What I learnt at a lesbian and gay community forum on drug use

Last night I presented these findings on the use of tobacco, alcohol and illicit drugs by lesbian, bisexual and queer women engaged with the LGBT communities in Sydney. This comes from SWASH data.

I have presented this data to professional meetings several before but this is the first outing at a community forum. Why do people attend a community forum on trends in lesbian and gay drug use? I’m not sure but the questions people asked were really interesting. I thought I’d canvas them again here.

How reliable is the data?
People were really quite demanding on this. Did we capture all lesbian / bi / queer/ same sex attracted women in our survey (no); are we just catching people who are heavily engaged in the scene (certainly a bit).
I talked about the scope of the SWASH survey and what we can say on the basis of it. I talked about the best we have being better than nothing at all – and that in the absence of SWASH we don’t know much at all (the National Drug Strategy Household Survey asks about sexuality but doesn’t report the data by gender… so we can’t see how lesbians are doing). Part of the solution is for large well funded health surveys to include sexuality and gender questions so we can collect better and more varied data.

How dangerous is the data for the LGBT community?
A few people intimated this, but two put words to it. Are the findings on rates of tobacco, alcohol and illicit drug use among lesbians not well know in the wider community because we’re afraid of the what people will do with it? This was followed by a community member reminding us of the damage the Australian Christian Lobby tired to do late last year with erroneous data on short life expectancy among LGBT people. [Crikey explored these claims here ]
My answers to these very reasonable concerns – possibly but if we don’t collect data on these issues, if we don’t talk about them within our community, and if we don’t point out the very real health needs of our communities then we can’t address them (or convince anyone to provide resources for health interventions).

Why are LGBT communities smoking more, drinking at more risky levels more often and using illicit drugs at much higher rates…?
Some great responses here from community representatives and from Ross the substance use counsellor at ACON about experiences of marginalisation, stigma, minority stress, coping with mental health issues. Reference was made to the National Drug & Alcohol Research Centre’s recent report on this. We also talked about how LGBT people might have more cause to socialise in spaces where they are exposed to alcohol, tobacco and drugs because many have to go out and create new families and support networks. There was also talk at my table about whether women are less critical of their partners smoking and drinking then male partners are – perhaps to do with violating gender expectations being a bad (or good) thing.

Someone suggested that the LGBT community might be better at looking after alcohol and drug issues at community events (and as a consequence divert people away from emergency departments) than the straight community does at its large music events (I’m not sure how LGBT folk who attend these large music events would feel about them being characterised as straight community events…).
In response, we heard about the amazing community-based volunteer medical teams that work at Mardi Gras events. Others talked about the ways peer support works at events where people are taking drugs… Be interesting to hear more about this.

Lastly, a few people challenged my use of women in the general community as comparisons when I talked about rates of tobacco, alcohol and illicit drug use by lesbian, bisexual and queer women.
Good question. I wasn’t suggesting that the general community (ie primarily heterosexual women) are a standard by which to judge our communities. Actually maybe I was. They are not a norm to meet, but they are a useful comparison to give us pause. I want to provoke a conversation about the levels of smoking in our communities. Rates in the general community are falling and the government has put huge resources into achieving this. Even though *only* 16% of women in the general community smoke, the government is still working hard to reduce this rate. Australia is leading the world on public health initiatives here – Plain packaging anyone? And yet, twice as many lesbian, bisexual and queer women smoke compared to the rate of women in the general community (33% compared to 16% in 2012). The rates are higher for young women – 42% compared to 17%… What does the community think is an acceptable rate?

We didn’t talk about what we’re going to *do* to help people not take up smoking, and for those who already smoke but want to stop, how we as a community can best support them…

I’d be interested to hear what other people at the forum got from it.