Women and Substance Disorders Throughout Research
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Throughout research there has been a direct correlation amongst women and the usage of substances and dependency. There have been many risk and protective factors that have been identified as to why women turn to illegal substances or remain abstinent. Studies show that as early as the 1800’s roughly 66%-75% of women were using opium and it was even noted that many of them were pregnant while using (Jones, 2013). Unfortunately, substance abuse contributes too many medical conditions such as human immunodeficiency virus (HIV), pregnancy complications, cardiovascular complications. It also presents many social consequences such as unwanted pregnancies, increase in crime, domestic violence, accidents, sexual abuse and suicides (Straussner, 2014). Barriers, environmental factors as well as culture and psychological factors also all play a significant role in the usage and seeking out assistance when it comes to drug or alcohol use. Although, there are many prevention and intervention programs now available often the barriers are far more efficient than the help.
As previously stated, there are many risk factors and barriers that pose a threat to the treatment of women with substance and alcohol use disorders. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) a substance use disorder is defined as a recurrent use of alcohol or drugs that clinically and functionally causes a significant impairment in a social or occupational way (SAMHSA, 2018). Impairments can be seen as a health issue, disability or the deficiency in one being able to meet daily responsibilities at home or work. Women have a significant amount or risk factors when it comes to substance use disorders and the damage that they cause. There are two types of risk factors that may be experienced which are individual and environmental elements. Influence of family, friends, culture, genetics, psychological, the community, depression or trauma are all significant risk factors within women and their pathway to substance use disorders.
Risk factors often cause a slippery slope effect in environmental situations. For example, is a person comes from an environment where poverty and a substance use disorders are prevailing then it becomes a norm that may causes other issues such as crime. Crime has been directly correlated to both poverty and substance use disorders and crime has been a prevalent concern in women history. The number of female incarcerations have been steadily increasing throughout federal and state prison within the United States. The prevalence of substance abuse in the population of women offenders has caused an increase in criminal activity. Evidence shows that approximately 40-72% of women who are imprisoned have a history of substance or alcohol abuse and 46% of all federal convictions are drug related offenses (Federal Bureau of Prisons, 2018).
Signs and symptoms are things that we should look for closely in the female population. These are important trademarks that need to be followed through with in order to better help the women population. Some signs and symptoms that need to be looked for are past and present trauma. This can be presented as physical or mental abuse from spouses, intimate partners, family members and even friends. Sexual abuse also plays an important role within the women community and substance abuse. There can also be physical and behavioral symptoms that give us an idea if women are currently or have previously had a substance disorder. When it comes to physical symptoms problems sleeping or sleeping too much may arise. As well as unexpected weight changes, dilated pupils or bloodshot eyes. There may also be track marks that could be visible due to certain drugs being injected.
Behavioral symptoms alter the way a person acts and it changes their normal habits. Drugs tend to debilitate our brains ability to think and its function which can increase our aggression or irritability. Symptoms also include depression, changes in our attitudes or our personalities, and our priorities may alter. When these things happen, a person can also seem very distant from people close to them. Normal patterns also change, confusion and things may begin to slip from memory and the involvement of criminal activity can emerge.
In a study conducted by Kopak and Ruiz (2014) they were able to administer a survey to female state and federal inmates utilizing the DSM-5 with drug and alcohol disorders to see which offenses women were being imprisoned for. Their analysis showed a severe association between substance and alcohol disorders with violent offenses in which women were likely to commit further property and drug related offenses to sustain an addiction (Kopak and Ruiz, 2014). Sadly, crime presents a serious risk when it comes to women and addictions. It can further usage since substances and alcohol are available inside of prison as well as in their normal environments. Also, with drugs being so relentless in low income areas it can often be difficult to maintain or stay in an abstinent lifestyle.
Another important barrier that should be established is poverty and not having the means to be able to receive treatment. Poverty is present is all types of families and communities around the United States and it has been directly associated with drugs and alcoholism. Funds and insurance that isn’t available to everybody especially in low income communities. There are not many rehabilitation programs that are trustworthy and available that take government insurances or that are free. Most rehabilitation programs that are decent only take private insurances or they cost an arm and a leg in order to receive their services. In low income communities’ drugs can either be the reason why they have no money because they are supporting an addiction. Or it can be the only reason they do have money which means they’re selling it to bring in revenue into their homes to be able to provide for their families. There are many challenges when it comes to income and substance use disorders. Such as stated about the means to have transportation, employment, mental health and rehabilitation facilities. Without income people do not have the luxury to try and find reliable transportation as substance abuse facilities often require (Lois, Wilson, Fretwell 2018).
Trauma is a significant element that should be addressed when working with the female population such as sexual abuse. Approximately one in five women have reported being raped and 13% of women mentioned having been sexually coerced in their lifetime (Salina, Ram, Jason 2016). It has even been said that women that experience some sort of sexual abuse often have worse outcomes that women that experience physical abuse (Kennedy, 2017). Symptoms that have been associated with sexual abuse include post-traumatic stress disorders (PTSD), substance abuse admissions, poor health, HIV, domestic violence and sadly have a higher risk or re-experiencing sexual abuse.
The correlation between women, sex and substance disorders are far too common to not have more awareness. The tradeoff between sexual acts for drugs is prevailing just as the high number of women who participate in prostitution. Women who have been involved in justice related incidents as well as experienced sexual abuse tend to have histories of prostitution as well. Unfortunately, females who were sexual assault victims age 34 and or younger all lived in lower income households and lived in rural areas and 78% of all of them were committed by a family member, intimate partner, acquaintance or friend (Department of Justice, 2016). Data also shows that African American women have higher sexual abuse rates than those of White or Latina/ Hispanic women (Basile, Smith, Fowler, Walters, Hamburger, 2016)
Food and housing insecurity along with sexual abuse amongst women all played a component in the course of su2bstance disorders. In a study conducted by Basile, Smith, Fowler, Walters, Hamburger, they carried out face to face as well as paper interviews of 168 women from different socio-economic classes. The purpose of this study was to share community samples of women and their rape and sexual coercion victimization and their associations between negative mental, physical and health related behaviors. Findings from the study revealed that approximately 66.3% that they exchanged sex for food and housing because they were concerned for their ability to pay their rent as well as ability to provide nutritious meals. We hear about afflicting stories like this but, yet it’s can often take up to a year to be able to receive section eight and food stamps.
Many women also disclosed that after experiencing a mortifying trauma such as sexual abuse, 49.5% of them engaged in binge drinking and began misusing illegal drugs or prescription drugs on the daily. These women suffered terrible experiences, but even after the act is committed there are still mounds of negative effects that come after it. The PTSD stays with them for years if services are not sought out, many experienced anxiety attacks as well as depression and there are still many women out there that don’t report sexual assaults for various reasons. There’s embarrassment, funding, many women are scared of their predators and if there will be retribution, lack of family support and many other reasons.
Spouses are another reason why women begin using drugs or abuse prescriptions. Many women are introduced to them because of their spouses or intimate partners. I have heard many stories where women use drugs to either please them or because their scared and told to. Although I know this is a research paper, I wanted to share a personal example as I have seen this in my own life, my mother is a recovering addict because of my father. Growing up as many other teenagers my mother tried marijuana but never any hardcore drugs as we would call it. She then met my father who lived a different lifestyle than her, but he ultimately introduced her to crank. Until this day she says she did it to please her husband and numb the pain that she felt in her everyday life and marriage and a way for her to cope with the stress she was experiencing. This is another prime example of a reason of why women often turn to substance disorders.
Substance disorder not only effect the host but it often also comes with the following consequences such as the possibility of contracting the human immunodeficiency virus (HIV). According to the Centers for Disease Control and Prevention HIV is the leading vector for HIV transmissions (Centers for Disease Control and Prevention, 2013). Risk often include a combination of sexual behavior and substance abuse to include alcohol, methamphetamine, opioids and injectable drugs. Kidd, Tross, Pavlicova, Hu, Campbell, Nunes, (2017) explore the Theory of Gender and Power where they describe disparities in structural and social norms as well as resources that have discerning implications for HIV risk. Within this theory they analyze and tie gender disport potions of money, labor and power to normalize the dependency of women on men for basic resources (Kidd, Tross, Pavlicova, Hu, Campbell, Nunes, 2017). By women being depending on men it can limit their ability to be strong willed. These imbalances are enhanced amongst substance using women who often have limited resources, support, social- mobility and live in poverty. Sadly, we see cases like this more than we should where dependency plays as a barrier between women and their health and wellbeing.
Genetic transfers also play an important role in substance use disorders for women. Till this day many women still use drugs while being pregnant just as in the 1800’s during the opioid crisis. Women who use drugs during pregnancy have a probability of passing on genetic susceptibility to their unborn children. It is not uncommon to hear about babies being born and addicted to a substance. Nicotine has the same effect and is the leading cause to morbidity rates in the United States. Nicotine contains harmful toxins that readily transfer to the fetus throughout a women’s pregnancy (Bidwell, L., Palmer R, Brick, L., Madden, P., Heath, A., Knopik, V, 2016). It’s not only bad for the mother’s health it also effects the neurodevelopment of the fetus throughout growth.
The stigmatization that comes with prenatal substance abuse is also a barrier for many women as they feel reluctant to seek treatment. Medical professionals seek to minimize and manage risk through protocol, formally and informally and social professionals as well as women’s internalization of social norms associated with risk (Stengel, 2014). Once drugs are located in a women’s body there is an assumption that women have the “ability” and thus the “responsibility” to manage all possible risk during their pregnancy. When women don’t meet medical professional norms especially during pregnancy they are labelled as “risky” and then are treated differently and put under increased monitoring. Although it’s not good for women to use drugs during pregnancy due to potential health exposure for the mother and the fetus it’s hard to have a woman willingly walk into a clinic without being judged or treated different. Everybody makes mistakes and people sometimes don’t ask for help because of the stigma that is attached to women using drug during pregnancy and being labelled as a “bad mother”.
So far in this research paper we’ve talked about prevalence rates associated with women and substance disorders. As well as some risk factors as to why women initiate using substances or continue using them. As well as signs and symptoms that allow us to better observe the female population to more effectively meet their needs. As we know diverse population require diverse and special treatments needs. For women this means acknowledging that what works for other special populations sometimes will not work for them. Special treatments for the female population means that in order to design or place them in a treatment program we have to understand who they are. For example, we need to be able to identify their demographics, their history, we need to be able to connect on deeper level. In order to be successful with the female population we are obligated to figure out the immediate barriers that are present in every case and overcome them to be able to achieve retention. Every case is different so in female population the barriers could be the lack of effective treatment for them, also specific life circumstances such as pregnancy or dependency.
These are all unique barriers that need to be handled differently and individually. Research is essential in gender specific treatment as well, as counselors it is our job to be know our resources that are gender specific. If a woman needs safe harbor from her sexual assailant, then we have to be able to point out client in the correct direction for their ultimate safety. For special populations such as women we need to observe and ask pertinent questions to their individual obstacles. That being their accessibility to treatments or certain locations, parenting responsibilities, or trauma. Women have more “complex” needs than men with regard to treatment services and programs and that they require “gender sensitive” and “gender aware” services on this basis (Martin, Aston, 2014). By remaining nonjudgmental and keeping our bias in check it increases the odds of the female population to return and seek treatment. Also advocating for our clients and knowing their special treatment needs is crucial in order for them to achieve success.
Knowing how to attend to a special population is only a part of what it means to help and make a difference. To be able to retain women in drug and alcohol treatments programs is the second part. In order for the retention of women in treatment programs we have to make sure that the treatment benefits and applies to their current situations. Also, we need to make sure were setting out clients up for success and things that are feasible to them within their means. If a client doesn’t have transportation but their assigned five different courses and counselling sessions in one week then all were doing is creating another barrier for them to be able to receive help.
Nonetheless, there have been factors that have been identified as conditions that influence the rate of retention in the women population. The first one being support from family, spouses or friends. There has actually been studies that show that support systems that participate in group therapy sessions as well as behavioral couple’s therapy increases the rate of retention, abstinence and substance recovery. Pregnancy status was also correlated with a higher rate of retention. Women who entered treatment in their late pregnancy phase showed higher rates of completion, especially if they were open to receive mental health services, they were more likely to engage in treatment. Another important factor was the relationship and experience that they received with their counselors. Research indicated that if women experienced a safe and nurturing therapeutic experience then they would be more inclined to continue sessions. When using a positive and collaborative therapeutic approach clients and counselors were able to effectively focus on the clients on the treatment goals that were important to the client (SAMHA 2018). Access is a big element when it comes to retention as well. Women who had various locations available that offered various services proved to have higher retention rates. Notably residential treatment programs that offered onsite child services and care also had better rates. By attending to women and appealing to their immediate needs we have been able to achieve better retention rates amongst this population.
As humans it can commonly be hard for us to remain un-bias based on morals or up bringing but it’s important to empathize with individuals who may have gone through strenuous circumstances. By keeping our internal feelings checked and remaining nonjudgmental we can help the female population as it’s important for women to continue to seeking treatment and make sure they follow up with appointments. As counselors and future counselors, it is critical to do our own research and never assume that what works for one population is going to work for another. There are many resources available to us that allow us to keep learning prevalence issues that often go un-noticed. The female population is special and requires special treatment and different connections in order to undergo treatment and be successful. Diversity and the ability to be open minded to learn new approaches is essential. The female population is filled with different demographics and cultures that need to be addressed and respected. Ultimately our job is be the voice that our clients sometimes don’t have. As counselors it’s important to strive to make the change and remove barriers from our client’s lives in order to fight the constant struggle of substance disorder within our women population.