The treatment and recovery community must evolve to meet the needs of 21st century women.
The social distance between men and women in today’s society is ever-shrinking. An increasing number of women are employed full-time, and strides are being made to treat women as equal to men with respect to pay and opportunities, both inside and outside the workplace. Because the foundation of our society was built to view men as the norm, however, we are still lacking in our ability to fully understand and support women.
This fact is especially clear in the area of substance abuse treatment.
Women Today Abuse Drugs and Alcohol at a Higher Rate Than Ever Before
Historically, substance abuse has been much more common in men than women. The social pressure to use substances, as well as the social acceptability of doing so, was much greater for men, and substances were more widely available for their consumption.
While that gap still exists (substance use disorders are about twice as prevalent in men than in women), studies show it’s been decreasing over the last half-century. This is thought to owe to many factors, from increasing socialization (women who work outside the home are more likely to go out for happy hour, for example) to increased stress over balancing the demands of parenting, which often falls disproportionately on mothers’ shoulders, with social and professional obligations.
While an increasing proportion of the female population suffers from addiction, a majority of the research on addiction and recovery has been performed on male subjects. This poses a problem because it ignores biological distinctions between men and women as well as the different social pressures to which women are still subjected, even in modern society.
Thankfully, in the last thirty years or so, researchers have increasingly focused on the ways in which the differences between men and women play out with respect to substance use. While work is still ongoing, what they’ve found highlights the complexities of providing treatment for women with substance abuse disorders.
Complex Factors Affect Women’s Substance Use Profiles
Several aspects of a woman’s biology affect the way she uses substances, including whether or not she is likely to become addicted.
Women are affected more strongly by alcohol than men, for example: because the average woman’s total body water is lower, alcohol becomes more concentrated in her blood. Additionally, the same woman is thought to have lower levels of an enzyme, which metabolizes alcohol – so the substance lingers in her body for longer than it would in a man’s.
A woman’s hormones and menstrual cycle can play a role in how rewarding a substance is, and therefore how likely she is to use it again. And, once a woman begins using a substance, the disorder of substance abuse is likely to progress more quickly than it would in her male counterpart, a phenomenon known as telescoping.
Women are also significantly more likely to have experienced trauma or sexual abuse, and exhibit signs of major depression, anxiety, and PTSD at much higher rates than men; these conditions can further complicate the presentation of substance use disorders.
For one thing, it takes a practitioner with a high level of expertise in both arenas to tease out the mental health condition from the addiction and create a treatment plan that acknowledges the multi-faceted nature of the client’s need.
Also, in cases where a mental health condition needs to be treated with medication, balancing the introduction of the prescription medication with the removal of the addictive substance can prove difficult. Clients with mental illness are also more likely to relapse when their mental health condition resurfaces.
Socio-emotional Barriers Affect The Way Women Seek Treatment
Women face a suite of pressures in today’s society that men, in general, don’t, and many of these play into a woman’s ability to seek addiction support and her comfort level in doing so.
One large obstacle to women seeking treatment for substance use disorder is child rearing responsibilities. While women are more likely to work outside the home now than they were even a couple decades ago, many women still bear the majority of the responsibility for the care of their children, from attending school events and arranging childcare to physically caring for the children before and after the work day.
A mother who feels these pressures is understandably hesitant to enter a treatment program that would affect her ability to see and care for her children, especially if she fears they will be removed from her care because of it. Losing custody, in fact, is such a salient fear that the mere prospect might dissuade a woman from admitting she has a substance abuse problem and seeking treatment for it.
Even a woman who does enter treatment is less likely than a man to stay in a residential program for more than 30 days, in large part because being away from her family and responsibilities becomes a distraction to the point that it prevents her recovery from progressing.
Women, on average, make less money than men as well, which could affect their ability to pay for treatment. Additionally, many women feel undervalued and replaceable in their jobs and fear that once treatment is completed, they will face the additional pressure of having to find a new job or being subjected to undesirable scheduling.
Women may also be discouraged from going into treatment from their partners, for the financial and family reasons outlined above in addition to the possibility that the woman’s partner also suffers from substance use disorder.
Finally, many women who do seek treatment choose do so in mental health settings. While the reasoning for this isn’t clear, it could be due to a number of factors. First, the decreasing stigma on recognizing and seeking treatment for mental health struggles might make it easier to seek treatment in an inpatient mental health program.
Mental health placements are typically shorter than 30 days; such shorter treatment intervals might seem attractive, but can also lead to greater levels of relapse since the substance use disorder itself is only peripherally addressed in such a setting.
Women Have Unique Treatment Needs and Preferences
Preliminary research differs on whether or not women respond best to different treatment methods than men. What is clear is that many women who seek treatment choose to do so in women-only treatment facilities, which are much less prevalent than men-only programs.
Women also typically use substances for different reasons than men, and they also respond best to different therapeutic approaches, and so therapists must adjust their style to account for the needs of different genders, regardless of whether or not the general treatment approach is the same.
Society must evolve in order to meet and support
women’s treatment and recovery needs
Women face many barriers to finding effective treatment for substance use disorders. Whether because of family obligations, mental health concerns, or societal inequities, women who suffer from addiction are less likely to seek treatment and less likely to stay in programs once they get there.
Women alone cannot bear the sole responsibility for removing these obstacles. As a society and a treatment community, we can take many steps to make it easier for women to seek treatment.
How Can We Help Women Struggling with Addiction?
First and foremost, treatment options must be available which acknowledge and value a woman’s need to protect and care for her children. While some recovery centers exist which provide care for children, often the care occurs during the daytime only, precluding a residential stay for the woman.
For women who don’t have the option of entering a program with child care, there are even fewer options available. Absent the ability to provide residential care for children, centers could work with women to secure temporary placements for children during treatment, or could work with social services to provide another parent or family member with support in caring for the children while their mother receives the help she needs.
The addition of women-only treatment centers, or women-only programs within existing treatment centers, would be another step toward ensuring the ability of all women to have their needs met around addiction treatment and recovery.
It is vital in these cases that treatment providers are well-versed in the complexities that may be present in cases of women who suffer from substance abuse, including mental health diagnoses, response to trauma, and effective therapeutic approaches.
As a society, we have a tendency to look at substance abuse as a personal failing, and at failure or reluctance to seek treatment as a selfish choice. However, there are complex family, social, and biological factors which lead a person to begin using and abusing substances. Because of social pressures and biological differences, these factors can prove even more complex for women.
By showing compassion and support to our friends and family members who are suffering with this disease, we can help them get the help they need so they can begin to understand, and eventually change, their behavior.
If you know a woman who is suffering from substance abuse, you can take the first step by talking with her and showing your concern. If she expresses unease about seeking treatment, offer to help in any way you are able, and offer to connect her with the resources that can help ensure her responsibilities are taken care of while she gets help – social services, counseling services, or local treatment centers are a great place to start.
If you’re struggling with drug or alcohol abuse, give our Admissions Team a call at (817) 993-9733. Or, you can email us at firstname.lastname@example.org. We have gender-separate treatment options for both men and women, respectively, and are happy to help you kickstart your recovery.
Nikki is an author and mental health advocate who combines personal experience and scientific research to investigate topics that deserve to be discussed. You can read more of her work at medium.com/@nikkikayauthor, and follow her @nikkikayauthor on social media.