While addiction to alcohol or drugs was once viewed as a moral failing, the modern view treats addiction as a chronic and relapsing disease. While there is no cure for addiction, it is eminently treatable. Women in addiction treatment, whether in a drug rehab center or as an out-patient, face unique challenges stemming from social and biological factors.
While men across most age groups have higher rates of drug and alcohol use and dependence than women, women are nevertheless just as likely to develop substance use disorder (National Institute on Drug Abuse). Men are more likely than women to use almost all varieties of illicit drugs, including marijuana. Illicit drug use is more likely to end up with a visit to ER or death by overdose for men than women.
According to the National Institute on Drug Abuse, women use drugs differently than men and they respond to drugs differently, too. Throw in the barriers to effective treatment that can so often prevent females from getting the help they need for addiction, and there is still plenty of work to be done.
How does gender impact rates of substance abuse?
Men have historically been more likely to abuse substances than women, but some evidence shows this pattern is shifting. This review of studies on substance abuse rates by gender spanned several decades. The findings show that the ratio of male/female substance abuse is gradually equalizing. Whereas in the 1980s, the male/female alcohol abuse ratio was 5:1, a more recent snapshot shows this gap has narrowed to 3:1.
Age has a noticeable effect on drug use between the sexes. SAMHSA data shows that in the 12 to 17 demographic, there is parity in the use of illegal drugs between the genders. Only in adulthood does this ratio swing in favor of males.
Despite these changes, more men still struggle with substance abuse than women. The most substantial substance abuse study in recent years was NESARC (the National Epidemiologic Survey on Alcohol and Related Conditions). Data shows that men are 1.9 times more likely than women to become dependent on drugs, and 2.2 times more likely than women to abuse drugs.
Thankfully, there are ways to get help. Women’s Alcohol and Drug Rehabs are designed to help women facing these struggles overcome them.
Women’s recovery: Biological and cultural factors
Women often experience a unique recovery journey due to some simple biological and cultural factors. Let’s discuss those influences in more detail.
Biological factors
Substance use disorder progresses more rapidly in women than men, on average. Women also may have more cravings than men when detoxing and withdrawing from substances. This is one factor that can make the difference between women relapsing during or following addiction treatment.
There are also physiological differences that speed up addiction’s progression. Women tend to metabolize drugs differently than men. With more fatty tissue and fewer stomach enzymes in women’s bodies, they are exposed to greater concentrations of substances than men.
Cultural factors
Women often suffer from higher levels of stigmatization when it comes to substance abuse. Why? They are often still viewed in traditional roles as mothers, caregivers, and the organizing force behind family life.
That view is, thankfully, starting to change. Women in the workforce are rocking it, although there are still gender barriers there.
How do women experience substance abuse differently?
To illustrate the different experiences women have when abusing substances, let’s look at four of the most common culprits:
- Alcohol
- Opioids
- Stimulants
- Marijuana
Alcohol
Alcohol is far ahead as the most commonly abused substance in the United States. While 7% of men had an alcohol use disorder in 2019, as per the Centers for Disease Control and Prevention, only 4% of women meet the criteria for AUD. As mentioned, recent research shows the gap between male and female drinking habits is closing, though.
By ages 14-15, girls have started drinking earlier than boys, on average, in the US, as per a recent study. Beginning to drink before age 18 is a disturbing trend. Not only is it illegal but also liquor can negatively affect the development of the teen brain.
When it comes to alcohol use and misuse, women are also impacted by booze differently than men. Since women typically weigh less than men, alcohol tends to impact the female frame more acutely.
Even when they weigh the same, women generally have less body water than men. This means that women achieve bigger concentrations of alcohol in the blood after drinking as much booze as men, indicates the National Institute on Alcohol Abuse and Alcoholism (NIHAA). Research has also shown that women are more vulnerable to alcohol-related organ damage, including liver issues, and trauma (NIHAA).
A recent research review also noted that moderate to heavy abuse of alcohol increases the risks of breast cancer in some women. This same review concluded that reducing alcohol consumption can potentially reduce cancer risk.
Among those diagnosed with alcohol use disorder, women have a 50% to 100% higher chance of dying than men. Shocking, right?! The causes include stroke, heart disease, liver disease, suicide, and alcohol-related accidents. Alcohol misuse also increases the chances of engaging in unsafe sex, increasing the risk of unintended pregnancy, and the transmission of STIs.
Opioids
The opioid epidemic has ravaged the United States for the past two decades. In the late 1990s, pharmaceutical companies lobbied the medical community to prescribe opioid painkillers more widely than for the treatment of pain in cancer patients.
Insisting to doctors that opioids were not addictive, they were encouraged to liberally prescribe opioid painkillers for a range of chronic pain. Millions of Americans became addicted to these painkillers.
While men are more likely to die from an overdose of prescription medication than women, there has been a sharp spike in the number of women experiencing overdoses involving opioids. Since 1999, there have been 642% more fatalities from overdoses in women, while men have experienced a 439% increase.
One recent study shows that women are not only more likely to receive an opioid prescription than men, but they are also given higher doses of opioids and for longer periods. These are all strong contributory factors for addiction.
Stimulants
Studies suggest that women are more susceptible to the rewarding and reinforcing effects of stimulant drugs. It is believed that estrogen plays a role in this heightened female sensitivity to stimulants. Women report stronger highs than men and typically become addicted to the drug quicker.
Women are also more sensitive to the effects of stimulants when the menstrual cycle is in the follicular phase. That is, when estrogen and progesterone levels are low, as per many studies.
Marijuana
While marijuana is widely used in the United States, legislation is changing nationwide, and many states are legalizing marijuana medically and/or recreationally. Roughly 43.5 million people in the US reported using marijuana in 2018 alone.
In Canada, men are twice as likely to use marijuana daily or weekly than women. Smoking was the most common way of consuming it, with 68% of men choosing that way. It was 62% for women, who were almost three times more likely than men to use other methods, such as edibles.
While some research indicates cannabis use can be linked with mood disorders in men and women, there is still more research necessary to be done in this area. It is a fairly new area of study. The federal illegality of marijuana until recently means that more research is needed into the way the drug affects women biologically.
Does gender-specific rehab work?
Unsurprisingly, given the above-mentioned differences, gender-specific programming is available at addiction centers.
Commonly, women who suffer from substance abuse find themselves experiencing symptoms of panic or anxiety when asked to open up emotionally in mixed-gender groups. By utilizing gender-specific groups for rehab, women might be more likely to engage with therapy.
Women also can benefit from a different therapeutic approach. Many rehab centers for women put a big focus on support and collaboration, with a strong emphasis on rebuilding self-confidence and changing negative behaviors.
Gender-specific areas of sensitivity for women with addiction
There are several core areas where women may require extra input in recovery. They are:
- Trauma
- Stigma
- Co-occurring disorders
- Motherhood
Trauma
A staggering 80% of women experiencing addiction have suffered one or more traumatic experiences. The primary source of this trauma is sexual assault.
Although men are more likely to witness traumatic events than women, women are more likely to develop PTSD (post-traumatic stress disorder).
Stigma
While anyone battling addiction can face stigma, it is typically more prevalent for females.
Women have long been viewed as the moral compass of the family, and addiction was for generations, considered a moral failing. Even though this antiquated and flawed view of addiction has been debunked, the stigma persists.
Once ready to engage with treatment, women often face the feeling that heading to rehab will be a strain on the family, both emotionally and financially. Luckily, the intensity of the stigma surrounding female addiction is firmly waning.
Co-occurring disorders
More than twice as many women as men experience the symptoms of major depressive disorder. It is well-known that anxiety and depression closely relate to many people.
Often, addiction and mental health conditions co-occur in women. This dual diagnosis sees each issue feeding the other. Self-medicating the symptoms of mental health conditions with alcohol or drugs not only does nothing to address the root cause but can also worsen the symptoms over time.
For women with dual diagnoses, gender-specific and integrated treatment can be the most effective route to sound mental health and sustained sobriety.
Motherhood
Women face unique challenges when seeking addiction treatment as they may not be able to find child care or transportation. They also might find outreach is unavailable to them. Then, once reaching the programs, they may feel the lack of attention to health and family issues there.
Providing attention to these areas that are important to women is essential to reducing their drug use.
Shockingly, 50% of pregnant women take drugs (OTC), whether prescribed or not or use social drugs, such as alcohol. As drugs can harm the unborn fetus, this activity is very risky.
Specifics of women’s rehab
Over the years, addiction treatment programs have been tailored to meet mens’ needs. Although that doesn’t mean that women cannot successfully engage with generalized programs, there are some specific needs best met with gender-specific programming. These include:
- Family support and childcare
- Sexual health care
- Supportive therapies
If you’re addicted to drinking or drugs, the right combination of evidence-based medication-assisted treatment and psychotherapy can help you achieve ongoing sobriety. Many women in rehab find choosing a gender-specific program makes the whole experience more comfortable. All that counts is doing what feels right for you: there is no boilerplate solution for addiction, so do what works for you.