming from the upper part of a person’s face, and their voice has intonation modulation or what’s called prosody, we become attracted to the person. We like to talk to them – it’s part of our co-regulation.

So when we become polyvagal-informed, we start understanding not only the other person’s response but also our responsibility to smile and have inflection in our voice, to help the person we’re talking to help their body feel safe.”

Clink on the link below to hear Dr. Bessel van der Kolk, one of the world’s leading experts on developmental trauma, explain how our long-term health and happiness can be compromised by prior exposure to violence, emotional abuse, and other forms of traumatic stress.

https://youtu.be/53RX2ESIqsM

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Self-absorption, self-obsession, the need for validation from others, toxic vanity, being in the spotlight … the list goes on. Please do not judge yourself if you possess any of the mentioned characteristics – however, I would encourage you to investigate if your self-worth and esteem are contingent on how others’ perceive you. Ideally, our self-worth comes from within. We do not need to seek it outside of ourselves. When you find yourself doing so, pause, and offer yourself what you need.Self-absorption, self-obsession, the need for validation from others, toxic vanity, being in the spotlight … the list goes on. Please do not judge yourself if you possess any of the mentioned characteristics – however, I would encourage you to investigate if your self-worth and esteem are contingent on how others’ perceive you. Ideally, our self-worth comes from within. We do not need to seek it outside of ourselves. When you find yourself doing so, pause, and offer yourself what you need.

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The stages of change modelThe stages of change model

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‘The stages of change model’ was developed by Prochaska and DiClemente. Heard of them? It informs the development of brief and ongoing intervention strategies by providing a framework for what interventions/strategies are useful for particular individuals. Practitioners need an understanding of which ‘stage of change’ a person is in so that the most appropriate strategy for the individual client is selected.

There are five common stages within the Stages of Change model and a 6th known as “relapse”:

1. In the precontemplation stage, the person is either unaware of a problem that needs to be addressed OR aware of it but unwilling to change the problematic behaviour [or a behaviour they want to change. It does not always have to be labelled as “problematic”].

2. This is followed by a contemplation stage, characterized by ambivalence regarding the problem behaviour and in which the advantages and disadvantages of the behaviour, and of changing it, are evaluated, leading in many cases to decision-making.

3. In the preparation stage, a resolution to change is made, accompanied by a commitment to a plan of action. It is not uncommon for an individual to return to the contemplation stage or stay in the preparation stage for a while, for many reasons.

4. This plan is executed in the action stage, in which the individual engages in activities designed to bring change about and in coping with difficulties that arise.

5. If successful action is sustained, the person moves to the maintenance stage, in which an effort is made to consolidate the changes that have been made. Once these changes have been integrated into the lifestyle, the individual exits from the stages of change.

6. Relapse, however, is common, and it may take several journeys around the cycle of change, known as “recycling”, before change becomes permanent i.e., a lifestyle change; a sustainable change.

(Adapted from Heather & Honekopp, 2017)

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