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August Embracing Diversity Crossing Barriers To Deliver Treatment to Everyone

John de Miranda Ask the Expert

Aug Embracing Diversity Crossing Barriers To Deliver Treatment to Everyone

Ask the Expert:  John de Miranda, Ed.M., President and Chief Executive Officer of Stepping Stone of San Diego and the pro bono Executive Director of the National Association on Alcohol, Drugs and Disabilities, Inc.

  1. Can you recommend some good LGBT online recovery forums and/or blogs?

There are lots of internet sites focusing on LGBT recovery issues. Since most are geographically based you should do some Googling. is 12-step oriented and has a nice listing of gay AA meetings and news items.


  1. I have been to general population recovery support groups in the past, but I have always felt that my specific needs as a gay man have been unaddressed.   Is there any way to find out more about support groups/programs specifically geared towards the gay community?

In addition to the website above, the Pride Institute, an LGBT-specific treatment program in Minnesota discusses LGBT-specific AA Roundups on its website as another resource for sober socializing. 

“Almost every major city in the United States has a weekend set aside for an LGBT AA Round Up every year. Round Ups are Alcoholics Anonymous Conventions aimed toward recovery, unity, and service for the LGBT community.”

I would also suggest identifying other individuals who could form the core of an LGBT support group or gay 12-step meeting.



  1. What role does culture play in the treatment and recovery process for LGBT patients? How do culture and sexual preference interact?

A terrific resource for exploring our understanding these and other issues is A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual and Transgender Individuals, published by the federal Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration.


“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.”

The 190+ page manual is available as a free download:



  1. How can I advocate for LGBT recovery initiatives in my local community? Can you give me any advice or lead me to any tools for creating change/awareness about addiction within the LGBT community?  And, not just recovery, but also prevention too?  Thanks.

A good place to start is Chapter 17 in A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual and Transgender Individuals is titled “Using Alliances and Networks to Improve Treatment for Lesbian, Gay, Bisexual and Transgender Clients.”

My organization, Stepping Stone of San Diego, began including advocacy skill training into our treatment program with an expectation that as people enter long term recovery they may be interested in joining organizations that seek to change societal attitudes towards marginalized groups. An article about our program appeared in Addiction Professional. “Mixing Advocacy with Treatment: A California treatment center helps clients find a voice on community issues” is available.


  1. I have been in recovery of alcohol for over 20 years now and would love to share my knowledge and experiences with those who are just starting out in their recovery process. Do you know how I could get involved in a LGBT peer support program?

Specialized treatment services specifically targeting the LGBT community are rare and mostly exist in large metropolitan areas. If you live in a community without a visible LGBT treatment program you might have to hunt around…or consider starting something yourself. Our organization which today employs 20 staff and has a budget of almost $2 million was started by several members of the LGBT community 34 years ago, because the existing treatment providers were unfriendly to gay people.

Please consider sharing your story on the Faces and Voices of Recovery website. Here you can join with other’s to speak your truth about recovery.



  1. Can you provide advice or support on how to start up a new LGBT Recovery Month event?

I would start by checking to see if there is a recovery month event already in place that would be interested in a visible LGBT component. If your community has a walk for recovery, for example, maybe you could organize an LGBT contingent or after-party. If you start a new event make sure that you post it to the Recovery Month website, which is also where you can learn of other events in your community.


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