Dr Miriam Hillyard is an MRC Addictions Research Clinical Fellow at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London. Her academic research focuses on LGBTQ+ health, addiction, and health inequities. Alongside medical NHS work, she is currently completing a PhD on the experiences of sexual minority women with drug/alcohol problems.

Abstract

Sexual minority (LGBQ+) women’s experiences of addiction and recovery: A qualitative study

Sexual minority (LGBQ+) women are known to experience a disproportionately high burden of addiction problems. This study aimed to explore their experiences of harmful or dependent drug/alcohol use. We also aimed to understand the barriers they face to accessing specialist addiction treatment services, such as stigma and discrimination. We wanted to discover what resources (e.g. peer support groups) they use in their addiction recovery. Responding to study adverts online or via relevant mailing lists, self-identified sexual minority women were recruited. All participants had experience of harmful or dependent use of drugs and/or alcohol. Semi-structured, confidential telephone interviews were completed, which were recorded and transcribed. Transcripts were analysed qualitatively using grounded theory methods, including line-by-line coding following an open, axial, and selective coding approach, until theoretical saturation was reached. 21 interviews were completed with a diverse range of participants. Participants described a multiplicity of motivations for drug/alcohol use, including enhancing LGBTQ+ community connection, joy and pleasure, and managing mental illness or past traumatic experiences. The vast majority had not accessed specialist addiction treatment, with barriers including shame, stigma, and low knowledge of services. Support from peers, friends, and family had helped many recover. Sexual minority women have distinct experiences of addiction and recovery, shaped by social connection, trauma, and dual stigma. Their drug and alcohol use must be contextualised in the psychosocial and cultural fabric of wider LGBTQ+ life. Existing addiction services may be inaccessible or unappealing to them, making informal communities of care vital. To reduce disparities, services may need to actively target interventions towards this group.