A recent white paper from the Office on Women’s Health concluded that the prevalence of prescription opioid and heroin use among women is substantial. It provided dramatic statistical data on what kind of impact the opioid addiction epidemic is having on women. “Between 1999 and 2010, overdose deaths from prescription painkillers increased more than 400 percent among women, compared to an increase of 237 percent among men; between 2002 and 2013, heroin use among women increased 100 percent compared to an increase of 50 percent among men.” The white paper pointed out that “the picture of substance use is different for women compared to men” and gives a number of examples.
Chronic Pain A significant number of individuals requiring addiction treatment suffer from chronic pain conditions, presenting a particular challenge for these patients. Women are especially affected. “Women are more likely to experience chronic pain and use prescription opioid pain medications for longer periods and in higher doses than men,” according to the white paper. Women are also more likely than men to report any pain and are “more likely to be prescribed prescription opioids, be given higher doses of opioid pain medication, and use them for a longer duration of time than men.”
Different Biology Being more likely to be prescribed opioids and in higher doses carries a greater risk of developing a substance use disorder. Several biological gender differences enhance this risk further. According to the Harvard Medical School, women “tend to progress more quickly from using an addictive substance to dependence (a phenomenon known as telescoping). They also develop medical or social consequences of addiction faster than men, often finding it harder to quit using addictive substances, and are more susceptible to relapse.” The white paper adds that they also experience more cravings than men. It is well known that biological factors make women more vulnerable to the effects of alcohol.
Trauma A significant number of women who require addiction treatment have co-occurring conditions caused by trauma. Damaging relationships and sexual abuse at the hands of men are common traumatic experiences for women with substance use disorders. Approximately 1.8 million women are abused each year in the United States. As the authors of the white paper remind us, “studies have repeatedly found that rates of both childhood and adult sexual abuse are higher among women than among men and that this abuse is correlated with substance use disorders.” “A history of traumatic childhood events, such as physical or sexual abuse and domestic violence, has also been associated with the initiation of substance use among women,” reported the white paper. “Research has shown that physical and sexual trauma followed by post-traumatic stress disorder (PTSD) is more common in drug-misusing women than in men seeking treatment.”
Caregivers The white paper points out that approximately 66 percent of caregivers are women. “Increased levels of stress and depression can be common among women who are in caregiving roles, whether they are caring for children, parents, family members, friends, or other loved ones. The role women often play in society as caregivers means they tend to define themselves based on the relationships in their lives.” “Because women place high values on their relationships and families, treatment should focus on promoting and supporting healthy attachment and relationships between parents and children and on women’s relationships with others. Family-centered treatment helps not only the woman dealing with adverse outcomes of drug use, but with her family and their needs.”
Gender-specific Treatment If substance use is different for women, it makes sense to provide treatment tailored to the needs of female patients but only 44 percent of treatment programs provide special programs or even groups for adult women. Lakeview Health follows an integrative and gender-responsive approach to providing patient care. The integrative health model at the Rose of Lakeview Women’s Center looks at the medical, psychological, physical, and spiritual aspects of female patients’ recovery. All Lakeview Health staff—from the clinical, dietary, and environmental staff to senior leadership—have been trained in trauma-informed care. We recognize that treating trauma is often a necessary part of treating addiction, especially in women. Creating a safe space for our female patients to address their trauma openly can help with early recovery.