WHAT IS STOPPING US?

AS we all know, men are not the only ones who struggle with substance use, both men and women suffer greatly from the damaging effects of addiction to alcohol and other substances.

Up until recent years, substance abuse has been considered mainly a male problem. While it is true that men still outnumber women when it comes to alcoholism and illegal substance use, women are catching up. In fact, the number of female substance users has increased significantly over the years. This, unfortunately, also includes an increasing number of pregnant users and mothers. Women are well aware of the social shame and the possible disapprovals they may experience from friends, family, co-workers, and employers if they do reveal their substance use disorder, forcing them to steer clear of any possibility to seek treatment.

Women remain under-represented when it comes to addiction treatment. Shame, stigma, lack of childcare, lack of family or financial support, denial, co-occurring disorders and, fear of legal and social repercussions are some of the major barriers to women seeking treatment for their substance use disorders. To some extent, men and women are treated differently in the service system, and there are different expectations of them. Women, especially mothers, are not expected to use substances in our society; they are under strict moral and societal control, which might make seeking help difficult. A lack of trust and suspicion resulting from their previous experiences may have also created barriers for seeking help.

While men’s open confession to having a problem with addiction may be met with support and encouragement to seek treatment, women are more prone to harsh judgment and unsympathetic disapproval, especially by those closest to them. This is a significant barrier to treatment, as women tend to define their lives and personal worth by the quality of their relationships. The support and continued love by those they are close to are therefore crucial for success in treatment, and in continued recovery. Stigma is especially harsh for those among substance users who are mothers, as they rightfully fear to lose their children.

For many pregnant women, substance use treatment is difficult to obtain due to lack of programmes willing to treat pregnant women, cost, lack of medical coverage, fear of legal consequences, and threat of child protection involvement for women who have children. These factors intensify the stigma associated with prenatal substance use and are reinforced by social determinants, further limiting access to care. A woman is more often the one who raises children, even if she is still married or lives with a partner. Leaving the children in order to attend to her treatment may not be an option at all. Even women who are working may not find it possible to leave their work, or put their children in day care in order to attend regular appointments, or stay in an in-patient treatment center.

Women present with greater medical needs compared to their male counterparts when entering treatment. In addition to negative physiological impact as a consequence of using, women may face medical problems that actually paved the way for substance use in the first place. Research shows that women tend to suffer intensely from chronic pain, chronic fatigue or cramps, and women’s substance use may therefore be an attempt of coping with these chronic conditions. Whether or not a medical condition happened before or is the result of problematic alcohol and substance use for women, the bottom line is that these illnesses have to be addressed as part of treatment. This form of treatment is known as ‘Gender Responsivetreatment’, failure to do so may increase women’s risk of relapse.

Gender Responsive or Sensitive Treatment:

Gender responsive treatment acknowledges and addresses women’s very different experiences, including internal and external barriers. These include factors such as:

• The different physiological and

psychological responses to substances and alcohol.

• The difference in the progression

from experimentation/social use to dependency.

• Co-occurring mental disorders

(which women are more prone to than their male counterparts).

• Barriers to accessing or completing

treatment.

Biology as a Barrier:

• Women’s use progresses much more

quickly to problematic use than men’s.

• Women’s bodies have a stronger

response than men to even small quantities of toxic substances.

• While fertility is often negatively

impacted in both genders, women may face gynaecological problems that last well beyond treatment.

• Pregnant women who, unfortunately, make up an increasing number of substance-seeking women, may harm their unborn offspring through exposure to substances or alcohol.

Hidden Barriers:

For women, the relationships they have can act as pathways to the beginning of the substance use, barriers to seeking help and sometimes even as a factor that may lead them to relapse.

• Women’s problematic use often

starts at the encouragement of friends or a boyfriend.

• Female teens are the only age group

among women at par with men’s rates of problematic alcohol and/or illegal substance use.

• Women who inject substances are

more likely than men to die in the first year of use, and those that survive tend to suffer from greater rates of Hepatitis

C, TB and sexually transmitted

diseases compared to men. Unwanted pregnancies are also common.

• Women are less likely to seek and

access treatment for problematic use if their partner is unsupportive.

• Not surprisingly, their likelihood

of staying clean and sober even if they manage to complete treatment is also decreased if their partner continues to use, or proves unsupportive of, or indifferent to a sober lifestyle.

• Researchers have found that some

women’s substance use often starts or is maintained by a wish to seek, maintain or deepen human connections.

Interpersonal Violence:

Most women entering substance use treatment are victims of child abuse, or other forms of interpersonal violence, such as domestic violence, sexual harassment or rape. Many women are also subjected to violence in the context of alcohol or drug use. For example, rape, date rape and marital rape tend to happen when either victim or the abuser are intoxicated. In the case of date rape, women don’t necessarily consume alcohol themselves, but are made defenseless through the use of date rape drugs.

BOSASNET offers counselling services to people experiencing problems with substance use, depression, anxiety, stress, anger management and adjustment issues. If you think that you might have a problem mentioned above, or if you have a friend or family member who does, we encourage you to seek help. For some, it can mean the difference between life and death. You can find BOSASNET on Facebook, Twitter and Instagram, visit us on www.bosasnet.com, or call us on 3959119 or 72659891 for more information.