Liverpool’s relationship with drugs has been a long one. It was explored in the occasionally cheesy documentary series Liverpool Narcos (released in 2021), which sought to lay out a timeline of how heroin use, followed by ecstasy in the 80s and then cocaine in the 90s, spread across the city. The documentary shows the audience the misuse of drugs through a criminal lens, complete with dramatic recreations of drug busts that are intercut with former dealers sharing the details of how things ‘really went down’ - but what about those on the other side of dealing? It's important to understand that due to surrounding factors such as socioeconomics, being recruited at a young age, and drugs scenes being used as meeting points for socially marginalised people, dealers often are often also users who require support (Feltmann et al, 2021).
As of March 2023, 9.5% of people aged 16-59 and living in the UK reported using drugs in the past 12 months, equating to approximately 3.1 million people. Common reasons for drug use cited are curiosity, rebellion, or doing it to fit in with peers, but there are some deeper reasons that may lead people to substance misuse behaviours. Some people decide to take drugs when they are feeling stressed, unhappy, or struggling to cope with something that is happening in their life, and are looking for a form of escape. Substance use and trauma are deeply connected (Khoury et al, 2010) and people who identify under the LGBTQ+ umbrella face unique traumas in society, which can become a driving force for repeated and habitual drug use.
According to UK census data, around 1.3 million (2.8%) people in the UK identify as lesbian, bisexual, or gay, with 165,000 people identifying as ‘other’ sexual orientations and 262,000 people (0.5%) stating that their gender identity was different from their sex registered at birth. Although being LGBTQ+ does not automatically equal poor mental health, those who do not identify as heterosexual or ‘straight’ are 1.5 times more likely to be diagnosed with anxiety and depression. There are many complex reasons for this, including LGBTQ+ people being made to feel unwelcome in society due to social stigmas; homophobic hate crimes reportedly rose in the UK by 41% between 2021-2022 (from 18,596 to 26,152 recorded police cases). Feeling unsafe day-to-day because of your sexuality can heavily impact your mental health, which can then lead to the use of stimulants as a way of self-medicating for depression and anxiety. For lesbian and bisexual women, chronic social stress increases the likelihood of substance misuse with bisexuals often facing the ‘double stigma’ from both the heterosexual and gay communities for not being deemed “straight enough” or “gay enough”, with data showing very high comparative rates of substance use within the bisexual population. Drug use can often be linked to mental health issues, and it can also have an impact on a person’s physical wellbeing.
In recent years, raising awareness of the dangers surrounding Chemsex has been the focus of many working within the public health sphere. Chemsex is defined as “recreational sex under the influence of stimulants to facilitate/enhance sexual experiences”, with rates of Chemsex having the highest prevalence within the LGBTQ+ community. For those who participate in Chemsex, there is an increased chance of engaging in high-risk sexual behaviours such as engaging in unprotected sex leading to higher risk of contracting sexually transmitted infections (STIs) and HIV or other bloodborne viruses. Poor physical health has been evidenced repeatedly to be linked to poorer mental health outcomes. It is also worth noting that most research around Chemsex has been focused on men who have sex with men (MSM) and the inclusion of the effects that it may be having on lesbian/bisexual women is lacking.
First Person Project is well connected to the LGBTQ+ community, with identifying members of staff, partners, volunteers, and people who access our services. Part of our mission is to provide socially progressive mental health services that are as accessible to all, which is why we strive to ensure FPP is a safe space. Community support and cohesion, and the reduction of health inequalities, is vital for promoting recovery from substance misuse, especially within the LGBTQ+ community. Research shows that asset-based approaches have extreme value when promoting recovery from substance misuse, but effort must be made to include and engage socially excluded groups (such as those in recovery or those who identify as LGBTQ+) (Collinson et al, 2019). Barriers must be removed and accessibility promoted to allow everybody to engage with their community in a positive, strengths-based manner.
With all of this in mind, it is important to remember that people engage in substance misuse for a wide variety of reasons. When it comes to providing support, a holistic and multi-level approach is a necessity, and not making assumptions based on someone’s perceived (or known) sexuality, age, race, gender or other characteristics is vital.
If you are someone in the Liverpool area who is looking to access some support around substance misuse, here are a few services you where you can access help:
We Are With You – Drug & alcohol support services for adults, young people and families.
Brook Place – Recovery focused service including assessments, advice and information as well as peer mentoring and psychosocial interventions.
LGBT Foundation: Recovery Programme – For LGBTQ+ people in Greater Manchester and Liverpool affected by drugs, alcohol and Chemsex.
The Brink – A cafe and a centre for people who want to overcome addiction and rebuild their lives, offering services, programmes and support in a welcoming and dignified environment.
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