CHAPTER 18
Gender and Substance Use Disorders
LEARNING OBJECTIVES
After studying this chapter, students should be able to:
•
18.2: Describe the impact of gender on the rehabilitation process
•
18.3: Understand the different effects of various compounds on women as
opposed to men
CHAPTER OUTLINE
Gender and Addiction: The Lessons of History
Statement of the Problem
Substance Use Disorders in Women
The “Convergence” Theory
Does Gender Affect the Rehabilitation Process?
Work, Gender, and the Substance Use Disorders
Differing Effects of Common Drugs of Misuse on Women
Alcohol Use Disorders in Women
Physical Complications
Interpersonal Resources
A Positive Note
A Cautionary Note
Amphetamine Use Disorders in Women
Benzodiazepine Misuse by Women
Buspirone Misuse by Women
Cocaine Misuse by Women
Hallucinogen Misuse by Women
Ecstasy (MDMA)
LSD and Phencyclidine
Marijuana Misuse by Women
Narcotics Misuse by Women
Nicotine Misuse by Women
Smoking Cessation
Other Compounds
Aspirin
CHAPTER OVERVIEW
The purpose of this chapter is to examine the evidence suggesting that “drug misuse” and
“alcohol misuse” are not unitary phenomena for both men and women. Rather, a growing body
of evidence suggests that there are major differences in how various compounds affect women
as opposed to men, and that there are often different pathways to substance misuse or SUDs
between the sexes. This chapter thus provides an overview of this problem. The need for
gender-specific treatment facilities is discussed, as well as whether women should be referred
to a traditional 12-step support group as opposed to a gender-specific group.
Break-Out Discussion #1:
The convergence theory: It has been suggested that the percentage of women who have
substance use disorders (SUDs) is slowly approaching that of men with similar disorders. Is this
true? Society has hidden the problem of substance misuse in women for the better part of the
Questions
1. If the woman’s substance use was sanctioned by a physician, is it an SUD, or just a woman
receiving another prescription?
2. Should multiple prescriptions for a compound with a moderate or high misuse potential be
counted as part of the substance use problem in this country?
3. What statistics comparing SUDs in men and women can you find? Is the percentage of women
with an SUD approaching that of men, or is it just that society is able to recognize such problems
now?
4. Your text notes that not all substance rehabilitation programs offer gender-specific
treatment. But what should be included in a “gender-specific” rehabilitation program? Why
those components and not others? If a hypothetical woman is admitted to a male-dominated
rehabilitation program and is handed a booklet on recovery for women, does that make the
program “gender specific?”
5. Does “gender specific” mean only specifically for women, or are there “gender-specific”
programs for men as well? Should such programs be offered? Why, or why not?
Break-Out Discussion #2:
Childhood sexual abuse and subsequent development of substance use disorders: One of the
more controversial theories concerning substance misuse is whether there is a causal
The apparent relationship between childhood sexual abuse and the later development of SUDs
are flawed because (1) these studies are based on a skewed or highly selective sample and (2)
they are subject to selective perception. This has not, however, prevented untold numbers of
persons in treatment for SUDs from being told over and over again that their SUDs were caused
Studies that uncover no significant relationship between variables examined are rarely
published. This trend in the professional literature, as well as the readers’ expectations,
contributes to the shaping of therapeutic myths that are not supported by clinical research.
Anecdotal data also contribute to the development of such therapeutic myths: If you know of
one case in which a person had been sexually abused as a child and went on to develop an SUD,
does this mean that every child who is victimized in this manner will go on to develop such a
disorder?
Questions
1. Can you find any studies that deal with the correlation discussed above? How do these
studies deal with the issue?
2. What type of evidence would be necessary to support that this correlation is causation?
3. Why do you think people believe that being sexually abused in childhood makes a person
prone to develop an SUD later in life? Do you think these beliefs are logical?
Reference
KEY CONCEPTS AND TERMS
Positron emission tomography (PET) scan: This process produces three-dimensional images of
specific organs after a molecule “tagged” with a radioactive substance is injected. Special
Myocardial infarction: The blockage of blood to the tissue of the myocardium, which is to say
the tissues of the heart. If this blood flow is not restored in a short period of time, the tissue will
Women
die. Often called a “heart attack” by the layperson
Myocardial infarction gender gap: Nonsmoking women tend to experience heart attacks 10
years later than men
LO/STANDARDS CORRELATION CHART
A-head
LO
Standard—CACREP
Gender and Addiction: The
Lessons of History
Substance Use Disorders
in Women
18.1:
Understand
the lessons
from history
regarding
gender
similarities
and
differences
for alcohol
and drugs
3d: theories and etiology of addictions
and addictive behaviors
3e: biological, neurological, and
physiological factors that affect human
development, functioning, and behavior
3f: systemic and environmental factors
that affect human development,
functioning, and behavior
2h: strategies for identifying and
eliminating barriers, prejudices, and
processes of intentional and
unintentional oppression and
discrimination
Does Gender Affect the
Rehabilitation Process?
18.2: Describe the
impact of gender on
the rehabilitation
process
3e: biological, neurological, and
physiological factors that affect human
development, functioning, and behavior
3f: systemic and environmental factors
that affect human development,
functioning, and behavior
2h: strategies for identifying and
eliminating barriers, prejudices, and
processes of intentional and
unintentional oppression and
discrimination
Differing Effects of
Common Drugs of Misuse
on Women
Alcohol Use Disorders in
Women
Amphetamine Use
Disorders in Women
18.3:
Understand
the different
effects of
various
compounds
on women as
opposed to
men
3d: theories and etiology of addictions
and addictive behaviors
3e: biological, neurological, and
physiological factors that affect human
development, functioning, and behavior
Buspirone Misuse by
Women
Cocaine Misuse by
Women
Hallucinogen Misuse by
Women
Marijuana Misuse by
Women
Narcotics Misuse by
Women
Nicotine Misuse by
Women
Other Compounds