Addiction is a disease that affects both men and women, but that doesn’t mean each gender benefits from exactly the same approach to treatment. Since the sexes have some inherent differences, it stands to reason that their experiences with substance abuse will differ.
These experiences form part of the criteria considered when establishing a treatment plan, and it’s possible to use some broad strokes when determining the best ways to offer drug and alcohol treatment to men and women. Gender-specific recovery programs have some definite advantages for addicts, since they address the different experiences of the sexes, are sensitive to the needs of each group in treatment and provide a comfortable environment for healing without distractions.
Men and Women Experience Addiction Differently
The following facts and statistics were provided by the National Council on Alcoholism and Drug Addiction.
- Approximately 4.5 million women in the US have a substance abuse issue. 3.1 million use illicit drugs on a regular basis and 3.5 million misuse prescription medications.
- Women’s body weight tends to be lower than men’s, and they carry more body fat and less water. The body will retain alcohol in its fatty cells longer than if it had a higher water content. A woman’s internal organs have a longer period of time where they are exposed to the effects of the alcohol she has ingested.
- Women also have lower levels of enzymes capable of breaking down alcohol in their stomach and liver. Alcohol is absorbed into the bloodstream at a faster rate for women, which means their blood alcohol content (BAC) will increase more rapidly than a man who has had the same number of drinks during the same period. As a general rule, one alcoholic drink for a woman will have twice the impact the same drink has for a man.
- When women become addicted to drugs or alcohol, they tend to progress more quickly than men. Their recovery looks different, and they will also relapse for different reasons than men.
- Women who use marijuana, cocaine or heroin also move from first use to dependence on these drugs more quickly than men. They report having problems of “greater severity” and also have more consequences related to their health than men.
The reasons women become involved with drugs initially are often linked to their relationships with men in their lives. Research studies indicate the majority of female drug users (more than 70 percent) have experienced sexual abuse by the time they turned 16. Most of the women have a family history where at least one parent had a history of drug or alcohol abuse.
Using illicit drugs always carries with it inherent health risks, such as injury or death from accident or overdose. Female addicts may also be engaging in risky behaviors that may put them at higher risk for sexual assault, as well as contracting sexually transmitted diseases, including HIV and hepatitis.
Abusing opioids and stimulants can have a harmful effect on a woman’s menstrual cycle, as well as her cardiac system, digestive system, nerves, and muscles. The same effects can also occur with prescription drug and over the counter (OTC) drug abuse. As well, the hormones which are a normal part of a woman’s reproductive cycle also have an effect on the way women experience addiction. As they rise and fall, these hormone changes can lead to stronger cravings during certain times.
Women are still more likely to be the main caregivers to young children than men and are more likely to have their children living with them. They are also more likely to be dealing with the child welfare system than a male parent.
Finally, women are also more likely to be living with mood disorders. These illnesses are ones which describe significant changes in mood, such as:
- Bipolar Disorder
- Cyclothymia (a milder form of bipolar disorder)
- Major Depression
- Persistent Depressive Disorder (a long-lasting, low-grade depression)
- SAD (Seasonal Affective Disorder)
Addicted women who have children may be afraid to seek treatment because they’re afraid they will lose custody of their children to the other biological parent or to the state. They may also be concerned that they could face criminal charges of child abuse or endangerment if their drug or alcohol addiction came to light.
Addiction and Pregnancy
Drug and alcohol use has been linked to a number of pregnancy complications, including miscarriage, low birthweight and premature separation of the placenta from the wall of the uterus. Research has linked alcohol use in pregnant women to Fetal Alcohol Syndrome, which can cause a number of physical and mental defects, ranging from mild to severe, in the child.
Using drugs early in pregnancy can have a negative effect on the fetus’ developing limbs and internal organs. In early pregnancy, it can lead to a miscarriage or a birth defect. Later on, drug use can have an effect on the development of the fetal nervous system. Once the child is born, a number of drugs can pass through breast milk and present harm to the newborn if the mother is nursing.
A number of women with substance abuse issues are afraid to tell even their healthcare providers about their drug or alcohol use. They are concerned about how the law in their states handle drug use during pregnancy and worry that their doctor must report or test them if they admit to being users. In a number of states, substance abuse during pregnancy is itself a crime, and women have been prosecuted in the past. Someone who is afraid of being arrested would be especially guarded about disclosing her addiction, even if she was looking for help to find a treatment center.
Why Offer Gender-Specific Recovery Programs?
Since we know that men and women experience addiction differently as a group, it makes sense that, when individual men and women come into treatment, their experience there would be different, too. Addicts have shopping lists of excuses and reasons why they can’t or shouldn’t go to rehab right now, and the types of reasons they use tend to vary by gender.
One size doesn’t fit all for each client coming in, and general treatment programs for men and women need to be different as well.
Different Reasons for Starting Drug or Alcohol Use
Christopher D. Brinkerhoff observed in his article Gender Differences in Substance Abuse Create a Need for Single-Gender Treatment Programs that treatment programs were developed based on the needs of male clients. These generalized programs were then used originally for female drug and alcohol abusers, even though the circumstances between each gender’s use of substances varies tremendously.
Men tend to start abusing drugs or alcohol for the perceived benefits they hope to gain from ingesting the substances, according to Brinkerhoff, who cites that males are looking to increase work hours, have a good time or even improve their sex lives. Women, on the other hand, are seeking to escape painful emotions caused by victimization or sexual abuse. They may also start using drugs or alcohol because their spouse or partner is using.
This explanation is a bit simplistic, though, since there are also men who develop substance abuse issues as the result of self-esteem or relationship issues, the result of a childhood trauma, post-traumatic stress disorder (PTSD), mental health concerns and in the aftermath of being molested or sexually assaulted.
Women have a variety of reasons why they started using as well, and not all of them will have a history that includes abuse. Some of them will be living with mental health concerns and will have started using as a way to self-medicate, while others may have been looking for ways to improve their performance at work or at school by increasing their energy levels. Still, others were seeking a way to have a good time or improve their sexual experiences, like their male counterparts.
Sensitive to Gender Differences in Early Recovery
In order to start the recovery process, a client is going to have to be honest with the staff, his or her counselor and, most importantly of all, themselves. Anything that has the potential to interfere with the process needs to be taken out of the equation when clients go into treatment, and that includes having mixed groups going to treatment together.
It’s easy to want to “replace” the feeling of being vulnerable and (perhaps) a little lost when entering the early stages of recovery with a flirtation or even the promise of a new romance. It’s understandable that, since both of them are away from home and feeling vulnerable, when they start sharing thoughts and feelings in group therapy, they feel a connection. Keeping men and women segregated when in treatment virtually eliminates the issue of clients developing attractions to each other instead of focusing on the reason they are in rehab, which is to get well.
Gender-Specific Treatment for Addiction for Men
Men use drugs and alcohol for different reasons than women do, and for this reason, their expectations and goals in treatment will be separate from those of female clients.
- More Comfortable — Men entering treatment are more likely to contribute to group discussions if they feel they can relax and simply be themselves. A male-only treatment environment encourages clients to develop a sense of trust and bonding with fellow clients. Once this sense of trust is established, the participants will find it easier to discuss issues such as:
- Feelings (Embarrassment, shame, anger, aggression, guilt, anxiety, love)
- Relationships with spouse and family members
- Control (Need to be in control, and what happens when they don’t feel they have control)
- Fear (How does the prospect of living without their drug of choice affect them? Are they concerned about having to “make it” on their own?)
- No Expectation to Be Tough or Strong — Society puts expectations on men that they should be strong and keep their emotions to themselves, in spite of what they’re feeling. The idea of being someone who needs help flies in the face of the idea that some men (and a number of women) have set for themselves. In a treatment program reserved for men only, this expectation is removed and the participants can focus on doing what they need to do to achieve a new life of sobriety.
- Less Judgment — Being around other men can make male clients feel as though they are less likely to be judged than if there were women included in the treatment group. Some of their experiences with addictive substances may include episodes where the men have acted out aggressively (verbally, physically or both), and discussing these incidents may be very challenging for female clients to hear without reacting as if the incident took place in the present day.
- Less Time Spent Discussing Gender Issues — Men and women will both have gender issues when in treatment. A group for men only will not become “stuck” specifically on women’s issues in group, but will instead be able to spend time on the reasons why men become addicted, and the pressures they face as husbands, fathers and sons.
- Discuss Their Common Experiences — Clients participating in a male-only treatment program will be able to interact with each other in a manner based on having shared similar types of experiences, even if their backgrounds are dissimilar.
Dealing With Abuse as Part of Men’s Rehab
Abuse can manifest in different ways in relationships, and it must be addressed as part of healing in an addiction treatment program. The approach will vary depending on whether the client is male or female, and this is one of the reasons gender-specific treatment for substance abuse can be so effective.
Male Sexual Assault Victims
A number of people tend to think about sexual violence as being perpetrated toward women only when men are also victims of these types of crimes. According to statistics collected by the National Sexual Violence Resource Center, one in 71 men and one in five women will be raped at some point in their lives. Sexual violence other than rape was reported by 20.8 percent of heterosexual men, 40.2 percent of gay men and 47.4 percent of bisexual men during their lifetimes (National Sexual Violence Resource Center).
When these types of crimes occur, the victims are often left with deep-seated feelings of guilt or shame as a result. They may feel they should have done more to prevent it from happening, or that it was somehow their fault. It can be very difficult to discuss these complicated emotions in mixed company, and male clients can feel it is easier to open up about and share them in a men’s-only treatment program.
Men With a History of Domestic Violence
Male clients coming into drug and alcohol treatment may have a history of abusing their spouse or domestic partner and need treatment to deal with those behaviors. It’s not uncommon for instances of domestic violence to involve alcohol, but this is not the reason for these events, nor is being “under the influence” a reason or an excuse for being physically or verbally abusive.
Drinking or using drugs may be used as a coping mechanism by some men who are dealing with anger issues. Since men generally have less practice at putting names to their emotions, they may describe what they are feeling as “stress” and tell themselves and those closest to them that they are using substances to control the stressors in their lives. Instead, they are dealing with internalized anger and do not realize that drinking and using some types of drugs can make the problem worse.
Anger management can be offered as part of a treatment program for men only, where clients can learn to identify what they are feeling and to accept responsibility for their emotions instead of shifting the blame to their spouse, partner or someone else. They can also learn more positive ways to deal with these emotions, which everyone experiences, instead of trying to numb them with chemicals or lashing out.
Gender-Specific Treatment for Substance Abuse for Women
Women have their own needs when it comes to seeking treatment for drug and alcohol abuse, which can make a women-specific program a good option.
Cultural Issues and Women
Traditionally, women have had the role of caring for the home and children. They are the foundation of the family and the caregivers for everyone in the household. And, as women have taken on a greater role in the workforce, many of them have found it difficult to give up the feeling that they should still be the primary caregiver for the family and their children.
It’s often difficult for them to go to treatment because they don’t want to face the criticism (either direct or implied) that they are letting their families down by taking time to look after themselves and getting help for their substance abuse issues. Women in a gender-specific treatment program can discuss this aspect of getting help with other clients who will have a true understanding of their point of view and get support for staying in the program.
Women and Body Image Issues
Women in drug and alcohol treatment programs are more likely to have body image issues than men. These may need to be addressed in therapy as part of their treatment. Since these issues tend to involve a woman’s sense of self-esteem, self-worth, and value, female clients may not feel comfortable being open about them in a group that includes men.
A treatment program for women only would be an atmosphere that would encourage open and honest sharing.
Parenting and Addiction
The women coming into treatment for their addiction may have concerns about whether admitting they have a substance abuse issue and getting help will have a negative effect on their status as a caregiver. To be branded an “addict” is not considered a positive label. The mothers may need to talk about their feelings around what it means for them to have lived with their addiction while trying to care for their children.
If their children no longer live with them, or they have limited access to their children because of drug or alcohol use, the women have thoughts and feelings to explore those ideas, as well. These are difficult ideas to address, and women would feel more comfortable discussing them with other women present.
Abuse or Sexual Assault Survivors in Treatment
Placing women who have been the object of abuse (verbal and/or physical) or sexual assault in a treatment program which also includes men who have anger issues, or have been offenders, is not an appropriate mix to help women deal with their experiences and move into sobriety. The survivors need to feel they are in a safe place where they can express their feelings about their experiences and come to terms with them.
Having males in the same space coming at the experience from its “opposite” side will not help at this stage.
JourneyPure’s Gender-Specific Treatment for Substance Abuse
Seeking treatment for drug or alcohol addiction is not an easy process for anyone living with an addiction. It’s a major lifestyle change for the person who has become used to having chemicals as a coping mechanism. Giving them up and learning new ways to deal with life stressors means having faith that sobriety is more worthwhile than continuing to use. Gender-specific recovery programs make this transition more comfortable for men and women alike.
If you or a loved one would like more information about rehab for men or women, contact Journey Pure At The River today.
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Chris Clancy is the in-house Content Manager for JourneyPure’s Digital Marketing team, where he gets to explore a wide variety of substance abuse- and mental health-related topics. He has more than 20 years’ experience as a journalist and researcher, with strong working knowledge of hospital systems, health insurance, content strategy, and public relations. He lives in Nashville with his wife and two kids.