By: Jerry P. Abraham, MD MPH CMQ
Photo by: Photosvit | Dreamstime.com
As the season of spring arrives, it reminds us that growth, renewal, and transformation are always within reach. This time of year encourages reflection and the possibility of moving forward in a healthier, more authentic direction. For many in the Latin LGBTQ+ community, spring brings a chance to explore healing and change, particularly as we confront the pressures and struggles that can lead to substance use and alcoholism. Whether it’s alcohol, drugs, or chemsex, substances often serve as a temporary escape from deeper issues of trauma, stress, or unmet needs for connection. But there are alternatives to self-medication that offer real solutions, and with the right support, we can move toward a more sustainable sense of well-being.
Substance use, including alcohol and drugs, can be deeply intertwined with emotional and psychological pain. Chemsex, a practice where drugs like methamphetamine, GHB, and mephedrone are used to enhance sexual experiences, has become a significant issue in the LGBTQ+ community, particularly among men who have sex with men. These substances are often chosen for the temporary escape they provide from anxiety, stress, or feelings of isolation. They can heighten the intensity of experiences, but the high is always fleeting, leaving behind deeper emotional and physical consequences.
When it comes to substance use, it’s crucial to understand that it is not merely a matter of choice but often a response to deeper needs. The need to feel connected, confident, or even loved can lead some individuals to substances as a form of self-medication. For some, these substances help them feel more outgoing or less inhibited, which can be appealing in a world where rejection or lack of acceptance feels all too common. However, the issue is that substances can quickly take over, leading to addiction and physical harm, without addressing the root causes of these feelings.
In many cases, substance use is not simply about seeking pleasure but about managing pain. Trauma, whether from bullying, family rejection, or experiences of discrimination, can leave lasting emotional scars. This is particularly true in marginalized communities where support systems may not be as accessible or accepting.
There is also the challenge of stigma within the LGBTQ+ community itself. Those who may have experienced rejection from family or society might turn to substances as a way to cope with feelings of inadequacy, guilt, or shame. But while substances might numb the pain temporarily, they don’t provide a solution to the underlying trauma.
The connection between mental health and substance use cannot be overlooked. Depression, anxiety, PTSD, and other mental health conditions are common among individuals struggling with addiction. The use of alcohol or drugs can be a form of self-medication for these conditions. However, there are more effective treatments available for both mental health and substance use disorders that don’t involve turning to substances.
One of the most promising aspects of today’s treatment options is medication-assisted treatment (MAT), which combines medication with counseling and therapy. These medications are designed to help individuals reduce cravings, manage withdrawal symptoms, and sustain long-term recovery.
For individuals struggling with alcohol dependence, Vivitrol (an extended-release injectable form of naltrexone) can block the pleasurable effects of alcohol, making it easier to resist the urge to drink. It has been shown to significantly reduce cravings and prevent relapse, offering individuals an opportunity to rebuild their lives without the constant pull of alcohol.
For those struggling with opioid addiction, including fentanyl and heroin, Suboxone (buprenorphine/naloxone) is a critical medication. Suboxone helps reduce cravings and withdrawal symptoms without producing the intense euphoria associated with opioid use. It’s one of the most effective treatments for opioid addiction and has helped thousands regain control over their lives.
Nicotine addiction, particularly with cigarettes, remains a common challenge for many in our community. Chantix has been a breakthrough medication, helping individuals quit smoking by reducing cravings and withdrawal symptoms. Combined with behavioral therapy, Chantix can be a powerful tool for long-term success.
Medications like Wellbutrin, typically used as an antidepressant, have also shown effectiveness in treating addiction, particularly nicotine addiction and even binge eating. Topiramate, an anticonvulsant, has shown promise in treating binge eating disorders, which can be another form of self-medication, especially for those dealing with emotional distress.
For individuals struggling with methamphetamine use, treatment options like methadone and buprenorphine can help manage withdrawal symptoms and cravings, making the recovery process more sustainable. It’s important to remember that recovery from meth use is often complex and requires a multifaceted approach, including both medication and therapy.
Another substance used in our community, particularly in sexual settings, is poppers (alkyl nitrites). While they are legal and widely available, they carry serious health risks, including respiratory issues, increased risk of HIV transmission, and even sudden death in some cases. Though poppers are commonly associated with a rush of euphoria and relaxation, their long-term use can lead to significant health problems, including damage to the cardiovascular system and other organs.
Understanding the risks associated with these substances is crucial, as many users may not fully realize the harm they are causing to their bodies. While the short-term effects might seem benign, continued use can have serious consequences.
What many in our community need most is acceptance—not just from others, but also from ourselves. We are all shaped by our unique experiences, and the search for meaning, connection, and love often drives us to seek out substances for comfort. But true healing comes from building a community where we feel seen, heard, and valued for who we are, without needing to rely on substances to fill the gaps in our lives.
This journey of healing involves recognizing that we are worthy of love, acceptance, and support just as we are. It’s about finding ways to connect with others in meaningful, healthy ways—whether through support groups, therapy, or simply surrounding ourselves with people who lift us up. While substances might offer a temporary escape, they do not provide the lasting sense of belonging and self-worth that we all need.
As we enter this season of renewal, let’s remember that healing is possible. The tools and treatments are available to help us move beyond the reliance on substances and toward a life of authenticity, self-acceptance, and true connection. Let this spring be a time when we choose health, healing, and most importantly, the acceptance of ourselves and each other.
The journey toward healing is not always easy, but by embracing both medical interventions and emotional support, we can create a future where we no longer have to seek validation through substances. Together, we can build a community of acceptance, love, and renewal.
Remember, you can visit Dr. Jerry P. Abraham and the whole JWCH-Wesley HIV Street Medicine Team at Tempo Nightclub every Sunday night. Come get HIV-tested, PrEP’d, and your LGBTQ+ health questions answered.
Opening Soon! Come join us at the Wesley Lounge next door to Tempo!