Michael Liimatta

In our previous installment, we introduced the July 2002 Caron Foundation report, “Women & Addiction: Gender Issues in Abuse and Treatment.”   In discussing the first part of this report, we paid particular attention to the some of the trends related to addiction among women and some of the reasons women become addicted.   Now we will turn to what the researchers have learned about women and addiction treatment and explore some of the challenges they face in getting help to overcome addiction.

A.         Limited Access to Services — The Caron Foundation study found that only about one third of women who want addiction treatment are able to get it.   We face a time of great cutbacks in the willingness of insurance companies to pay for treatment services.   Even those who do cover it, rarely pay for more than two weeks of inpatient programs.   Meanwhile, for those without insurance, most government-sponsored programs have long waiting lists that discourage most from seeking the help they need.

B.         Gender Differences in Attitudes Toward Treatment – Men are more likely than women to become involved with treatment for addiction. This is partly because men are more likely to experience legal problems or trouble on the job because of their drinking or drug use.   As a result, the focus for the need of treatment and counseling tends to be on the male adult in the family.   Meanwhile, the addiction of the female adult family member may not be detected.   Women usually do most of their drinking and drug use in private, so their problems may not be as immediately apparent.   For a variety of reasons, women have a very difficult time when it comes to admitting an addition problem.   They are more likely to look to a mental health profession, instead of an addictions counselor, to deal with problems in their lives.   Admitting to addiction is sometimes considered more shameful for women than it is for men.

C.         How Relationships Affect a Woman’s Decision to Seek Help —Women function in the context of a complex web of relationships that includes both their male partners, their children, and their parents and siblings.   For instance, women addicts are more likely to receive the money they use for alcohol and drugs from their parents than are men.   There is a real tendency for family members to protect and make excuses for the female addict.   It is interesting to note that women are usually more supportive of their men seeking treatment, while men are usually not as likely to be supportive of female partners seeking treatment.   This is an important point, since many of the female addicts seeking help at rescue missions probably will have a male partner out there who is actively discouraging them from seeking help.

D.       Issues Related to Children – Fear of losing their children is often a reason many women do not want to admit to having an addiction problem.   This same fear can be a very significant motivation for completing treatment and seeking a life of sobriety.   Residential programs that allow female addicts to have their children remain with them while in treatment have much higher rate of success than programs that do not provide living arrangements for children.   One study found that six months after completing a treatment program, women assigned to live with their children were more likely than the other women to report abstinence from drugs and alcohol, involvement in aftercare or support groups, employment, custody of children, and no arrests or incarceration. An important ministry for rescue missions is providing supportive family-oriented housing for women while they participate in either an in-house or outpatient treatment program.

E.         Gender Specific Programs     Recent studies confirm what rescue missions have known all along; women do better in treatment programs that are gender specific.   In mixed gender programs, women tend to take a “back seat” to the men and are less likely to share their own struggles.   Additionally, the research shows that female addicts do better with female counselors.   This is especially true for counselors from whom they sense a great deal of caring and those with whom they have developed a significant level of trust.

F.         Specialized Services for Women — To be successful with addicted women, a variety of specialized services are needed.   These may include:

•        Food, clothing and shelter
•        Transportation to treatment
•        Child care during treatment
•        Job counseling and training
•        Legal assistance
•        Literacy training and other educational skills
•        Parenting skills training
•        Family and couples therapy
•        Medical care and family planning services
•        Social support services
•        Psychiatric assessment and mental health services

While most rescue missions are not able to offer all of these programs in-house, they can accomplish this by developing a good referral network and bringing in resources from the local community.

“Women & Addiction: Gender Issues in Abuse and Treatment “is available online at:

https://www.caron.org/pdf/Wmn&Addctn-GenderIssues.pdf.

See Women and Addiction Part 1

When most people think of the alcoholics and addicts served by rescue missions, they think of the “Skid Row bum” — a disheveled older alcoholic who has lived on the streets for years.   But, especially in recent years, the number of young female addicts who look to missions for help is on the rise.     According to Dr. Susan Merle Gordon of the Caron Foundation, “Addiction doesn’t have the face most Americans imagine when they think of an alcoholic or drug addict.   Dr. Gordon is the author of “Women & Addiction: Gender Issues in Abuse and Treatment,” a 2002 research report issued by the Caron Foundation, one of the nation’s most respected alcohol and drug addiction treatment centers.   Here are some of the most significant findings of this research:

A.   Prevalence of Addiction   – About 4.5 million American women abuse alcohol, 3.5 million abuse prescription drugs, and over 3 million regularly use illicit drugs.   Drug use among women is increasing at higher rates than among men. At this time, teenage girls abuse drugs and alcohol at the same rate as boys.   This is bad news because women tend to become addicted more quickly than men, and then experience resulting medical problems sooner.

B.   Gender Differences     Men are more likely to be binge drinkers and start using drugs and alcohol at an earlier age than women.   Men are more likely to drink in social situations and in response to positive emotional feelings.   Women tend to drink in isolation, when pressured by an alcoholic partner or in response to negative emotions.

C.   Intimate Relationships – Women are likely to be introduced to drugs and alcohol by men with whom they have an intimate relationship, while for men, it is usually a male friend. One-third to one-half of women with addictions live with a man who also is addicted to drugs or alcohol. Women who are married to men who drink heavily also are likely to abuse alcohol.

D.   Violence and Addiction — Women who experience physical and sexual violence are at a higher risk for substance abuse compared to others. They also suffer more severe addiction along with mental health problems. Some studies indicate that up to 90% of women with drug problems have been sexually abused at least one time in their lives.   More than half of alcoholic women seeking treatment have experienced incest or rape. Nearly a quarter of them experience this abuse in childhood compared to 11% of other women. Drug and/or alcohol abuse are also a risk factor for continued victimization.

F.   Psychiatric Risk Factors   – Every psychiatric diagnosis is more common among female addicts and alcoholics.   Depression and anxiety disorders are the most common, most often appearing prior to the substance abuse problems.   The combination of depression and addiction leads to a high vulnerability for suicidal thoughts and behaviors. Alcoholic women are five times more likely to attempt suicide than other women.   Therefore, a primary diagnosis of depression requires psychiatric treatment in addition to addiction treatment. Female substance abusers have lower levels of self-esteem and a poorer self-image than do male substance abusers.     They often suffer from extreme feelings of guilt, anxiety, self-blame, depression, suicidal thoughts and feelings, and dissociation. Eating disorders are also more common among female addicts and alcoholics.

G.   Medical Problems – Women are more vulnerable to the negative health affects of drugs and alcohol abuse than men. Four times as many women will die this year from addiction-related illnesses than from breast cancer. Other medical conditions, such as malnourishment, hypertension, and sexually transmitted diseases are also more common among female addicts.   Female addicts experience increased rates of accidental death, automobile crashes, breast cancer, osteoporosis and gynecological problems. Heavy alcohol consumption results in inadequate absorption of calcium that increases an addicted woman’s chances of serious bone disease. They are also likely than men to develop alcoholic hepatitis and cirrhosis of the liver.

H.   Addiction and Pregnancy   – Mood altering drugs and alcohol cross the placenta and cause harm to the developing fetus. Exposure to drugs, such as alcohol, cocaine, amphetamines, heroin, and nicotine, increases the chance of spontaneous abortion, perinatal mortality, premature birth, low birth weight, and to developmental and behavioral problems in infants.   Fetal alcohol syndrome (FAS), the most preventable form of mental retardation,   is characterized by abnormalities to the central nervous system and is associated with mental retardation and other behavioral, facial, and neurological abnormalities.

I.       Social Consequences of Addiction – Substance abuse negatively affects women, as well as their children and families. Young female alcoholics experience higher rates of assaults and victimization.   This may be due to violence in their homes and because drinking in public spaces makes them vulnerable to attack. Arrests and incarceration of girls and women for drug-related offenses has increased dramatically in the past decade. Arrests of girls and women for sale and/or possession of illegal drugs increased 42% from 1991 to 1996. Incarcerated women often have children who are then raised by relatives or placed in foster care. These children also have an increased risk of drug and alcohol abuse.

“Fortunately, research shows that addiction treatment works, although only 30% of addicted women get treatment,” said Gordon. Those who are treated in women-only treatment programs are more likely to complete treatment than those in mixed gender programs, and have a better recovery rate.

“Women & Addiction: Gender Issues in Abuse and Treatment “is available as a PDF file online.

See Women and Addiction Part 2