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Counselor: Compassion, understanding go a long way in LGBTQ substance abuse treatment

Pardon Ronald Piaseczny if he gets up on his soapbox.

He understands that everyone might not see eye-to-eye on the gay marriage issue, maybe not on homosexuality itself, but strongly believes that when it comes to fellow human beings who are hurting or troubled, folks of all beliefs can open their hearts and their minds.

Piaseczny , a mental health counselor featured this weekend in the In the Field story in WNY Refresh, has made it his professional passion to help those challenged in a number ways: wounded solders, the mentally ill, those addicted to drugs.

He also has become a beacon for those in the Western New York lesbian, gay, bisexual, transsexual and queer (LGBTQ) community in need of mental health support and drug addiction intervention.

Piaseczny leads a Recovery With Pride support group for those in the LGBTQ community who struggle with substance abuse. The group will next meet at 6 p.m. Thursday, and continue to meet the third Thursday of every month, at the Pride Center of Western New York, 200 S. Elmwood Ave.; for more information, visit pridecenterwny.org or call 852-7743.

The Centers for Disease Control’s best estimate is that 20 to 30 percent of gay men are dealing with some sort of addiction, versus 9 percent in the general population,” Piaseczny  told me during an interview last week.

“If we as a society were more accepting, more open, saying, ‘It doesn’t matter what your orientation is,’ then depression rates would probably go down,”  he said. "Stressors would go down. People wouldn’t have to use other substances to cope with depression, anxiety. Where do you start? I don’t know. It’s a whole package that contributes as to why somebody uses, be they gay or straight."

Piaseczny  stressed that the vast majority of those in the LGBTQ community live free of addiction, and that many people misuse substances, for different reasons.

“If we could identify those reasons and figure out how do you best support that person to make better choices and give them better avenues to explore, that would help a lot of people struggling with addiction,” he said. “Every individual is unique in their personal journey and life issues. Some people struggle with food addictions, smoking, drinking. Not everyone does. Other people use other coping mechanisms. The Pride Center support group is designed to help the LGBT community. If those issues are present and they want help, and want to work on it, then we’re here to help them on their personal recovery journey.”

Below are more excerpts from the interview at Spot Coffee that didn’t make it into the Refresh print piece:

Q. How important is it for someone who is LGBTQ to be accepted by family and friends?

Who doesn’t want to have the support of their family or the love of their family, to have unconditional love? Everyone of us wants that. When it comes with a caveat, ‘I love you but I don’t love your lifestyle’ – and I hate that phrase; wearing cowboy boots or polo shirts is a lifestyle, not necessarily who you love – that can grate on somebody. It can lead to a lot of family tensions, separation. You lose not only support but an integral part of the family dynamic. You talk about the sanctity of marriage and how it’s supposed to bring families together. You want a child raised in a loving environment. Even if it’s two men or two women, why would you not want the grandparents there and the aunts and the uncles? … Why would you want to split that up because Uncle Bobby doesn’t approve of who you’re with? This ties into mental health and addiction. It’s all connected. Empirical evidence for those with mental health issues show that those with support of family and friends have done better health-wise. The same is true with addiction. If it’s working with the general population, why would you not want all those support pieces in place to help somebody who is LGBT?

Q. What would you say to a family members who may be accepting but are struggling under the weight of a loved one’s addiction? When it comes to addiction alone, those issues aren’t easy.

They’re not easy, and you don’t want to become an enabler. That goes back to having your own support network. As much as you want to help the person and shelter them, and make sure they’re doing alright, in the end it’s all about independence and personal choice. You’re not going to be there 24/7. You want to make sure that person knows what to do, knows where to go, but you’re not going to be there taking the drugs out of their hand or taking the glass away when they pick up a drink all the time.

If it’s getting to be too much for you, or if you sense you’re enabling – becoming part of that problem – part of it is separating and saying, ‘I can love you and I can love you by getting you help – linking you with the right providers, getting the resources that you need – but that’s all we can do as a family at this point in time.’

There’s nothing wrong with that. There’s nothing wrong with knowing your limits and trying to be helpful in a positive way and not enabling the addiction to continue or worsen. ... Sometimes it really does take a team to help somebody and to get somebody to help themselves.

Q. You have some websites with some statistics and resources?

Websites with statistics include cdc.gov/msmhealth/substance-abuse.htm; lgbtdrugrehab.com/addiction-treatment-statistics and glbthealth.org/sabuse.html.

As for community resources, samhsa.gov offers info on mental health and substance abuse; lgbthealtheducation.org/publications/lgbt-health-resources is a really comprehensive source of LGBT-related health, mental health, and substance abuse resources.

 Q. So there’s definitely a need for counseling.

There are a lot of different treatment programs. In some cases, there’s a lack of cultural sensitivity with LGBT clients or there’s an idea that you can’t use a cookie-cutter approach to treatment. There’s a thinking that maybe it might be harder for counselors to apply the right techniques to the individual during general group counseling. As a result, people drop out of counseling and it’s not as successful.

Q. The substance abuse rates also are higher for those with mental illness?

Yes. A lot of people will use this as a mechanism to cope with symptoms. They go undiagnosed, untreated, and they’re not getting proper counseling or the right medication to take care of treatment so they turn to other substances to try to deal with that.

 Q. Whether we’re talking about someone who is straight or LGBTQ, or may have a mental illness, are there some common ways to address substance abuse?

There’s some very successful programs that have helped a substantial number of people: AA. Narcotics Anonymous. SOS, which is a nonsecular group. A lot of the treatment facilities that do substance abuse counseling tend to go with this abstinence-only model. It’s worked for a lot of people and I don’t bash it in any way, but abstinence requires people to completely give up their drug of choice and find positive support systems almost immediately. If you’re going to continue in that program, you can’t use.

What this (Pride Center) group does that’s different – and other groups do this around the country, too – is what’s called ‘harm reduction.’

The goal is to basically get you to stop, but not immediately. It’s reducing harm by building positive support systems. Part of what happens with addiction is substitute addictions. If you were a heroin user and that’s what you use as a coping mechanism, and you say you have to stop immediately, a lot of individuals will say, ‘OK, I’m going to go to the liquor store and start drinking,’ so they’re substituting one negative addiction with an other. What if we linked you to a support group instead, and looked at your mental health? Are you getting treatment? Do you need that? Are all of your medical needs being taken care of? Do you have friends and family that can help you? Instead of using three times a week, what if one of those times you could call a family member or went to a group instead, with the ultimate goal of stopping completely?

It’s the same concept for addressing smoking, food addiction. What about doing a 20-minute walk instead of eating a whole container of HaagenDasz Ice Cream, then have a scoop of ice cream? Slowly work in those positive ways. That’s been successful for a lot of people because you’re building better habits.

Q. What is unique to the LGBTQ community when you’re trying to find these positives?

For a lot of people, if they’re not out of the closet, if they’re not open to their family members or friends, that adds a whole stressor, a whole dimension where we’ll say, ‘Let’s build your friend support, let’s build your family support,’ and this person can’t come out to their family. Automatically, they’re restricted in that support network. They don’t have that. Or maybe they can’t go to their local places of worship because they’ve lost that support network. There’s a lot of fear about coming out at work because of job discrimination. They don’t want to ask their employers for that assistance because of what can happen with their employment.

The medical profession that is supposed to be helping individuals, a lot of times there is concern with outing yourself to a medical professional, or the medical professional is just not comfortable or knowledgeable about LGBT issues, and may do a cookie-cutter approach to treatment and may not be able to treat the whole person.

Q. What tends to work best when looking to be supportive?

Being out and open and having open discussion always is a positive thing. The more you keep things secretive – be they in a family or in a community where you don’t want to talk about a gay pride center or something like that – it makes it feel shameful and gets people secretive. It gets people to internalize stuff, which leads to more depression, more anxiety and more substance use. Get out and open in family discussion, in community, in general.

That aside, take a look at the community resources. We have the Pride Center of Western New York, a fantastic organization which has a lot of supportive groups and programing. They have book clubs to get people who identify as LGBT to get together and meet other people for something simple. They do things for seniors. That’s something you don’t hear a lot about but as baby boomers are aging, they definitely want community resources.

There’s GLYS, Gay and Lesbian Youth Services, which provides resources and 'a safe space' for young people.

It’s getting yourself linked with and identifying programs that might be helpful.

Pride has a list of other resources, including counseling services.

Q. Can you share, generally, a success story?

In the Northtowns, there was an identified male transferring to female, so it was a transgender individual. Multiple suicide attempts. Severe depression. Anxiety. Could not afford the surgery to complete the transition but was on hormone therapy. Could not find any community resources in the Northtowns so came to Buffalo and attended the support group I was running, used it as a support. She attended with her girlfriend at the time and her girlfriend was incredibly supportive. Just having the girlfriend sit in on the group was so meaningful. It reduced the mental health issues. Her self-esteem improved. You could clearly see she went from being suicidal to seeing hope.

 email: refresh@buffnews.com

Twitter: @BNrefresh

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