Abstract
In the United States, lesbians are the subject of discrimination due to homophobic practices. Within the realm of substance abuse, there are disparities in substance use and treatment. Literature was reviewed to assess factors that contribute to lesbian substance abuse and effective treatment modalities that provide positive outcomes for this population. Literature suggested several reasons for a lesbian's higher risk for substance abuse including social stigma, discrimination, difficulty with identity development, and obstacles in relationship acceptance by society. Literature points to the importance of cultural competency and gay affirmative substance abuse treatment practitioners when working with lesbian clients. Recommendations for substance abuse practitioners are presented.