When a man and a woman drink too much alcohol — by far the
most widely abused substance in the country — they not only do it for different
reasons, they also get different results.
Where men may use alcohol to feel “powerful,” women usually
drink to fight feelings of hopelessness and anger.
Though women generally drink less than men, the risk of
alcoholism kicks in a lot faster: Seven or more glasses a week is considered
risky for a woman, compared to 14 or more for a man.
Alcoholism also carries greater risks to women. Heavy
drinking increases the chances of a woman becoming a victim of violence and
sexual assault. Most women who abuse alcohol and drugs — studies show as many
as 80 percent to 90 percent — have a history of physical or sexual abuse.
Women are more likely than men to develop liver inflammation
and to die from cirrhosis. They are more vulnerable to alcohol-induced brain
damage and cardiovascular disease. And heavy
drinking appears to increase the risk of breast cancer, as well as cancers of
the digestive tract.
The stigma for using
drugs and alcohol also is greater, and it’s often one of the biggest obstacles
to a woman seeking treatment. She fears — rightly — that she will lose custody
of her children if she admits to having a substance abuse problem. Or
she’s so busy being the caregiver that she puts off asking for help, often for
so long that she develops serious ailments.
The numbers, fairly consistent since the 1990s, say it all:
Of the 15.1 million people who abuse alcohol, 4.6 million are women, and only
25 percent of them are in traditional treatment, according to the National
Institute on Alcohol Abuse and Alcoholism. Women also tend to go more nontraditional
routes for help with addiction, looking to either their doctors, therapists or
psychiatrists.
During the past
decade, segregated treatment has become a key to success for women, providing a
more nurturing environment that encourages patients, often childhood victims of
physical and sexual abuse, to open up and talk about the traumas that led to
their substance abuse.
“Eighty to 90
percent of the women in our treatment program, in all programs,
have been significantly abused in their life,” says Marsha Nadell Penrose, executive
director of The Next Step, a 14-bed intensive treatment center in Albany, N.Y. “It’s a vicious cycle: You get abused, which
makes you end up drinking. You drink, so you end up getting abused.”
But many programs
fail to address that cycle. And few programs offer child care.
The Next Step, one of three women’s programs in upstate New York, made a
deliberate choice not to provide quarters for children, and Penrose thinks it’s
a double-edged sword.
“The women usually feel terribly guilty when they first get
here because their children are in foster care,” she says. “I try to tell them
to think of this as the only time they can focus just on themselves. I tell
them, ‘You can’t take care of your children unless you’re OK.’”
Some studies,
however, show that women-and-children programs are twice as successful as
women-only programs.
The Mothers’ and Toddlers’ Program, a National Institutes of
Health pilot project in New Haven, Conn., works on the premise that continued
drug use actually “hijacks” the maternal drive pathway that emanates from the
brain. Over the past two years, it’s shown promise in resetting the
pleasure-reward effect from drugs like cocaine and heroin by intensifying the
relationship between mothers and their young children.
By including
children in treatment, “you’re tapping into the woman’s last thing to go
— her desire to be a good mother,” says Norma Radol Raiff, executive director
of Sojourner House in Pittsburgh, one of only
two residential treatment programs for women in western Pennsylvania. Like most women’s programs, it
offers child care, therapy and classes on child development, healthy parenting,
domestic violence, educational tutoring and remediation. Residents get guidance
on planning menus, with trips to the grocery store to help them make healthy
decisions.
Today, treatment also may include medication for depression
or other mental illness, a direct outcome of new acknowledgement of alcoholism
as a disease that creates a host of other issues for both sexes.
The fact that women get an early start with drinking and
drugs also shapes treatment strategy. Recently, three federal surveys found
that binge drinking among girls is growing at a faster rate than boys. A
February report from the White House Office of National Drug Control Policy
revealed that in 2004, 1.5 million girls started using alcohol, 173,000 more
than the number of boys who started drinking. Girls also outpaced boys in using
marijuana at younger ages. The report cited stress, such as peer pressure and
the trials of being an adolescent in a fast-paced society, as causes, as well
as eating disorders, other illegal drug use, prescription drug misuse and low
self-esteem.
Girls also find warped messages in advertising and popular
culture. Three-quarters of the college coeds surveyed in an American Medical
Association report released in early 2006 said they “use alcohol as an excuse
to engage in outrageous behavior” on spring break. An overwhelming majority — 84 percent — thought images of partying
college girls contributed to that behavior; even more agreed these images
contributed to men’s dangerous behaviors toward women.
“These survey results
are extremely disturbing,” said AMA president J. Edward Hill, “because it
brings up an entirely new set of issues, including increased risk of sexually
transmitted diseases, blackouts and violence.”
This younger clientele also translates into a different
level of care.
“A lot of them are kids who never grew up and now,
frequently, they have babies themselves,” Penrose says. “They haven’t gone
through their adolescent years and come through the other side. They need more
support. They’re much more emotionally fragile. And it takes longer to get
through the treatment process.”
From the Robert
Wood Johnson Foundation's "Silent Treatment: Addiction in America"
project, produced by Public Access Journalism LLC.