Research on Alcohol Addiction Among Women - Coursework Example

Introduction For many years alcoholism appeared to be a problem for men, some of whom worked hard and drank hard. For some of them, in time, as the alcohol took its toll, various health problems, such as cirrhosis of the liver brought them gradually to their end. As women have gained more power in society and been allowed into domains that were previously the sole enclave of men, it has emerged that it is not only the good things in society that women crave but also the opportunity to indulge themselves whether this involves sexual promiscuity, being involved in war, or drinking alcohol and using drugs. As more women have begun to suffer the consequences of addictions such as those relating to alcohol the question has come up regarding how best to deal with these problems. Does the supposed equality between men and women mean that medical interventions on problems affecting men and women are identical? Preliminary research suggests that there may be important differences that have implications for how women alcohol abusers are treated. As Bradley and Ashley (2006) note: “Gender is especially important in substance abuse treatment services research because the background characteristics, substance abuse patterns, and personal histories of female substance users may differ from those of males. As such, treatment programming designed specifically for women is needed to address not only women's substance abuse-related problems but also their special needs and barriers to treatment.” This paper examines some of the questions and answers surrounding women who are addicted to alcohol and some of the interventions currently available for dealing with the issue. Gender differences in effect of alcohol use Among adolescent girls, the habit of binge drinking has caught on. Their counterparts in the universities and colleges are no slouches either when it comes to drinking. After all, some of them had their start in their early or late teens. In her book about alcoholism, author Koren Zailckhas writes about having her first drink at the age of fourteen, and going through years of blackouts and hangovers and waking up in the house of a strange man (Roan 2006). Smashed: Story of a Drunken Girlhood is not as far-fetched as it might seem because surveys show that this author’s experience, far from being out of the ordinary, is the norm for many young girls today. In the case of Zailckas she had the courage to go sober at the age of 22 but not all other women are so fortunate. Those who are not able to get the proper interventions sometimes end up failing in school, getting into car accidents, having unwanted pregnancies, or becoming involved in other equally damaging drugs such as cocaine or heroine. Regarding the toll that alcohol takes on women, Shari Roan writes in the Los Angeles Times that there are estimates that between 16 and 27 percent of girls binge drink and that even as the behaviour decreases among adolescent boys it is holding steady among girls. “The gender gap for young kids has effectively closed,” says Susan Foster, vice president and director of policy research at the National Center on Addiction and Substance Abuse at Columbia University. “If you look at eighth and ninth grade girls, they are drinking, smoking and using drugs at the same rates as boys are. But the main problem is that the physiological impact is much stronger on girls than on boys (Roan 2006). The greater impact of alcohol on girls can be explained by the simple fact that women do not have as much water in their bodies relative to fat so alcohol in their bodies does not become as diluted as is the case in men for whom the water content is higher. In addition, alcohol dehydrongase, an enzyme that helps to break down alcohol in the body is not as active in women as it is in men. As such, women’s brains and organs are exposed to greater concentrations of alcohol compared to their male counterparts. Not surprisingly, women are more likely to die of cirrhosis. To get an accurate perspective on the differences between women and men as regards alcohol use, Becky Flood, executive director of News Directions for Women, a non profit substance abuse treatment center in Costa Mesa, California, states: “We know that two years of a woman’s drinking equals 10 years of a man’s…What alcohol does to the body of a woman in her developmental years is very damaging. We even see cognitive impairment in women” (Roan 2006). In addition, women are apt to get addicted to alcohol faster than is the case with men, a fact that explains the increasingly young ages at which girls become dependent on alcohol. Those who have started drinking by the age of fourteen are on a straight clear path towards alcoholism, at least, much more so than those who begin drinking at the age of 21. As Roan explains, “Problem drinking in women may also be more likely to escape attention from medical professionals. Women are less likely to seek or be referred for treatment than men – and only 38 percent of substance abuse programs in the United States are designed for women, despite research that shows women do better in gender-specific programs…” (Roan 2006). Women’s drinking may not be getting the attention it deserves in the spotlight but those who follow this issue closely know that it is at the point of quiet crisis already. If more women are attending college than men it must also be acknowledged that in the latest National Survey on Drug Use and Health teenage girls were found to be trying marijuana, alcohol and tobacco products are higher rate than boys, showing that for these girls whatever boys can do they can do better, with possibly alarming consequences to their health and future! Understanding why more and more girls are using alcohol and other drugs, for some professionals, is the first step in being able to provide them with the kind of interventions that have a chance for success. For some girls, it has been found that peer pressure is the main reason why they get involved in using alcohol; for others there is a belief that alcohol and other drugs can help them slim down, while for still others, these drugs may be used to cover up the pain of sexual abuse. “Still other girls drink, smoke pot and dabble in drugs because they are self-medicating for untreated or undiagnosed mental illness…Even moderate drinking by girls can disrupt their growth and the development of their reproductive systems. Drinking also disrupts brain development, which is the case among boys and girls” (Girls’ drug habits alarming 2006). In the research report “Substance Abuse in Women: Does Gender Matter?” Back et al (2007) point out that there is increasing awareness in the research community that biological and psychosocial differences between men and women could affect not only the prevalence and presentation of alcohol addiction but also affect co-morbidity and possibly the appropriate interventions. Regarding the biological differences, Back et al (2007) note the evidence that hormonal fluctuation in the menstrual cycle of women can affect their craving for alcohol and other drugs. For some women, there is stigma attached to seeking treatment for alcoholism. For others, there may not be much support from their partner or there may be fear that acknowledging the problem can affect issues such as those relating to child custody. Understanding these barriers can also help in providing the necessary care for women where they might be more receptive to such interventions. In fairness, it is important to note that even as young females have been noted to be drinking more, overall, “of the 15.1 million alcohol-abusing or alcohol-dependent individuals in the United States, approximately 4.6 million (nearly one-third) are women. On the whole, women who drink consume less alcohol and have fewer alcohol-related problems and dependence symptoms than men , yet among the heaviest drinkers, women equal or surpass men in the number of problems that result from their drinking” (Alcohol and women 2006). There are also differences with regard to life cycle and role, whether a female is in her teens, a mother, or retired, and how this affects their drinkign behavior. In fact, Contrary to popular belief, women who have multiple roles (e.g., married women who work outside the home) may have lower rates of alcohol problems than women who do not have multiple roles (6). In fact, role deprivation (e.g., loss of role as wife, mother, or worker) may increase a woman's risk for abusing alcohol (7). Women who have never married or who are divorced or separated are more likely to drink heavily and experience alcohol-related problems than women who are married or widowed. Unmarried women living with a partner are more likely still to engage in heavy drinking and to develop drinking problems. (Alcohol and women 2006) Gender-specific interventions Some of the most well known substance abuse treatment studies such as the Drug Abuse Reporting Program and the Treatment Outcome Prospective Study (TOPS) did not inlcude a consideration of the differences between males and females in the treatment of their data. The final report did not take into consideration, in both cases, with differences that might be due to gender. In fact, in some cases, female research subjects were not taken into account at all. The winds began to shift in the 1990s when the National Treatment Improvement Evaluation Study (NTIES), which ran between 1993 and 1995 provided an analysis of treatment outcomes based on gender. As the proportion of alcohol abuse treatment clients who are women has increased, it has become increasingly clear that women cannot be excluded from such studies if they are to benefit from dealing with the problem of alcoholism. “In 2002, according to the Treatment Episode Data Set (TEDS), about 30 percent (565,000) of admissions to substance abuse treatment facilities were females, up from 28 percent in 1992 (Substance Abuse and Mental Health Services Administration [SAMHSA], 2004)” (Bradley and Ashley 2006). Research indicates that women who were treated for their alcohol problems in a medical setting abstained from alcohol use at a higher rate than men. For men, it appears that peer group oriented facilities provided better results. Also, it was found that women who were treated in a facility with only a few female clients had greater rates of success. The above study, however, needs to be followed up since it did not include a control group (Women and alcohol 2006). Among the programs that have been found to be effective for women are those that are connected with ancillary services such as child care or transportation services, that is, interventions that make it easier for women to gain access to facilities. After all, if a woman has no one to take care of her child it is unliekly that she will go through the effort involved in seekign help for herself. She can rely on the convenient excuse that she has to take care of her child and that she cannot leave the child behidn to go and seek treatment. Likewise, for women who are impoverished a convenient excuse might be lack of money or transportation to access the necessary services. Once again, if transportation is offered then this barrier is eliminated. It has also been found that women are often more comfortable when they have to attend an all-women facility rather than one in which they have to commingle with men with alcohol problems. In addition, services that include workshops on topics of interest to women might get them interested in improving their overall wellbeing rather than being a slave to the bottle. Among the characteristics of alcohol abusing women that has implications for their treatment is the fact that female alcohol abusers were more likely to have children compared to their male alcohol abusing counterparts (Bradley and Ashley 2006). Evidence that facilities treating female alcoholics are paying attention to the research can be seen from the fact that “An estimated 13 percent of substance abuse treatment facilities offered child care services, and 12 percent offered prenatal services. Of all substance abuse treatment facilities, 6 percent served women only, 37 percent offered special programs for women, and 19 percent offered special programs for pregnant women” (Bradley and Ashley 2006). Women in treatment cannot be treated without consideration of their psychological health. Such women may have other problems such as depression, anxiety or bipolar affective disorder along with eating disorder or posttraumatic stress disorder. In one research for instance, it emerged that there were more problems of psychiatric disorder among women than men prior to first use of the abusing substance. “In addition, substance-dependent females have been found to be more likely to need help for emotional problems at a younger age and to have attempted suicide than substance-dependent males (Haseltine, 2000)” (Bradley and Ashley 2006). All of these go to show that the treatment of alcohol abuse cannot be divorced from other issues pertaining to healthy mental functioning. As noted above, for some women, the impetus for alcohol abuse may be the experience of physical or sexual abuse. Other factors might be involvement in an accident or some other major disruption in the family such as the loss of a significant other. And not to be ignored is possible domestic abuse. In terms of treatment, the Alcoholics Anonymous 12-step program which has been quite effective for many men does not appear to work particularly well for women because the confrontational style might bring about feelings of distress or helplessness, thus undercutting the potential effectiveness of the intervention. Interventions also need to take into account the kind of relationship within which a woman may be embedded. For some women, bad relationships with their children or their spouse or boyfriend may be part of the trigger for alcohol abuse. In a case where the partner is also a substance abuser it may be futile to provide treatment for the woman without also considering the needs of the partner. This may be particularly so in a case where the woman is in a less dominant position compared with the male counterpart. For those women from minority communities where the experience of racism may be common, interventions that also do not address coping mechanisms might not be effective because as long as the underlying problem, such as racism, continues to exist, and the client chooses alcohol abuse as a coping mechanism not much can be done. On the other hand, if the client is given new frameworks for looking at the problem of racism or empowered to seek avenues for self-affirmation rather than buying into the society’s assessment of her, the client may be more successful in treatment. Perhaps more for the concern of their children, women in pregnancy have had more opportunities than others in accessing programs that assist them to deal with their alcoholism. For example, “Using Los Angeles County data, a 1994 study of 161 drug treatment programs for adults found that 42 percent provided activities for children, 39 percent targeted pregnant women, and 19 percent served women only (Grella et al., 1999). Compared with mixed-gender programs, women-only programs were more likely to provide priority admission for pregnant women, charge no fees, and plan for longer treatment duration” (Bradley and Ashley 2006). Many women only programs obtained funding from the U.S. government, or accepted Medicaid payment thus making it possible for women from low-income backgrounds including those from Latino and Native American communities to more easily access such programs. With respect to the efficacy of programs that target women, it has been found, for instance, that when women are allowed to live with their children in a residential facility, they have greater success than when they have to use outpatient services. “Although the literature contains many reports of women-only treatment programs, only one randomized study in Sweden compared females in a women-only treatment unit consisting of an outpatient clinic and a residential ward with females placed in the care of traditional mixed-gender alcoholism treatment centers (Dahlgren & Willander, 1989). A 2-year follow-up showed a more successful rehabilitation in terms of alcohol consumption and social adjustment (including employment status) for the females treated in the specialized women-only unit” (Bradley and Ashley 2006). For those in outpatient services, the inclusion of other services, such as those relating to parenting or pregnancy have been useful. Conclusion It seems that in the past women were ignored with regards to studies that related to alcohol use. This may simply have been because of the prevailing belief that women were not heavy users of alcohol or that they were able to control themselves in their use to the point where such use did not become debilitating in their lives. As women have been able to assert themselves more in society and to have the benefit of social and legal protections equal to those of men they have also sought to experience the whole range of social pleasures and challenges whether these involve having a greater number of sexual partners or using drugs such as alcohol. In fact, while there are indications that binge drinking is on the decrease for boys the rate for girls is either holding steady or increasing. The age at which girls start drinking also appears to be going south, with girls as young as fourteen being involved in overdrinking. The social factors that encourage girls to get involved in drinking behaviors are certainly similar in some cases to those of men. One such may be the influence of peer pressure. There are indications, however, that for some girls, the impetus for drinking may be that they have experienced sexual or physical abuse or that they may have mental problems that are not addressed. Be that as it may, the physiology of women makes it more likely than not that their consumption of alcohol has a greater effect on them, including a greater chance of having cirrhosis of the liver and dying from it. It has also been found that women who abuse alcohol are likely to have children and may have had some significant trauma in their lives such as the loss of a spouse or a significant other. In some cases, the partner himself may be part of why the woman abuses alcohol. This may be in a case where the partner is also an alcohol abuser or that the partner may be abusing the woman, leading her to seek refuge from the bottle. Because of the stigma attached to alcohol abuse, women may hold back from seeking the treatment they need. It has been found quite effective to provide care and attention to women alcohol abusers in settings that are women-only or where outpatient facilities are available, to supplement these with educational programs such as workshops that address other needs that these women may have such as those relating to pregnancy or child care. For women who may have mental problems it stands to reason that success in dealing with the alcohol abuse may be linked with dealing with their mental problems. And for those for whom poverty is a problem, government programs that make it possible for the poor to take advantage of treatment are highly welcome. It is clear that equality is a double-edged sword. Society has made great strides in ensuring that more and more women are able to benefit from educational opportunities that were denied them in the past. Unfortunately, the accompanying liberation of women has also meant that they are more and more exposed to potentially harmful behaviors and at earlier and earlier ages. While no one can advocate that society recede to the dark ages when women were not free to express themselves, it appears that society has a responsibility to educate these women so that they can make the kind of decisions that will make them an asset to themselves and to society as a whole. A generation of smart women who cannot see their way clear because of being perpetually drunk cannot be good for their families or for society as a whole. Bibliography Brady, T. M., & Ashley, O. S. (Eds.). (2005). Women in substance abuse treatment: Results from the Alcohol and Drug Services Study (ADSS) (DHHS Publication No. SMA 04-3968, Analytic Series A-26). Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies. http://www.oas.samhsa.gov (January 31, 2007) Gordis, Enoch. “Alcohol and Women.” Alcohol Alert National Institute on Alcohol Abuse and Alcoholism No. 10 PH 290 October 1990. http://pubs.niaaa.nih.gov/publications/aa10.htm (January 31, 2007) Back, Sudie E. et al. “Substance Abuse in Women: Does Gender Matter?” Vol. XXIV No 1 (January 2007). http://www.oas.samhsa.gov/WomenTX/WomenTX.htm (January 31, 2007) “Girls’ drug habits alarming.” Deseret News, (Feb 14, 2006):A14. Roan, Shari. “Consequences of alcohol abuse hit girls harder than boys.” Los Angeles Times/Times Union (May 21, 2006):G7. Read More

In addition, alcohol dehydrongase, an enzyme that helps to break down alcohol in the body is not as active in women as it is in men. As such, women’s brains and organs are exposed to greater concentrations of alcohol compared to their male counterparts. Not surprisingly, women are more likely to die of cirrhosis. To get an accurate perspective on the differences between women and men as regards alcohol use, Becky Flood, executive director of News Directions for Women, a non profit substance abuse treatment center in Costa Mesa, California, states: “We know that two years of a woman’s drinking equals 10 years of a man’s…What alcohol does to the body of a woman in her developmental years is very damaging.

We even see cognitive impairment in women” (Roan 2006). In addition, women are apt to get addicted to alcohol faster than is the case with men, a fact that explains the increasingly young ages at which girls become dependent on alcohol. Those who have started drinking by the age of fourteen are on a straight clear path towards alcoholism, at least, much more so than those who begin drinking at the age of 21. As Roan explains, “Problem drinking in women may also be more likely to escape attention from medical professionals.

Women are less likely to seek or be referred for treatment than men – and only 38 percent of substance abuse programs in the United States are designed for women, despite research that shows women do better in gender-specific programs…” (Roan 2006). Women’s drinking may not be getting the attention it deserves in the spotlight but those who follow this issue closely know that it is at the point of quiet crisis already. If more women are attending college than men it must also be acknowledged that in the latest National Survey on Drug Use and Health teenage girls were found to be trying marijuana, alcohol and tobacco products are higher rate than boys, showing that for these girls whatever boys can do they can do better, with possibly alarming consequences to their health and future!

Understanding why more and more girls are using alcohol and other drugs, for some professionals, is the first step in being able to provide them with the kind of interventions that have a chance for success. For some girls, it has been found that peer pressure is the main reason why they get involved in using alcohol; for others there is a belief that alcohol and other drugs can help them slim down, while for still others, these drugs may be used to cover up the pain of sexual abuse. “Still other girls drink, smoke pot and dabble in drugs because they are self-medicating for untreated or undiagnosed mental illness…Even moderate drinking by girls can disrupt their growth and the development of their reproductive systems.

Drinking also disrupts brain development, which is the case among boys and girls” (Girls’ drug habits alarming 2006). In the research report “Substance Abuse in Women: Does Gender Matter?” Back et al (2007) point out that there is increasing awareness in the research community that biological and psychosocial differences between men and women could affect not only the prevalence and presentation of alcohol addiction but also affect co-morbidity and possibly the appropriate interventions.

Regarding the biological differences, Back et al (2007) note the evidence that hormonal fluctuation in the menstrual cycle of women can affect their craving for alcohol and other drugs. For some women, there is stigma attached to seeking treatment for alcoholism. For others, there may not be much support from their partner or there may be fear that acknowledging the problem can affect issues such as those relating to child custody. Understanding these barriers can also help in providing the necessary care for women where they might be more receptive to such interventions.

In fairness, it is important to note that even as young females have been noted to be drinking more, overall, “of the 15.

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