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Generally, for the average person, admitting you have a problem is very difficult. Even though I think we have made significant strides in how the general population views behavioral health issues, we still have a long way to go. In my own situation, admitting that I had a problem was very difficult.”

Steven Haden, a psychiatric rehabilitation practitioner with the Mental Health Center of Denver, has been sober for 13 years. While working in New York City, following graduate school at New York University, he developed a substance use disorder and had some complications with depression.

“I struggled, for a period of time, trying to come to grips with my addiction, which I think was made more complicated because I’m in the LGBTQ community.” Haden’s personal journey led him to work with folks who had similar struggles.

The complexities that the LGBTQ community faces with alcohol include higher rates of use due to discrimination, the community’s historical relationship with alcohol, and lack of LGBTQ-competent resources. This is why it’s so important to support queer folks in sobriety challenges like Dry January.

At its core, Dry January is a New Year’s challenge designed to help drinkers curb indulgence and take stock of how drinking impacts them. Created by the U.K.’s leading alcohol charity, Alcohol Change U.K., it offers abstinence-minded folks around the globe a 31-day opportunity to reset their relationship with alcohol.

However, alcohol’s relationship to LGBTQ culture and identity can introduce unique obstacles for non-heterosexual drinkers looking to participate. Historically, queer bars and clubs have been a place of refuge for folks looking to socialize and build community, normalizing social drinking.

“If you think about how often there are gay bars versus bookstores or coffee shops, having those spaces where people felt safe and felt free from discrimination, they were often bars. To try and say that someone doesn’t want to be a part of that can at times be paramount to saying that they are no longer a part of the community,” said Alexis Chavez, co-founder of the IMAGINE Clinic at the University of Colorado. The clinic specializes in mental health care for members of the LGBTQ community.

The LGBTQ population of America has alarmingly high rates of alcohol addiction, in large part due to the stress that comes from discrimination. Even though there are no standardized, statistical measurements on the rate of substance abuse in the LGBTQ community, The Center for American Progress estimates 25 percent of the LGBTQ population abuses alcohol, compared to 5 to 10 percent of the general population.

Colorado’s LGBTQ population—roughly 200,000 people—experiences higher rates of tobacco, alcohol, and substance use, according to the Colorado Department of Public Health and Environment.

In a separate state survey, 25 percent of lesbian and gay respondents and 28 percent of bisexual persons reported binge drinking, compared to 16 percent of heterosexuals.

Nationally, substance use among those identifying as LGBTQ is significantly higher across all drugs, according to the Substance Abuse and Mental Health Services Administration.

In 2015, nearly 40 percent of adult sexual minorities used illicit drugs at least once, compared with 17 percent of heterosexual adults, according to a 2016 survey from the federal substance abuse agency. LGBTQ adults were nearly three times as likely to use cocaine and hallucinogens and more than twice as likely to misuse pain relievers, the survey found.

In 2015, an estimated 15.1 percent of LGBTQ adults had an alcohol or illicit drug use disorder in the past year, compared with 7.8 percent of heterosexual adults, according to government data.

The LGBTQ community suffers from higher levels of alcohol abuse than their heterosexual counterparts due to various social issues, including discrimination or stigmatization based on sexual orientation, rejection or shame from family or friends after coming out, and internalized homophobia or self-hatred.

These social issues make culturally competent healthcare providers paramount in sobriety access and success.

“Some of the issues that I deal with as a gay man are going to be very different than a heterosexual counterpart. While I don’t need my provider to identify as LGBTQ, it certainly helps for them to have an understanding of my world and the unique challenges a person who identifies as LGBTQ encounters,” Haden said.

“In the past, we may have thought that everyone with depression should follow a certain sort of treatment protocol. Or, if you have an addiction issue, here are the five things that you need to do. Today, especially at the Mental Health Center of Denver, it feels great to work at an agency that looks at each person as an individual.”

Binge drinking and alcohol use disorder have negative, long-term, and fatal effects on the body, the most prevalent being damage to the liver—inflammation, scarring, and complete failure. Excessive drinking is also linked to six types of cancer, including esophagus, bowel, and breast cancer.

The Centers for Disease Control found that six people die every day from alcohol poisoning. They also found Colorado to be one of the top states where these deaths occur, with an average of five deaths per day.

Dry January’s validity in the wellness space has been questioned since its 2013 launch. Critics have wondered whether abstaining from booze for such a brief period of time can have any effects, let alone significant ones. It’s also been asked if the challenge has the potential to lead to increased binging following its completion.

A recent study conducted at the University of Sussex has found that the short-term challenge can leave a long-term impression.

More than 800 Dry January participants took part in the self-completed online surveys led by psychologist Dr. Richard de Visser. The surveys found that eight months after the challenge, participants were still drinking less.

Additionally, 88 percent of participants saved money. Eighty percent felt more in control of their drinking. Seventy-one percent slept better. Fifty-eight percent lost weight.

“There are various ways that people can begin their journey to sobriety. Some people want to stop completely, and some people just want to reduce. The programs that do exist, some of the 12-step programs, are very faith-based, which can be helpful for some people. For others in the LGBT community who have experienced negative things in the past surrounding faith communities, that might be an additional struggle for them,” Chavez said.

Not only is Dry January a simple way to check in with habits and goals if you find yourself drinking a little too much and a little too often, but the program also offers easy-to-use tools that can track progress and make maintaining a sober month simpler. More importantly, the app and Facebook group can offer additional, virtual support and community if you don’t live in a bigger metropolitan area and have easy access to services.

“In general, we encounter some complications in terms of the lives that we live,” Chavez said. “When you add a layer of addiction or a mental health disorder in there, it’s very challenging. When you attempt to access treatment and don’t find a provider that’s culturally competent, I think it often leads people to step away from treatment and perhaps go back to some of those harmful behaviors, because they didn’t get the compassion and support they needed.”