Helping Women Suffering from Drug Addiction: Needs, Barriers, and Challenges

Specific research in women who use drugs is very scarce and treatments are not gender-sensitive oriented. For these reasons, it is important to guarantee access to the appropriate treatment of women who use drugs and a need for a gender perspective in the treatment and research of substance use disorders. The drug overdose death crisis in the United States has expanded and worsened over time, and is estimated to account for nearly 841,000 deaths since 1999 (CDC, 2021; Mattson et al., 2021). Opioids have contributed to significant increases in overdose deaths, starting in 1999 with prescription opioids and followed by waves involving heroin and then synthetic opioids (CDC, n.d.).

Alcohol-Related Disparities Among Women: Evidence and Potential Explanations

Social position and sociocultural context also affect the likelihood of experiencing alcohol problems, particularly negative social consequences, at a given level of consumption. Because these studies were based on older data that, in some cases, were collected nearly 20 years ago, data from the 2017 National Women and Alcoholism Survey on Drug Use and Health (NSDUH)15 were analyzed to provide updated national estimates for women. As shown in Table 1, most of the significant racial/ethnic differences in DSM-IV alcohol dependence prevalence were no longer apparent when abstainers were excluded.

Drug and Alcohol Dependence

While synthetic opioids (primarily illicitly manufactured fentanyl) continue to play a major role in overdose deaths, recent years have seen a significant increase in deaths involving stimulants like methamphetamine and cocaine (Mattson et al., 2021). For example, stimulant-involved overdose deaths have increased faster among Black/African American and American Indian and Alaska Native (AI/AN) populations compared to all other racial/ethnic groups (Kariisa et al., 2021). In addition, the opioid overdose death rate for Black/African American individuals increased by 38% from 2018 to 2019 in four U.S. states, while the rates for other racial/ethnic groups decreased or stayed the same in those same four states (Larochelle et al., 2021).

Individual-level Factors

To treat these problems adequately, the relationship between a woman’s abuse history and substance use or co-occurring mental disorders must be determined. See TIP 36 Substance Abuse Treatment for Persons With Child Abuse and Neglect Issues (CSAT 2000b) for more information. A strong cultural prohibition exists against discussing family matters such as substance use or abuse during childhood, thus the use of psychoeducational groups to provide information on these topics may be more effective initially than therapy groups, where experiences are discussed openly. However, substance abuse counseling based on a family model often is well suited and is more culturally congruent for many Hispanics/Latinas.

• Experiencing of both forms of discrimination put women at higher depressive symptoms and higher substance use than experiencing only a single form of discrimination.
• In other cases, there has been a greater increase in women than in men; this is the case of cocaine use in some countries as Argentina and Bolivia 1.
• Social position and sociocultural context also influence access to, use of, and the quality of alcohol-related and general health care.
• They don’t drink more than any other racial or ethnic group—in fact, they tend to hit the bottle a lot less, especially compared to white people, whose alcohol consumption outstrips other groups.
• The onset of alcohol and drug abuse among some Hispanics/Latinas may be explained by acculturative and environmental stresses (e.g., new roles, expectations, opportunities) that result in greater exposure to these substances (Gilbert 1991; Mora 1998).
• Compared with women who had not experienced childhood abuse, those with such a history experienced more severe health problems and were more likely both to lose custody of their children and to drop out of treatment.
• Third, this brief attempts to study patterns by specific racial and ethnic groups, but enormous heterogeneity exists within these groups (e.g., related to culture, language, age, citizenship, and immigration status).

Treatment

In one study comparing differences in alcohol prevalence across age groups, ethnicity, and gender, prevalence rates among African-American females from 19 to 29 years of age rose from 2 percent to 4 percent between 1992 and 2002 (Grant et al. 2006). In a study evaluating the correlates of alcohol consumption of African-American women, women age 40 to 49 have shown the highest prevalence of alcohol consumption (Rosenberg et al. 2002). Research indicates that some Hispanics/Latinas generally maintain the cultural norms of their countries of origin and resist social pressures to engage in substance use (Mora 2002).

• Women who identify an addiction problem in themselves and consider seeking treatment often do not seek treatment precisely for fear of being stigmatized or, if they are mothers, for fear of being restricted or losing parental rights 44,45.
• Several studies have examined sex differences in stress response (e.g., subjective, autonomic) and relapse 53, 54.
• For women who inject drugs, underfunded healthcare systems and barriers to accessing harm reduction and addiction treatment programs are significant obstacles to accessing care and entering treatment 71.
• Overall, African Americans have disproportionately higher rates of disease and illness, a wider variety of undetected diseases, more chronic health conditions, and shorter life expectancies than Caucasians.
• First, the NSDUH data are self-reported and thus subject to recall and social desirability biases, which may vary by racial or ethnic group and type of substance use.
• We also limited our analysis to only Black and White students and did not consider non-White Hispanic and Asian students due to the small size of these groups in our sample.
• Women of Hispanic origin in the United States numbered 17 million or slightly less than half the total U.S.

Heterosexism and Anti-Bisexual Oppression-Based Stress

Substance use disorders (SUD) are complex and chronic diseases influenced by genetic, environmental, and social factors. Moreover, while one of three drug users is a woman, women continue to account for only one in five or fewer people in treatment 1. Many researchers indicate that these interactions are essential for improving education and awareness of risks. One of the most critical needs, however, seems to be the establishment or increase of facilities exclusively for women with addiction problems, as well as medical facilities for pregnant women or women with children, and above all, the adaptation of treatment programs to the specific needs of women 26,27,28,29,30,35,39. It is also important to introduce appropriate social, health, and care interventions for women suffering from drug addiction before and after drug treatment 5,23, if possible, with the introduction of interventions implemented by women for women 32. Of course, for these interventions to be implemented, adequate preparation of medical personnel is necessary, especially therapists’ high cultural competence, empathy, unconditional positive regard, and authenticity (Rogers’ triad) 25.

A Gender Perspective of Addictive Disorders

Terry D. Schneekloth, M.D., a Mayo Clinic psychiatrist with expertise in alcoholism and addiction, helps break down some of the differences. Receive free access to exclusive content, a personalized homepage based on your interests, and a weekly newsletter with topics of your choice. Studies of nicotine show a potential greater saliency in the luteal phase of the cycle, and women quitting during the luteal phase reported significantly greater increases in tobacco withdrawal and self-reported depressive symptoms than women quitting during the follicular phase 43, 44.