The Center for Substance Abuse Treatment (CSAT) of the Substance Abuse and Mental Health Services Administration (SAMHSA) is pleased to present A Provider's Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals.

This publication was developed through a systematic and innovative process in which clinicians, researchers, program and administrative managers, policymakers, and other Federal, State, and independent experts were brought together for a series of intensive sessions. These individuals reviewed and discussed current administrative and clinical practices for treating substance-abusing lesbian, gay, bisexual, and transgender individuals and then wrote and edited the resulting document. The goal of this process was to improve and advance substance abuse treatment for a community of individuals whose health care needs are often ignored, denigrated, or denied.

This document seeks to inform administrators and clinicians about appropriate diagnosis and treatment approaches that will help ensure the development or enhancement of effective lesbian, gay, bisexual, and transgender (LGBT)-sensitive programs. Serving as both a reference tool and program guide, it provides statistical and demographic information, prevalence data, case examples and suggested interventions, treatment guidelines and approaches, and organizational policies and procedures.
This publication focuses on the two most important audiences for successful program development and implementation—clinicians and administrators.

Section I provides an introduction for both audiences and includes information on sexual orientation, legal issues, and treatment approaches and modalities from a lesbian, gay, bisexual, and transgender standpoint.

Section II is written for the practicing clinician. It offers further information on clinical issues of lesbian, gay, bisexual, and transgender clients; an introduction to strategies and methods for improving current services to LGBT individuals; and steps for starting LGBT-sensitive programs.

Section III, developed for program administrators, provides an overview of the issues that need to be addressed when developing an LGBT program or when expanding current services for LGBT clients. It offers the data needed to build a strong foundation for a program, including an organizational mission and policies and procedures. It provides resources and strategies for working with managed care organizations and building alliances and cooperative arrangements to coordinate efforts on behalf of LGBT individuals so that members of the LGBT population can promote self-help programs within their own communities.

Besides increasing awareness of the need for LGBT-sensitive treatment services and helping all those involved in the treatment process become more aware of LGBT issues, this document also serves an important public health function. For example, the convergence of HIV, hepatitis, and substance abuse is a major concern that has not been adequately addressed in LGBT communities, especially regarding the availability of vaccines for hepatitis A and hepatitis B. Educating LGBT people about these vaccines, the importance of vaccination, and strategies for preventing hepatitis C infection is a responsibility of all health care providers, not just substance abuse treatment professionals.
This publication is the result of the collaboration of many contributors, and CSAT gratefully acknowledges the dedication, time, talent, and hard work that the writers and reviewers have brought to this publication.