Addiction Among Women
Evaluating an Individual’s Treatment Needs
Addiction Among Women
Though anyone can develop an addiction to an intoxicating substance, each individual’s experience with addiction is different. How one experiences addiction depends on many factors, including genetic biological traits, the environment during childhood and adolescence, and the current network of social support. It’s also affected by the person’s gender.
Much of the early research on addiction was focused on men as the researchers assumed that addiction was primarily a male problem or that women would have basically the same experience of addiction that men have. However, due to both biological and environmental factors, addiction in women is different enough that it affects the way in which treatment should be approached.
The signs of addiction can also be different for women. If you’re a women who suspects she may be addicted to a substance, or you know a woman who may be developing an addiction, this guide will help you to understand more about what dependence looks like in females and how to help a woman who has developed an addiction disorder.
Chosen Substances for Women
The most commonly used substances among women are alcohol, nicotine, and prescription medications. In all cases, except for prescription opioids like Vicodin and OxyContin, men are more likely to abuse the intoxicant than women. However, that gap has been steadily closing.
According to the National Institute on Alcohol Abuse and Alcoholism, 9.4 percent of all adult men in the US were considered to have alcohol use disorder (AUD) compared to only 4.7 percent of women. Men are also more likely to engage in heavy use and binge drinking, and more likely to die from alcohol-related causes.
When it comes to nicotine, 23 percent of women consume the substance compared to 35 percent of men, mostly through cigarette smoking. Like with alcohol, women appear to have a harder time quitting and are more likely to start up again. About half of all female smokers cited fear of weight gain when thinking about quitting smoking tobacco.
Women are almost just as likely as men to abuse illegal stimulants like cocaine and methamphetamine. In fact, women report starting the use of these substances at an earlier age than men. Once again, they find it harder to quit. However, men are three times as likely as women to abuse marijuana.
Finally, with prescription opioids, women are more likely to abuse them than men. Experts believe that this is due to the fact that women are more likely to suffer from chronic pain conditions. It also may be due to the fact that the social stigma attached to drug use is significantly reduced when it comes to doctor-prescribed medications like Vicodin.
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Why Women Abuse Drugs
Women tend to have different circumstances that men don’t often experience that inform their decisions to use and abuse substances. Social stigma, extra life pressures, and shame affect both why and how women interact with drugs. Some of the unique reasons women turn to drug abuse include:
- To reduce stress from the social pressure of being the perfect woman (a loving mom, caretaker, house manager, and career woman)
- To lose weight in the face of demands from society and the beauty industry to look a certain way
- To impress men or attempt to break stereotypes that women are unable to handle certain substances
- To deal with sexual trauma, which women are much more likely to suffer
- To self-medicate for a higher incidence of mental illnesses like anxiety and depression
When it comes to alcohol, excessive drinking was long considered to be socially unacceptable for women. As that social stigma vanishes, women feel free to drink as much as they want. Unfortunately, their models for alcohol abuse tend to be men, and they may feel pressure to “keep up” with men in terms of its consumption. Because women have, for the most part, bodies that are more apt to retain alcohol instead of flushing it out, and because women are typically smaller, attempting to drink as much as men can be very dangerous. On college campuses especially, women are also often pressured to drink more as part of an effort by predatory men to get them to become sexually available.
Though smoking tobacco has become less socially acceptable in general, women are more likely to use stimulants such as nicotine, cocaine, and prescription amphetamines. A big part of this is simply due to the fact that these drugs suppress the appetite and tend to contribute to weight loss. The pressure for women to maintain an excessively thin appearance is tremendous in the US. Though things are slowly starting to change, female models and actors have become thinner over the years, and tolerance for any sign of body fat seems to be at an all-time low. However, for many women, it’s nearly impossible to achieve anything close to this beauty standard on their own. They therefore turn to appetite suppressants to make the intense dieting bearable.
Social stigma against illegal substances other than stimulants, as well as safety concerns, have kept rates of use among women low, though it’s still rising. During 2009-2011, 6.7 percent of womenreported using an illegal drug in the past month compared to 11 percent of men. It’s important to note that illegal drug use is correlated with poverty, and women are more likely to be living under the poverty line than men in every state in the country.
Prescription drugs are, of course, much easier to access than illegal substances, and there’s much less of a stigma associated with taking them. Women actually may face less social stigma than men when it comes to obtaining these drugs as many are associated with pain and mental illness. Our society tends to label men who need help with these issues as “weak,” telling them they should “man up” and deal with it on their own. This is a harmful stigma, but conversely, it may be keeping prescription medication abuse among men lower.
Both long-term illnesses caused by the accumulation of damage in the body and brain as well as the more immediate risk of overdose are different for females. Part of this is due to biological factors. Women weigh less than men, have less water in their systems, and have more fatty tissue on average. Water dilutes alcohol, so having more water in the body as well as more mass in general makes it harder to become intoxicated and protects the organs from damage. Fatty tissue, on the other hand, retains alcohol. Women also have lower levels of certain liver enzymes that break down alcohol, meaning more of the substance enters the blood stream.
One of the dangers of focusing medical research and treatment on only men in terms of substance abuse is the fact that women are more at risk for overdose due to lesser body mass and other biological factors. Though men still die more from drug overdose than women, the average man can take a certain amount of most substances and live while the same amount would kill a woman. Because of all this, overdose death among women is on the rise.
With the increase in the popularity of prescription drug use and abuse comes an increase in overdose cases. The number of women who died from overdose of prescription medications increased 400 percent from 1999 to 2010, according to the Centers for Disease Control and Prevention (CDC). This is considerably more than the increase in deaths among men, which was 250 percent in the same time period. This increase was even more extreme for middle-aged women (age 45-54). Experts believe that this is due to the fact that women around this age are more likely to suffer from chronic pain issues. They’re therefore more likely to obtain a prescription from a doctor, be prescribed a higher dose, and tend to use the drug for a longer period.
Even if overdose is avoided, women suffer greater long-term health effects from substance abuse simply because it takes less of a drug to do the same amount of damage that would be found in a typical man’s body. Women more easily accumulate organ damage from drug abuse, making them more vulnerable to liver disease, heart failure, kidney problems, intestinal damage, cancer, etc.
In spite of the fact that women are generally less likely to abuse alcohol, 42.7 percent of all liver disease deaths among women in 2013 were related to alcohol compared to 48.9 percent for men. This is significant considering the fact that nearly twice as many men are considered to have AUD as women. Women are also twice as likely to have a heart attack related to smoking nicotine and more likely to develop lung cancer.
Women are more prone to developing an addiction to substances through lesser use of any drug. They also tend to experience more social consequences yet have a harder time quitting and are more likely to relapse. Part of this is due to differences in the response to stress between men and women. Though the reasons are unclear, women are more likely than men to relapse into substance abuse in response to a stress trigger and give in more easily to situations that trigger cravings.
Mental Illness and Addiction
Women are significantly more likely to be diagnosed with common mood disorders such as depressive and anxiety disorders. All people suffering from mental illness are more likely to abuse substances than others – in a 12-month period, the rate of mood disorders among women who also suffered substance abuse disorders in a study group was 29.7 percent. The presence of a mood disorder makes it more difficult to quit and avoid relapse, and should be strongly considered when coming up with a treatment plan for an individual struggling with addiction.
There’s also a strong connection between substance abuse and eating disorders. Among cases of anorexia nervosa and bulimia nervosa, 85-90 percent of the sufferers are female. Up to 50 percent of women with eating disorders also have substance use disorders. This is especially true with stimulants that cause appetite suppression and weight loss. Plus, the further decreased body mass makes addiction even more likely.
Women are more likely to experience traumatic events that create a high incidence of post-traumatic stress disorder (PTSD). Rates of sexual abuse, sexual assault, and rape are far higher for female persons than for male persons, and a significant number of victims of this type of trauma will develop PTSD. According to studies, 34.4 percent of people with PTSD reported at least one substance use disorder. Even more alarming is the rate of physical or sexual abuse histories among women who seek treatment for drug addiction – anywhere from 55 percent to 99 percent.
Treating Addiction in Women
In 2015, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a new Treatment Improvement Protocol(TIP) entitled Substance Abuse Treatment: Addressing the Specific Needs of Women. It addresses the role of gender-specific stress and relationship patterns in women, economic factors, cultural issues, and more in reference to substance abuse and addiction among female individuals and how that affects how the type of treatment plan that doctors, addiction specialists, and mental health professionals create should be tailored.
Women are less likely to seek treatment for substance use disorders than men. This may be because there’s a greater stigma against substance abuse for women, meaning they are more likely to hide it if they have a problem. The only exception to this is with the abuse of anti-anxiety and sleep medications, for which women are more likely to seek treatment. This is likely due to the stigma men face for admitting they have mental health issues.
Women also face more practical barriers to treatment such as having more family responsibilities and a greater risk for poverty – more than one in seven women in the country lives below the poverty line. Treatment in the US can be expensive, and it can be taxing to both the individual and her wallet to find time to travel to and spend time at therapy appointments, support group meetings, and rehabilitation programs. They may also have to fear that their children will be removed from their care if they admit they have a substance abuse problem.
When it comes to pregnant women, it’s important that they are encouraged to seek medical help if they’re going to attempt quitting. While the use of any intoxicating substance during pregnancy puts the fetus at risk, suddenly stopping all use of the substance can be just as dangerous. Women may be apprehensive about seeking help due to even stronger social stigma against substance use while pregnant and the fear of being prosecuted for endangering the fetus. However, federal law requires that all hospitals and treatment centers prioritize pregnant women with substance use disorders and provide prenatal care. Doctors are also required by law to keep patient records and interactions confidential.
For all of these reasons, effective treatment for women looks different than it does for men. Women often need extra economic support, childcare options, and may respond better to outpatient treatment than traditional rehab programs that require the addicted individual to stay in a facility for an extended period of time. It’s important that women are screened for mental illnesses, especially PTSD, and be encouraged to reveal whether they’ve endured any past physical or sexual abuse. More emphasis needs to be placed on avoiding relapse and implementing methods to cope with stress triggers. Relationship management should be taken into account as well.
Due to the fact that there are so many unique factors that need to be considered when recognizing and treating addiction in women, it’s important for them to seek out programs that will address their specific issues and needs. Unfortunately, researching into gender differences among addicted individuals was lacking until recently, with 40 percent of all studies being published after the year 2000.
Here are some resources that women can turn to if they feel they need help addressing a substance use problem:
- Women for Sobriety:
WFS is a nonprofit organization dedicated to getting women suffering from addiction disorders on the road to recovery. It was created by women for women and focuses on the unique stressors that women face as the underlying causes of substance abuse.
- Women’s Services Coordinators:
A network of professionals who work specifically to address the needs of women in connection to substance abuse. Contact information for the professionals is listed by state.
This is a division of the U.S. Department of Health and Human Services. They provide information, services, and programs dedicated to improving the health of women.
- Substance Abuse Treatment for Women:
This is chapter seven of SAMHSA’s Treatment Improvement Protocols. This chapter includes a broad range of information on addiction among women and treatment needs.
- Counseling and Addiction:
This in-depth article describes the different types of therapy used to treat addictions and the benefits of each type.
Anyone suffering from addiction should seek information and professional treatment. Due to the lack of research on how addiction presents and should be treated in women until recently, it’s especially important for female individuals to do their own research and to make sure any health professionals they see are aware of the differences between men and women in terms of substance abuse and dependence.