The death of Betty Ford in 2011 reminded us all that alcoholism and addiction are non-discriminatory diseases, touching people of all ages, ethnicities, walks of life and both sexes. Within this, it’s particularly important to understand that alcoholism and/or addiction among women is not only a large and growing problem, but its physiological, psychological, emotional and social underpinnings and consequences differ significantly from those of men. Our Hope’s reason for being is to recognize and address these differences in treatment, thereby guiding more women to achieve and maintain lifelong recovery.
A real and growing problem
According to the National Institute on Drug Abuse, women age 18+ represent about one third of the total substance abusing/dependent population in the U.S. They are more likely than men to abuse prescription drugs, as well as to have multi-substance dependency, especially combinations like alcohol and prescription drugs. While data on the growth of alcoholism/addiction among women is scarce, a good indication that it has been significant is the fact that the number of women arrested for driving while intoxicated increased by 30% over the last decade. Needless to say, if you think you or a woman you care about may be an alcoholic and/or an addict, you are far from alone in your suffering.
Based in real physiological differences with real physical consequences
Women report greater problem severity related to their substance use than men. This difference is based in physiological fact. Relative to men, women’s lower body weight, higher concentration of body fat and lower activity of the primary enzyme involved in alcohol metabolism each contribute to women’s greater problem severity. Women not only achieve higher concentrations of alcohol in their bloodstream after consuming equal amounts, but alcohol remains in their bodies longer than it does in men’s. This means that chronic alcohol abuse exacts a greater physical toll on women than men. Female alcoholics’ death rates are 50-100% higher than those of male alcoholics, reflecting more liver disease, circulatory disorders, alcohol-related accidents and higher suicide rates. Women who abuse substances also experience more gender-specific medical problems, including higher infertility, miscarriage and premature delivery.
And real psychological and emotional differences
Women’s paths to substance abuse are more complex than men’s. For women, there is typically a pattern of breakdown of individual, family or environmental protective factors (e.g., 50-70% of female addicts in treatment report a history of physical or sexual abuse vs. only 10-15% of males) and/or an increase in childhood fears and anxieties, and failed relationships. In fact, a major factor contributing to female substance abuse is a predisposing psychiatric disorder. This partly explains why more women than men who abuse substances are diagnosed with co-occurring mental and emotional health disorders, like depression, eating disorders, Post-Traumatic Stress Disorder (PTSD) and low self-esteem. Research shows that female alcoholics are seven times more likely than male alcoholics to suffer from depression, not only due to the factors above, but also due to a stronger genetic association between alcoholism and depression among women.
Unless properly diagnosed and treated, co-occurring mental and emotional health disorders decrease the likelihood of sustained recovery for substance abusers. Therefore, it is critical that women be thoroughly assessed for the presence of these disorders at the same time they are assessed for substance abuse and that their treatment and recovery plans address any co-occurring disorders uncovered. The sad fact is that a woman is not likely to seek help if she feels unworthy of it or if she is immobilized by depression and/or trauma.
Exacerbating this, the social stigma women more readily attach to alcoholism/addiction may not only understate the number of women actually suffering from those diseases, but may also serve as a deterrent for them to seek treatment specific to their dependency. They often go untreated or seek help/drugs from “more legitimate” sources, like physicians, who are more likely to prescribe mood-altering drugs to female alcoholics because they under-diagnose the woman’s problem as depression, nervousness, or some other emotional difficulty. Sadly, all of this contributes to the fact that less than 15% of women who could benefit from treatment for alcoholism and/or addiction actually get the treatment they need.
As well as real social differences
Given the multiple roles women fill as mothers, caregivers, spouses, partners and employees, one woman’s addiction and/or alcoholism has the potential to shape her whole family and many others in her life. Guilt and shame result as women struggle with the impact their substance abuse has on their relationships. Making matters worse, female alcoholics/addicts are more likely than their male counterparts to be the heads of single parent households, resulting in childcare issues and fears of losing their children if they enter treatment, further deterring them from seeking the help they need.
Women do not necessarily drink more due to the stress of assuming multiple roles, but rather, research indicates that the opposite tends to occur, with more women abusing alcohol after losing a particular role. Women cite the loss, failure or lack of close, authentic relationships as a reason for their substance abuse more often than men.
Another key difference between the sexes is that women are more likely to abuse drugs/alcohol in private, while men are more likely to do so in a social setting. This reflects the vicious cycle of guilt and shame women feel to a greater extent than men. That guilt and shame is undoubtedly a major reason why addicted women often characterize themselves as having few or no friends and a limited social network. Since women are especially attuned to connection with others (while men are more attuned to differentiation/competition with others), the lack of social connection can be devastating.Effective treatment recognizes all of these important differences
All of these differences impact the decisions to seek and remain in treatment, and therefore, the ability to achieve and maintain recovery. Several deterrents to women seeking treatment were mentioned above—e.g., family responsibilities, social isolation, physiological complications and shame/stigma. Add to these denial, money/lack of financial resources, lack of referral networks and lack of awareness of woman-centered services and you have the reasons why so few women access the treatment they need.
Even if women do get treatment, they have a higher level of failure in traditional programs because many of these programs have been designed by and for men using research conducted among men. These more confrontational approaches only enhance shame and guilt among women. Research shows that women’s treatment is more likely to be effective if provided in a mutually supportive, non-coercive, non-punitive, safe therapeutic environment. If women are comfortable, they stay in treatment longer and therefore, show more improvement. We also know that the specifics of successful women’s treatment must address their multiple roles, complex psychological identities, physical health and the cultural/social realities in which they live and work.
Finally, we know that women need a strong support system to achieve and maintain recovery. The fact is that substance-dependent women are less likely than men to have someone actively supporting them in treatment or recovery. Since they are also more likely to be in a relationship with a substance-abusing partner than men, women face additional hurdles to remaining abstinent both during and after treatment.
Our Hope answers the need for effective women-centered treatment
Our Hope has 40 years of experience in women-centered treatment. We address each woman’s unique recovery needs with a comprehensive continuum of services (including Acupuncture Detoxification Therapy, Yoga and a special “Recovering Motherhood” program) provided by our all-female staff, including Master’s level Clinical Therapists licensed alcoholism, addiction and mental/emotional health care, delivered in a warm, homelike setting. Plus, we work with any woman to ensure our programs are affordable. All of this provides an ideal environment for any woman to heal. We invite you to get to know us better by visiting our website (www.ourhpeassociation.org), calling us (616-451-2039) or better yet, visit us in our gracious Victorian home hidden in the historic Heritage Hill neighborhood of downtown Grand Rapids, Michigan.
1. “Gender Differences and Their Implications for Substance Abuse Disorder Treatment,” Office of Substance Abuse Services, Virginia Department of Mental Health, et al.
2. Reviews to Use-Current Literature Reviews for the Substance Abuse Professional-January 2004. Multiple sources cited; available on request.
3. “Women Often Experience Drug Abuse and Addiction Quite Differently Than Men,” www.4therapy.com/consumer/conditions/article…(largely sourced from National Institute on Drug Abuse).
4. “Secret Drinking: A Mother’s Struggle,” PEOPLE Magazine, 11/2/2009.
5. “Alcohol and Women,” www.About.com.