Alcoholism and addiction does not discriminate. According to the National Survey on Drug Use and Health(NSDUH), 21.5 million American adults (aged 12 and older) battled a substance use disorder in 2014. While addiction to alcohol and other drugs is an equal-opportunity disease, women are affected differently than men. The disease of alcoholism is a progressive illness. In general, women tend to progress faster in their addiction than men and oftentimes face unique barriers to getting help. In order to determine the most effective treatment options, all of these differences must be looked at in closely identifying their addiction.
Many life circumstances predominate in women as a group, which may require a specialized treatment approach. For example, research has shown that physical and sexual trauma followed by post-traumatic stress disorder (PTSD) is more common in drug-abusing women than in men seeking treatment. Other factors unique to women that can influence the treatment process include issues around how they come into treatment (as women are more likely than men to seek the assistance of a general or mental health practitioner), financial independence, and pregnancy and child care.
Although men traditionally have had higher rates of substance abuse than women, some research suggests the gender gap may be closing. For example, a study published in 2015 found that rates between males and females ages 12 and older narrowed between 2002 and 2012 for current (past-month) drinking, number of drinking days per month, and past-year driving under the influence of alcohol.
Why Women Abuse Drugs
Trauma: There is a strong relationship between trauma and substance use—especially among females. Women are disproportionately affected by traumatic experiences such as abuse, assault, and domestic violence. Almost 80% of women who seek substance abuse treatment have a history of physical or sexual assault, or both. Rates of PTSD among women in treatment range from 30% to 59%. According to research, the majority of women diagnosed with PTSD and a substance abuse disorder experienced childhood abuse.
Romantic partners: For many women, drug or alcohol use begins when a significant other introduces them to the substance—either a boyfriend, family member, or close friend.
Pain relief: Women are more likely than men to report chronic pain including arthritis, fibromyalgia, headaches, and irritable bowel syndrome. They are also more likely to receive an opioid prescription than a man. According to the National Survey on Drug Use and Health (NSDUH), in 2015, 2 million women started using pain relievers in the past year compared to 916,000 men. In 2015, 5.5 million women (or 4%) misused pain relievers in the past year.
Life changes: Major events such as loss of child custody can also be a trigger to use-and women may use substances to cope with the overwhelming feelings.
Marriage status: Marriage can be a protective factor against addiction or a risk factor for using. Only 4% of married women abuse or are dependent on alcohol or drugs. But approximately 11% of divorced or separated women abuse or are dependent on alcohol or drugs, and 16% of women who have never married abuse or are dependent on alcohol or drugs.
Weight control: Eating disorders such as anorexia nervosa and bulimia nervosa commonly co-occur with substance abuse. Women with bulimia nervosa commonly abuse laxatives, diet pills, and diuretics. Misusing these over-the-counter medications can result in gastrointestinal, neuromuscular, and cardiac problems. These medications can cause serious health problems, and in some cases, be lethal.
Mental illness. Co-occurring mental health and substance abuse disorders are prevalent among women. In 2015, 7 million women had both a mental health issue and a substance abuse problem, and 1.2 million reported serious mental health issues co-occurring alongside addiction.
Types of Treatment Programs are Available to Women
Some programs may be specifically designed for women, while others may treat a mix of men and women.
Women who have medical or mental health complications should seek out programs that can address these issues, such as dual diagnosis inpatient programs or even hospitalization for more severe cases.
Levels of Care
Detox: During detox, clinical staff manage symptoms of acute intoxication and withdrawal. After detox, the woman is referred to the next and most appropriate step in treatment. If she is withdrawing from opiates, benzodiazepines, or alcohol, she will usually detox in a medical facility as detoxing from these drugs can have life-threatening medical complications. In addition, if a woman is pregnant, withdrawal should be closely monitored by medical staff.
Inpatient: Women who have complex needs or co-occurring disorders may benefit from inpatient centers. These facilities offer medical supervision 24 hours a day and provide a safe environment for women to stabilize in. Some inpatient programs allow children to accompany their mother. Studies show that when children are in treatment with their mothers, the mothers have better rates of abstinence, employment, child custody, and involvement with support groups.
Intensive outpatient program (IOP): IOP programs provide a more intense level of care compared to standard outpatient. But they do not require the person to live on-site to receive treatment. IOP programs are beneficial for postpartum women: Studies show that this population of women has better completion rates in IOPs than traditional outpatient.
Outpatient: If a woman’s substance use is less severe, this might be the most appropriate level of care. Outpatient recovery usually involves 1 to 2 weekly sessions of group therapy or individual, one-on-one therapy. If the woman has a stable job and housing, outpatient can be beneficial. Women-only outpatient programs are available.
12-step programs: These programs are often incorporated into rehab programs. But some women make them their primary mode of recovery. Attending a 12-step or non-12-step program during recovery can help build coping skills, and these groups offer a step-by-step system of recovery. A woman can attend groups with other women to learn how they stay sober.
Finkelstein, N. B. (2011). Substance abuse treatment: addressing the specific needs of women. Diane Publishing.
Campbell, C. I., and others. (2010). Age and gender trends in long-term opioid analgesic use for noncancer pain. American journal of public health, 100(12), 2541-2547.
Harvard Medical School. (2010). Addiction in Women.
Center for Behavioral Health Statistics and Quality. (2016). Results from the 2015 National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration, Rockville, MD.
Cohen, L. R., & Hien, D. A. (2006). Treatment outcomes for women with substance abuse and PTSD who have experienced complex trauma. Psychiatric services, 57(1), 100-106.
Substance Abuse and Mental Health Services Administration. (2009). (Treatment Improvement Protocol (TIP) Series, No. 51.) Chapter 2: Patterns of Use: From Initiation to Treatment.
White, A., Castle, I.P, Chen, C., Shirley, M., Roach, D., and Hingson, R. (2015). Converging Patterns of Alcohol Use and Related Outcomes Among Females and Males in the United States, 2002 to 2012. Alcoholism: Clinical & Experimental Research, 39(9), 1712-1726.