The Unique Addiction Treatment Needs of Women

Women are about half as likely as men to abuse, and suffer from dependence on, most substances (illicit drugs and alcohol). Psychiatric Times reports that women suffer from drug addiction at lifetime rates of around 7 percent while men are closer to 14 percent. The main difference is in regard to prescription drugs; women and men abuse these substances at similar rates.

Traditionally, substance abuse research and treatment programs have been designed with men in mind, as more men than women typically enter into treatment centers. The Treatment Episode Data Set (TEDS) publishes that in 2011, only about one-third of all substance abuse treatment admissions were female.

Men and women abuse substances differently, as men cited alcohol and marijuana as their primary substances of abuse most often while women were more likely to report prescription drug addiction. While it is true that men are more apt to abuse drugs at younger ages and more often than women in general, once drugs are introduced, women are just as likely as men to suffer from addiction to them.

The gender gap between men and women for drug abuse and addiction seems to be narrowing, as Psychology Today reports that 4.5 million women battle addiction in the United States, 3.5 million misuse prescription drugs, and just over 3 million women abuse illicit drugs on a regular basis. Gender differences can impact addiction treatment needs. Women may use and respond to drugs differently than men, and they may also face some unique barriers to treatment.

Gender Differences for Substance Abuse

Both biological differences in the sexes and expected cultural and gender roles can play a role in why a person may turn to substance abuse and even potentially be more prone to addiction. Women are liable to begin using drugs for different reasons than men. The National Institute on Drug Abuse (NIDA) reports that in 2014, almost 16 million women had abused drugs (both misuse of prescription drugs and illegal drug abuse) in the past year. Women cite pain, self-medication for mental health concerns, weight control, and combating fatigue as reasons for drug use.

Sex hormones and other hormonal influences as well as differences in how certain drugs impact brain chemistry can make women more likely to struggle with drug addiction. Women may also be more sensitive to pain sensations, which can make drugs seem like an effective method for self-medication, leading to issues with dependence and addiction.

Women are more likely to suffer from mental health issues, such as anxiety or depression, which can make them more susceptible to misusing drugs as a way to cope. Women may also be more vulnerable to stress, which is a known predictor for drug abuse and addiction. One out of every three women has suffered physical violence at the hands of a partner, the National Coalition Against Domestic Violence (NCADV) publishes, which increases the odds that they will battle addiction to drugs and/or alcohol. Women seeking treatment for drug abuse have suffered from sexual or physical trauma, leading to the onset of post-traumatic stress disorder (PTSD), more often than men seeking drug abuse treatment, NIDA reports. In addition, the cultural expectations of women as wives and mothers can raise stress levels and present further issues that are unique to this gender.

Women and Addiction

Women may abuse drugs for much shorter time periods than men and become addicted much faster. Drugs change brain chemistry, and for women, these changes may occur faster, leading more quickly to drug dependence, which can then progress to compulsive drug use and addiction.

According to NIDA, women are also more susceptible to drug cravings and more likely than men to experience relapse. Women metabolize drugs and alcohol at different rates than men, which can raise the risk for developing drug dependence. For instance, a woman will develop a dependence on alcohol more quickly than a man will due to several factors, Harvard Health publishes, including the fact that men often weigh more than women, and women have lower levels of two important enzymes that are involved in breaking down alcohol, resulting in more alcohol in their bloodstream.

Overall, the gap between alcohol addiction in women versus men is closing. This may be due in part to the widening social acceptance of alcohol consumption for women. More and more women are finding it socially acceptable to drink, in order to cope with motherhood and other life stressors. With increased consumption comes increased dependence and also possible addiction.

Hormonal changes associated with menstruation, menopause, and pregnancy may influence addiction vulnerability for women. Pregnancy can also add an extra layer of difficulty for a women concerning drug use and addiction. Overall, stigma associated with addiction may be greater for women, and this is especially true for those who are pregnant. Substance abuse can be especially harmful for an unborn baby, and shame and guilt associated with continued drug and/or alcohol abuse by the mother may make her less likely to seek out treatment for addiction.

Women may hide their addiction and substance abuse from their families and loved ones, and are less likely to seek treatment for these issues. Despite this reluctance to seek help, social and medical concerns resulting from addiction may be greater, and appear more quickly, for women.

Specialized Treatment Methods for Women

There are many potential barriers to treatment that may be unique to women, such as:

  • Financial struggles or a lack of financial independence
  • Childcare concerns and family responsibilities
  • Transportation issues
  • Social and cultural stigmas
  • Presence of co-occurring disorders

Women may be able to keep up with appearances and be considered “high functioning” even though they may be drinking or abusing drugs at problematic rates. Social drinking or drug use may be seen as a hobby or activity and not as a problem, or a woman may be embarrassed about her drug and/or alcohol misuse and therefore hide it carefully from those around her. Women may view their substance abuse as a consequence of a mental health concern and not necessary a separate issue, Psychology Today publishes, making them more likely to seek treatment from a primary care provider or mental health professional instead of in a specialized substance abuse treatment facility.

Women are often the main caretaker of their children and families, and fear of losing this role or of not being able to keep up with obligations may keep a women from seeking treatment. That being said, this fierce loyalty to family may be helpful in getting a woman help; when family members or loved ones ask a women to seek treatment, she may be more likely to do so.

Treatment methods that are specialized for women can be highly beneficial. Many women may benefit from a gender-specific treatment program that is populated with only people of the same sex. Women-only programs can focus on emotional needs, provide childcare and transportation, manage co-occurring disorders, and help women learn how to cope with stress, stigma, and cultural expectations. In addition, these programs can teach women how to minimize relapse.

Parenting workshops and other life skills trainings, as well as emotional support through peer groups, counseling, and therapy sessions, are helpful. Family counseling and therapy sessions can improve communication and functioning within the whole family unit. Women may also face greater medical and mental health complications resulting from addiction that should be managed through integrated care and potentially with a medical detox program first and medications throughout treatment. There are also specialized addiction treatment programs for pregnant women that can attend to the specific needs of this population.

Women and men are different. As such, treatment modalities will often need to be tailored appropriately.

Further Reading