Prevalence

Various older studies indicate that about one-third of all homosexuals will have a problem with substances at some time in their lives (Diamond-Friedman, 1990). In a more recent study, however, McKirnan & Peterson (1989) come to a strikingly different conclusion. Based on their very large (n=3,400) and well-controlled study, they criticize earlier studies as being biased for several reasons, not the least of which is that they were made in gay bars of the bar-going population. McKirnan & Peterson (1989, p. 549) found the following percentages of homosexuals reporting alcohol problems:

Significantly, up to age 30 the homosexual men in the study show no higher incidence of alcoholism than men in the general population (although homosexual women show significantly higher levels). But after age 30, the high incidence of alcohol problems declines much less in the homosexual population than it does in the general population.

Why are older homosexuals at greater risk of alcoholism? The author has found no sufficient explanation in the literature. McKirnan & Peterson (1989) suggest that psychosocial or cultural variables in the homosexual population might be responsible for increased alcoholism in the later years. They hypothesize that homosexual men and women do not typically enter traditional marriages or childbearing roles as they age, are often not in mainstream occupations, and do not typically adhere to traditional sex roles, all of which encourage control of drinking. The author suggests that more significant than "encouraging the control of drinking," the functions of childbearing and childrearing may have a significant part in the emotional happiness and stability of the parents, being biologically ego-syntonic which, in turn, could relieve feelings of loneliness and lack of fulfillment which give impetus to drink.

Author suggests several other explanations as to why today's older gays have a higher rate of alcoholism:

Today's older homosexuals faced a more closeted life in their young years, with a much higher prevalence of the stressors discussed above. Gay liberation had not yet struck. They began drinking heavily earlier and, addiction being a disease most frequently progressing into middle age before being addressed, were addicted by their middle 30's. Thus, the higher rates of alcoholism in those over 30 shown by McKirnan & Peterson (1989) may be caused by an even higher incidence of alcoholism in the pre-liberation group, which is now in its 30's, 40's and 50's. That male homosexuals under the age of 30 should show no greater incidence of addiction may be a testament to the positive effects of gay liberation.

Another untested hypothesis which occurs to the author is that many older homosexuals (say, over 35) are faced with the daunting task of competing for lovers, friends, and sexual partners in the unrelentingly youth-oriented, beauty-driven gay culture. One of the major tasks of middle age for homosexuals is to reach acceptance that they are no longer able to compete for lovers or sexual partners on the basis of beauty (of which youth, in the homosexual population, is ordinarily a requisite), and accept that their sex and love lives may be substantially less fulfilling, or fulfilling in different ways, than when they were younger. Many homosexuals as they pass 35 turn increasingly to drugs and alcohol for solace and companionship.

Treatment