Closing the Gender Gap in Addiction Treatment
Hugh C. McBride
Among the many strides women have made in the past generation, at least one “advancement” is unlikely to be cause for celebration: According to the Center for Substance Abuse Prevention, one in four abusers of drugs or alcohol in the United States is female, making women the fastest-growing segment of the nation’s substance-abusing population.
This increase in addiction-related behaviors among women is being mirrored by an enhanced effort to understand the gender-specific nature of substance abuse, and an attempt by researchers to “catch up” after decades of study that focused primarily on men.
THE SCOPE OF THE PROBLEM
On the “Women & Drug Abuse” section of its website, the National Institute on Drug Abuse paints an alarming statistical picture:
• 9 million women have used illegal drugs in the past year.
• Nearly 2 million of these women have used cocaine, and more than 6 million have used marijuana in the previous 12 months.
• 3.7 million women have used prescription drugs for nonmedical purposes during the past year.
• More than 70 percent of the AIDS cases among women (accounting for about 28,000 infections) are drug-related.
• Almost half of all women between the ages of 15 and 45 have used drugs at least once in their lives.
The Centers for Disease Control and Prevention estimates that 60 percent of women between the ages of 18 and 44 use alcohol, and about one-third of these women usually have more than three drinks at a single sitting.
Because the average woman weighs less – and has a lower percentage of water in her body – than the average man does, the CDC notes that women who drink expose themselves to greater short-term and long-term damage than male drinkers do.
A DEARTH OF DATA
Though substance abuse has never been a male-only endeavor, a Jan. 1, 2007 article in Psychiatric Times reported that, prior to the past two decades, most research into abuse and addiction ignored women. According to an analysis cited in the Psychiatric Times piece, of all existing articles addressing women and addiction, only about 10 percent had been written before 1990.
In September 2005, the U.S Department of Health and Human Services’ (DHHS) Substance Abuse and Mental Health Services Administration (SAMHSA) contributed to the alleviation of this imbalance with the release of a 104-page report titled “Women in Substance Abuse Treatment: Results from the Alcohol and Drug Services Study.”
In the introduction to this report, editors Thomas M. Brady and Olivia Silber Ashley expressed the importance of the subject and advocated on behalf of additional research into, and funding for, gender-specific rehabilitation and recovery:
Gender is especially important in substance abuse treatment services research because the background characteristics, substance abuse patterns, and personal histories of female substance users may differ from those of males.
As such, treatment programming designed specifically for women is needed to address not only women’s substance abuse-related problems but also their special needs and barriers to treatment...
At the national, state, and local levels, policymakers and service providers need new knowledge to understand how male and female substance abuse treatment clients differ in terms of socio-demographic and substance use characteristics and retention in treatment. Information about the availability and effectiveness of substance abuse treatment programming for women can help guide public policy about how the treatment system should be structured.
GAINING INSIGHTS
With women accounting for an ever-increasing percentage of the drug and alcohol abuse that occurs in the United States, researchers and treatment professionals are attempting to make up for lost time by working to better understand the gender-specific nature of addiction. The most obvious, and perhaps also the most important, result of this new attention is an increase in diagnoses of addiction disorders among women.
The authors of a study that was published in the March-April 2007 edition of the journal Women’s Health Issues found “dramatic changes” in the numbers of women aged 15 to 44 who received substance-specific diagnoses between 1998 and 2003. For example, the researchers found that diagnoses for cannabis abuse increased by 35 percent during the period studied, while hospitalization for amphetamine abuse increased by 50 percent.
The study’s lead author, Shanna Cox of the CDC, observed that overall hospitalization rates for substance abuse remained the same for the study group as a whole, but hospitalization for women in the age 15-24 subcategory increased by 23 percent. This and other data, Cox wrote, could be valuable “to quantify emerging trends in substance abuse and promote the use of hospital-based interventions.”
Another significant discovery from the past 10 years involves the speed with which addiction progresses in many women. Researchers have discovered that though most women who enter treatment have abused smaller quantities of substances for a shorter time period than have recovering males, their addictions had become acute much quicker than their male counterparts’ had.
Referring to this phenomenon as “telescoping,” Psychiatric Times noted that both biological and psycho-social influences may be responsible for the rapidity with which many women advance from regular use of a substance to treatment for addiction. The article also observed that women who are addicted generally encounter more “medical, psychiatric, and adverse social consequences of substance abuse” than males addicts do.
CONTINUED PROGRESS
With addiction recovery experts and other health care professionals gaining a greater understanding of how substance abuse affects women, they are better able to extend this knowledge beyond the diagnosis stage and into the treatment and rehabilitation arenas.
The Four Circles Recovery Center for young adults ages 18 to 28 in Horse Shoe, N.C., and the Passages To Recovery wilderness program for adolescents in Loa, Utah, are two of many facilities and programs that offer gender-specific treatment options.
Jack Kline, executive director, said that the Four Circles experience features female therapists who specialize in women’s issues and all-female support groups that provide recovering clients with “a compassionate, nonjudgmental environment for women to share their stories, fears, struggles, and life lessons with other women who have walked in their shoes.”
Rebecca Wildbear, a licensed professional counselor and wilderness therapist with Passages To Recovery, said that the all-female groups that she leads allow participants to discover “the beauty of nature and their own inner beauty” while becoming “more honest, more open, and more empowered.”
As gender-specific research continues to be performed – and female-focused treatment innovations continue to be implemented – a clearer understanding emerges of the many factors that influence the diagnosis, treatment, and recovery of women who abuse alcohol and other drugs.
According to some experts, this effort is producing results that are literally life-changing. “Women’s groups tend to be more supportive, less confrontational, grounded in women’s experiences, and focused on empowerment and women’s strengths,” said Heather Schnoebelen, clinical manager of the women-only track at Four Circles Recovery Center. “In an emotionally secure environment, young women challenge their beliefs about themselves in order to grow into the women they want to be.”
SOURCE: CRC Health Group
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