What, if any, are the differences between male and female substance abusers? The answer requires a review of research to determine which treatment services have been shown to be most effective for women. Although each woman in recovery is unique, women have unique shared experiences and needs, which can directly influence the type of services they require to succeed in the drug recovery process.
In general, a woman is less likely to form an addiction to any given drug of abuse compared to a man. However, as the Office of National Drug Control Policy (ONDCP) discusses, females abuse drugs for different reasons compared to males. A three-year study of females aged eight to 22 years of age found that depression, low self-esteem and peer pressure make females more vulnerable to drug abuse than males. Although fewer females than males may initiate into drug abuse, those who do use drugs become dependent on drugs at a faster rate than males.
The rate of female substance abusers is on the rise, which in turn means that women increasingly require substance abuse treatment. Gender-based substance treatment strategies are continually in development to ensure that recovering women are given every opportunity to succeed in recovery. According to the ONDCP, rehab programs for women must address the specific risks and consequences that women face when abusing drugs. Traditional drug treatment methodologies have largely developed around the needs of men, as males predominantly accessed treatment services in the past.
Same-Sex vs. Mixed-Sex Treatment
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), limited research on the benefits of same-sex versus mixed-sex treatment centers for women reveals that one is not more effective than the other. A factor more determinative of recovery success for women is the type of services that are offered to address women’s unique needs. However, this point aside, some women will only engage in drug rehab in a same-sex environment. In this way, same-sex rehab may improve access to drug treatment, and that is a significant contribution.
In rehab, women present with different life experiences than men and may therefore benefit from gender-targeted services. In other words, it does not appear that being separated from men is as helpful as women finding the support they need. According to NIAAA, women often have more acute problems than men upon entry to rehab. Women are more likely to:
|· Be of a younger age
||· Feel greater hostility toward treatment
|· Have a lower income level
||· Report more mental health and physical problems
|· Have less educational attainment
||· Report stress and mental suffering as reasons for alcohol abuse
|· Have experienced sexual, physical and/or emotional abuse
||· Express shame, guilt and embarrassment about the need for drug rehab
|· Have more acute depressive symptoms when depressed
||· Have childcare/family-related concerns
Research findings about the needs women can easily be translated into advice for women who are seeking rehab. The key will be to identify rehab programs that offer a suite of services the woman needs. Today, many mixed-sex rehab programs have gender-sensitive services, such as matching clients and counselors based on sex, same-sex group meetings, mixed-sex group meetings led by both a female and male counselor, and gender-specific treatment content. When selecting a rehab, whether a same-sex or mixed-sex rehab, a female client or loved one may inquire about the types of gender-sensitive programs available.
One of the most obvious ways in which the needs of women may differ from men in rehab relates to childcare issues. Many traditional drug treatment programs, whether outpatient or inpatient, are not designed for drug-dependent women with child care needs. Women who need treatment may decline to enter rehab because they do not have an alternate caregiver, or they are afraid that if they involve child protective care services they will lose custody of their children and/or involve the criminal justice system.
According to ONDCP, a shift must occur both in rehab service offerings and welfare system protocols. In order to increase a mother’s access to drug rehab services, ONDCP recommends that child protective services and the criminal justice system make assurances to women that seeking treatment will not necessarily result in a loss of custody or criminal repercussions. To avoid women feeling torn between seeking rehab services and losing custody or facing legal problems, more family-based treatment programs are required.
As discussed in an Addiction Science and Clinical Practice article, there are residential treatment programs that can accommodate recovering women with children. The availability of such programs may be limited, but they are built on a commitment not to separate mothers from their children. To provide insight into how family-based programs can work, the article focuses on the treatment model used at one of the earliest inpatient centers for recovering women and their children.
The family-based model program offers the following services:
|· Integrated services to address parent, child and other family member needs
||· Therapy for each family member
|· Substance abuse treatment
||· Family therapy as a group
|· Job training and permanent housing assistance
||· Parenting education
|· Visitation for the parent not in rehab
|· Primary medical care for each member
||· Educational support for children
The family-based program is built on the premise that substance abuse offers women a negative way to cope with unhealthy family relationships which in turn increases the family’s dysfunction. To reverse this dynamic, multifaceted treatment services aim to help the mother to become drug-free, assist each family member to build self-esteem, and encourage positive relationships between each family member. Unlike traditional drug treatment programs, this model dedicates considerable resources to supporting the children’s psychological recovery and helping them to build healthy life skills.
If a family-based residential program would help you or a loved one to access treatment, the next step is to locate a program. The centers that offer such services can help you to coordinate admission for you and your family.
Paying for services should not be a bar to rehab admission. When a family-based program is located, you can speak with an admissions coordinator about the forms of insurance that are accepted. If you do not have insurance and have a low-income level, you may be eligible for your state’s Medicaid program. As some family-based residential treatment programs are federally funded, there may not be any costs associated with treatment.
To date, research has continuously revealed that there is a greater number of people in need of drug rehab than the number who seek rehab treatment.
Pregnant substance abusers
are no exception, and the need for treatment in this demographic is acute.According to recent research sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), in the 15 to 44 year old age group of pregnant women, 11.6 percent used alcohol, six percent used prescription medications (e.g., sedatives, stimulants and pain relievers), and 4.3 percent used illicit street drugs. Despite these abuse numbers, the number of pregnant women who receive drug rehab treatment is alarmingly low. Per the 2013 Treatment Episode Data Set (TEDS), from 2000 to 2010, only 4.4 to 4.8 percent of pregnant women in the 15 to 44 year old age group were admitted to drug rehab.
Drug abuse presents numerous risks to the baby, including premature delivery, a lower than average birth weight, neurological complications, congenital problems, an increased risk of sudden infant death syndrome (SIDS), developmental delays, a greater likelihood of suffering parental abuse or neglect, and a stronger propensity to abuse drugs in their lifetime. But research shows that receiving drug treatment while pregnant can significantly improve birth outcomes and the child’s growth and development overall. For the health of the mother and the child, rehab is always advisable.At present, there does not appear to be an adequate number of rehab programs available to treat pregnant women. This may owe to the fact that only a small percentage of pregnant women have sought treatment, and there may be insufficient public efforts to get these women into treatment. For example, North Carolina only has 21 rehab programs that accommodate pregnant substance abusers. The availability of treatment for pregnant women depends largely on the community. Women often learn about drug treatment centers through word of mouth. But even when a suitable rehab is located, there may be a wait.
However, in any state, there will be some form of rehab service available to pregnant woman. For instance, treatment may begin in the detoxification unit
of a local hospital. After detox, pregnant women may enter either an inpatient or outpatient treatment center, depending on the severity of the addiction. Even if a pregnancy-specific program is not available locally, or the waiting list is prohibitively long, a pregnant substance abuser may engage in non-specialized rehab services. As long as the proper prenatal care is provided by a physician working in conjunction with the rehab center, the attending team of rehab professionals should be able to make any necessary adjustments to treatment protocols in order to help the mother-to-be. Paying for treatment is not likely to be a barrier to access because there is governmental funding in this area, and Medicaid and other public insurance may be available for low-income individuals.
Research suggests that pregnant substance abusers tend to have acute problems, such as mental health disorders, a history of trauma, poverty, a lack of adequate or stable housing, a history of domestic violence/relationship abuse, and legal problems. A rehab program dedicated to the treatment of pregnant women will likely have experience addressing these issues. However, if such a service is not available then in addition to traditional rehab treatment, the pregnant substance abuser is best advised to work with a social worker or counselor to coordinate support services in areas of need, such as housing. If ancillary services are not provided, the stress the recovering woman faces may trigger a relapse either before or after the birth of the child.
It is clear that female recovering substance abusers may benefit from gender-specific treatment services, but exactly what kind of services have proven to be effective for women? The Substance Abuse and Mental Health Services Administration
has drawn data from numerous research studies to provide insight into some of the treatment approaches that have worked best.Regarding the treatment setting, research shows that women have improved treatment outcomes when they receive supportive therapy. Women tend to respond best when the treating counselor (male or female) has qualities such as warmth, empathy, and a nonjudgmental attitude. Mutual respect and compassionate care have also been identified as particularly helpful. A treatment atmosphere that is both safe and nurturing is likely to be the most effective for recovering women.A collaborative approach has been found to be particularly helpful for women in drug treatment. This approach can be defined as the treating counselor working in unison with the recovering woman as equal problem-solving partners. The therapist/client dialogue should offer constructive guidance, give support, and promote optimism. Research shows that it may be most helpful for therapy to begin by addressing issues such as food and eating behaviors, housing and transportation. Studies support that if women feel their primary needs are being met, they are more likely to trust the rehab process and work on substance abuse issues.In terms of service options, women who have access to multiple types of services in one location tend to remain in rehab treatment longer than women without such options. In addition, women who are treated with intensive care services at the start of rehab are more likely to remain in treatment. Receiving individual counseling has also been shown to be a factor in women staying in treatment. These findings strongly suggest that women are more apt to remain enrolled in rehab if they feel their needs are being heard and addressed.Offering family therapy has been shown to be essential to the rehab process for women. Family therapy can help a woman to positively reconnect with family. However, if family members are not supportive or the woman does not have a family, then therapy can help a woman learn how to build a family-like network of trustworthy individuals. If the recovering woman feels grief around family issues, therapy will need to address this feeling because it could prove to be a relapse trigger.Women, like men, may be diagnosed with a co-occurring disorder before entering rehab or during rehab. Co-occurring disorders are often termed a “dual diagnosis,” and this applies when a substance abuse disorder exists simultaneously with at least one mental health disorder. Regarding types of mental health disorders in specific, women are most likely to suffer from post-traumatic stress disorder, depression, anxiety, or eating disorders. A rehab center committed to providing women with gender-specific treatment will need to conduct a diagnostics process to determine if a woman suffers from any mental health disorders. A system of care that integrates substance abuse treatment and mental health care treatment is best positioned to provide effective care to a woman who has a dual diagnosis.
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We can help to connect you or a loved to a number of women-only rehab centers or mixed-sex rehabs that offer gender-sensitive services. Our goal is not only to help you find a rehab but to also ensure you feel comfortable and informed about the process when you enter one. Call now.