Alcohol and Other Drugs and Women
Women have achieved great things but nearly catching up with men’s rates of substance abuse and addiction is an unfortunate reality in recent years. Research shows that among adults, alcohol use is increasing for women but not for men, and the gender gap has narrowed considerably, particularly among younger cohorts. NIAAA Alcohol Research Journal: “Gender Differences in the Epidemiology of Alcohol Use and Related Harms in the United States” https://arcr.niaaa.nih.gov/volume/40/2/gender-differences-epidemiology-alcohol-use-and-related-harms-united-states
Women’s liberation has granted us more rights and options in many areas of life. Despite progress, females confront additional barriers seeking recovery. When women show addictive behaviors families respond differently than when it is men doing the same things. Mothers are expected to be more perfect than fathers and are still disproportionately responsible for the children. Few places provide child care and we are still disproportionately responsible for the children.
Women’s Biology is Different
Most research has focused on male bodies. Our bodies are “the deluxe model” and more expensive to study. NIH Office of Research on Women’s Health: Policy guidelines https://orwh.od.nih.gov/toolkit/nih-policies-inclusion/guidelines
AAMC (Association of American Medical Colleges): “Why we know so little about women’s health” https://www.aamc.org/news/why-we-know-so-little-about-women-s-health
Key historical facts: In 1977, the FDA created a policy excluding women of reproductive potential from Phase 1 and 2 clinical trials. It wasn’t until 1993 that Congress required inclusion of women in NIH-sponsored clinical trials. Even as of 2019, women remain underrepresented in clinical trials for major diseases.
Women “get sicker quicker” from substances and we don’t respond to medications exactly like males. Women develop alcohol abuse and dependence in less time than men, a phenomenon known as “telescoping.” They experience more rapid and severe alcohol-related health consequences, including liver disease, brain damage, and cardiovascular issues at lower consumption levels. NCBI/SAMHSA: “Physiological Effects of Alcohol, Drugs, and Tobacco on Women” https://www.ncbi.nlm.nih.gov/books/NBK83244/
Alcohol Research Journal: “Alcohol’s Unique Effects on Cognition in Women” https://arcr.niaaa.nih.gov/volume/40/2/alcohols-unique-effects-cognition-women-2020-review-envision-future-research-and Therapy for women in recovery is essential.
“Sex differences in pharmacokinetics predict adverse drug reactions in women” https://link.springer.com/article/10.1186/s13293-020-00308-5
American Academy of Family Physicians: “Sex-Based Differences in Drug Activity”https://www.aafp.org/pubs/afp/issues/2009/1201/p1254.html
Women experience adverse drug reactions nearly twice as often as men. They have different metabolism rates for many medications, different responses to cardiovascular drugs, antidepressants, and pain medications, and are 50-75% more likely to experience adverse drug reactions.
Perhaps the biggest barriers however are internal. An important part of change is the internal work. The internal work is finding ways to fight shame and stigma that is more profound for females in our culture. The expectations for how we hold it together are just different.
Other Addictive Behaviors and Women
Many women who do not struggle with substances feel very out of control with addictive behaviors like: shopping, being an extreme workaholic, gambling, gaming, over-exercise and maladaptive relationship with food, which may be a full blown eating disorder or not. Some of the work we can do in therapy can use the same Wise Woman concept when trying to improve life when we get honest that we are struggling with these addictions.
Therapy Enhances Treatment and Sober Support Meetings
For many women it will be critical to go to a treatment center, but these experiences are quite time-limited and there will be a need for ongoing work on herself. Therapy for women in recovery is an important addition to her use of 12 Step or other sober support meetings in the community.
The Wise Woman
Who is The Wise Woman? She is you, me and every woman. Your Wise Woman is a part of you already. You possess inner wisdom. All women do. As a result, you need to cultivate that inner wisdom. This is a significant part of recovery.
This concept of The Wise Woman comes from Marion Hutton-Schoen. She sang with The Glenn Miller Orchestra. She was also someone who suffered from addiction. Marion got sober and found recovery. Marion didn’t stop there. She did more. She co-founded two treatment centers specifically for women. One is still in operation today, New Directions for Women in Costa Mesa, California. http://newdirectionsfor women.org
The other was Residence XII, which was in Kirkland, Washington. I worked there for over 16 years.
Marion Hutton studied Jungian psychology and she adapted some of Jung’s concepts.
(See related blog post Demystify The Shadow )
The Addict and The Wise Woman sides fight for control. The Addict is ruled by impulses. Immediate gratification is the focus. It works hard to avoid or numb or self-medicate pain. Seeking pleasure is a human drive. It becomes a problem when potential consequences are not considered. The Addict is driven by need, craving and compulsion. This is the definition of the cycle of addiction.
This dynamic doesn’t only apply to alcohol and drugs. Similarly, behavioral addictions can be the focus. Many struggle with gambling, gaming, over-eating, shopping and engaging in codependency. Just as it is with overcoming anxiety, it is all about finding a way to wrestle the stuff we have been repressing and depressing and trying to hide. Therapy is one of the ways to work on breaking free so the shadow is not holding us back in our lives. Therapy is also an excellent complement to support people get from 12 Step or SMART or Recovery Dharma etc. https://wisewomantherapy.com/self-help-community-resources/
Questions? debdettman@wisewomantherapy.com
Ready now? Set up a free phone consultation.
Individual therapy: $200/session. I provide Super Bills for clients seeking reimbursement from their insurance companies. PPO plans often reimburse 60-80%. Limited availability for reduced fee for those with financial need.
