Michael Shelton - Gay Men and Substance Abuse: A Basic Guide for Addicts and Those Who Care for Them

GAY MEN

AND

SUBSTANCE

ABUSE

A Basic Guide for Addicts
and Those Who Care for Them

MICHAEL SHELTON

M.S., C.A.C.

Hazelden Publishing
Center City, Minnesota 55012
800-328-9000
hazelden.org/bookstore

2011 by Michael Shelton
All rights reserved. Published 2011
Printed in the United States of America

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any meanselectronic, mechanical, photocopying, recording, scanning, or otherwisewithout the express written permission of the publisher. Failure to comply with these terms may expose you to legal action and damages for copyright infringement.

Library of Congress Cataloging-in-Publication Data

Shelton, Michael, 1965

Gay men and substance abuse : a basic guide for addicts and those who care for them / Michael Shelton.

p. cm.

Includes bibliographical references.
ISBN 978-1-59285-889-7
Ebook ISBN 978-1-61649-189-5
1. Gay mensubstance use. 2. Gay menAlcohol use. 3. Gay menDrug use. 4. AlcoholicsRehabilitation. 5. Drug addictsRehabilitation. I. Title.
HV5139.S54 2011
616.8606086642dc22

2010045849

Editors note

The names, details, and circumstances may have been changed to protect the privacy of those mentioned in this publication

This publication is not intended as a substitute for the advice of health care professionals.

Alcoholics Anonymous, AA, and the Big Book are registered trademarks of Alcoholics

Anonymous World Services, Inc.

15 14 13 12 11 1 2 3 4 5 6

Cover design by David Spohn

Interior design and typesetting by Percolator Graphic Design

For Donald: the co-creator of all that is best in my life

THANKS TO SID FARRAR and Patricia Boland at Hazelden for allowing this project to come to fruition, and to the following who offered their support and permission to use their materials: Sandra Anderson, Dana Finnegan, Jeff and Debra Jay, Sheppard Kominars, Duncan Osborne, Joseph Nowinski, Joe Amico, Penny Ziegler, and the staffs of tweaker.org and the Sexuality Information and Education Council of the United States (SIECUS).

THIS BOOK IS FOR GAY MEN who are struggling with substance abuse problems, as well as their loved ones, their partners and family members, and the helping professionals who work with them as therapists, social workers, medical doctors, clergy, or other counselors. The information in this book is intended to help the above audience make informed choices as they struggle to understand and make good decisions about dealing with a substance abuse problem. Since few people who are abusing substances seek out literature on the subject, they will probably read this book only when their loved ones and caregivers encourage them to learn more about their condition as a part of their decision-making process to seek help. While addiction professionals will be familiar with most of the basic information on substance abuse, they should find the sections specific to working with gay men enlightening.

Gay men, their partners, and family members often receive substandard and disrespectful treatment for substance abuse. I wrote this book to offer accurate and current information specific to their needs. All too frequently, knowledge about gay men is minimal in treatment facilities; counseling groups assume that members are heterosexual; staff and other clients look askance at sexual minorities; and their families are forgotten in planning interventions. Unless a gay male and his loved ones can afford the services of a treatment center targeting gay men (often $1,000 per day for residential services), he will likely end up in a public facility with varying degrees of experience, skill, and even interest in working with him and his loved ones. Gay men and the important people in their lives deserve better, and this book will guide you in making sure this happens, whether you are a loved one, a helping professional, or a gay male substance abuser seeking help.

THE IMPORTANCE OF INVOLVING LOVED ONES IN TREATMENT

A gay man with substance abuse problems is all too often squeezed between two forces: a treatment system that doesnt know what to do with him and a family system that cannot accept his sexuality, let alone his drug abuse problem. Research increasingly shows the value of involving the family during treatment, but this invaluable opportunity may be closed to gay men when treatment doesnt even recognize the existence of their nontraditional families.

Counselors, or helping professionals of any kind, need to not only understand the complexity and intricacies of gay male drug use and its close ties with sexual behavior, but also realize how the constellation of people in a gay mans life can support his recovery. If a clinician doesnt know how to work with a gay man individually, he or she will be even more at a loss when the family enters the office. Working with gay men and addiction problems entails being able to talk knowledgeably, and with care and sensitivity, about sexual orientation, heterosexism, homophobia, and sex practicesall topics the clinician, the family, and the gay man himself may be uncomfortable discussing.

Concerned others who will find the book helpful may be lovers, close friends, and any family members who are interested in, and willing to learn about, their loved ones lifestyle, drug use, and the history of their problem.

Often, there are also family members who care deeply about their loved one but from a removed position. They may be uncomfortable with his sexual orientation, but love him and want him to be happy. Although these family members may be uncomfortable with some of the sexually explicit language in this book, they will nonetheless find information here that can help them understand their loved ones motivation and the challenges of recovery.

HELPING PROFESSIONALS

Anyone entering treatment for a drug or alcohol problem is asked to describe his or her life history. Typically only two questions about sex are included in the inquiry:

• Are you a victim of sexual abuse?
• What is your sexual orientation?

Addictions professionals often understand their role in trauma work, and victims of past and current sexual abuse are offered at least cursory treatment materials even if the professional does not specialize in trauma work. Yet the second questionwhat is your sexual orientationleaves most professionals stumped when the response is anything but straight. What are they supposed to do with this information? Does the persons sexuality in any way impact the substance use? And if it does, what can they offer to help? Sadly, this basic question is often simply ignored in the history-taking process. Even experienced clinicians may skip over the question and simply check straight or heterosexual. Their own discomfort with the topic leads them to overlook sexuality. And of course gay men themselves often answer the question dishonestly. This may be due to their own shame issues or the seeming disapproval of the clinician (or both).