As addiction rates rise, addiction in women appears to be increasing faster than it is for men. Women now account for approximately one-third of all substance users globally.[1]
Women’s experience of substance use and substance use disorders (SUDs) are typically different from those of men. Despite this, the majority of treatments available are focused on the male patterns of SUD.
Treatment focused on women’s specific needs may be trauma-informed and multi-disciplinary, covering a wider range of problems that women with SUD face. By addressing the causes and circumstances around their substance use, these treatments aim to reduce the probability of relapse.
- Women’s experiences of alcohol and drug abuse are different from men’s, especially the factors that led to their substance use
- Drug and alcohol rehab options that focus on women’s experiences and needs are more successful at treating substance use disorder in women
- Women-only rehab options can overcome some of the barriers women face in accessing treatment, for example by providing childcare or a safe space away from the risk of violence
Why is gender-specific rehab important?
Many forms of addiction care and rehab are focused on men’s needs. Women experience addiction in a subtly different way than men, and their needs can be more complex.
Women's reasons for substance use
Initial alcohol and drug use in women is often the result of negative feelings about themselves or their lives. [2] For example.
- Anxiety
- Low self-esteem
- Depression
- Feeling isolated
- Trauma following sexual abuse or violence
Women are also often introduced to drug use (and their drug use is maintained) by a drug-using partner.[3] This is a different set of triggers than men typically report, which usually center around social inclusion and wanting to be part of a group.
Women's complex needs
Women who have SUD often also have other needs, which can make their treatment more complicated. They might be pregnant, homeless, have past or current abusive relationships, and have other mental health concerns, including PTSD.
Attempting to treat their substance use without addressing those additional needs leaves them vulnerable to similar forces once their treatment has ended, increasing the risk of relapse.
Additionally, women who have experienced sexual violence or those who are pregnant may feel particularly vulnerable in mixed-gender treatment facilities.
Social perceptions of women and substance use
Women who abuse substances, especially those with children, are often stigmatized more heavily than men who have similar behaviors. This can create additional feelings of guilt and shame among women who feel that they are failing in their ‘natural’ role as caregivers.
Women with SUD may have been involved in prostitution or other sex work as part of their addiction, which adds to the stigma.[5] Masculine-focused treatment for addiction disorders, including 12-step programs, often emphasizes the harm substance use has caused to other people in the patient’s life. This approach may be counterproductive for women.[6]
Women's pattern of addiction
In addition to the differences in how men and women might experience rehab and their different needs, there are also differences in the ways addiction manifests. Women often experience “telescoping”, where they move far more quickly than men from first substance use through to misuse and dependence.[7]
Women are also more likely to relapse than men. This may be connected to fluctuations in hormone levels, but the exact mechanism is unclear.[8] Withdrawal effects may also be greater for women, which can, in turn, lead to an increased likelihood of relapse to ease those symptoms.
Types of treatment and rehab options for women
There are a wide variety of different treatment and rehab options that aim to meet women’s needs. Here are some examples and the specific difficulties they set out to address.
Trauma-informed care
Many women with SUD have experienced violence, including sexual violence or abuse. Trauma-informed care aims to support women who have experienced these kinds of trauma and create a safe space where they can start to rebuild their lives.
Trauma-informed approaches, such as Seeking Safety, are often important for women who have PTSD as well as SUD.[9]
Comprehensive care
Comprehensive care options recognize that women often face more significant practical barriers to accessing treatment than men. They may be primary caregivers for children, be pregnant, or have other responsibilities. They are also likely to have more complex needs.[4]
Comprehensive care brings together services to meet those needs in one place. This might include childcare, legal assistance, help with housing, vocational counseling, and occupational therapy to assist with skill-building. Some comprehensive care options can include individual psychosocial therapy, family intervention, psychodynamic group therapy, and 12-step groups within a residential rehab facility.[6]
Key features to look for in women's rehab program
Not all rehab facilities that cater to women are designed to meet their needs.[6] Sometimes, even rehabs set aside exclusively for women are still using models that were designed to meet the needs of men.
Centers that require adherence to strict rules and structures can exacerbate the shame and over-emphasis on personal responsibility that many women feel. It can be better to try to find somewhere that feels more home-like, especially if recovering from abuse, trauma, and deprivation.
For women with other mental health problems (commonly called co-morbid conditions), treatment facilities need to have the expertise required to deal with these at the same time as addressing substance use.[12]
For women with children, childcare facilities can be an important consideration. Those who are pregnant may also wish to look for a comprehensive care option that includes prenatal care.
Detox for pregnant women
Substance abuse disorders present dangers for pregnant women. The substances can harm the fetus, but pregnancy can make it harder to receive help. Many treatment centers are unwilling to accept them, and specialists may feel unable to meet their specific needs.[10]
Detox or the use of medications such as methadone offers improved outcomes for both the mother and the fetus.[11] For the greatest impact, help should be sought as early as possible in pregnancy.
The best outcomes for pregnant women with SUD appear to come from coordinated treatment programs that include extensive prenatal care, obstetrics, pediatrics, education, and psychosocial therapy alongside addiction treatment.[10]
Common barriers women face in seeking treatment
Deciding to attend rehab is a difficult decision, but many women experience additional barriers that make it harder for them to take this important step.[2]
Here are some of the most common barriers that women face when seeking treatment for substance use:
- Lack of childcare provision
- Fear of social stigma
- Programs that are not tailored to women
- Only having access to interventions that they don’t believe will be effective
- Risk of violence and lack of provision to help with this
- Economic disadvantage, including the inability to pay for treatment
- Strong feelings of shame, guilt, and anxiety
- Fear of losing custody of or access to their children
- Fear of other legal consequences
- A romantic partner’s continued drug use
- Lack of support from close family
These barriers to treatment can be more significant for some groups of women, including those over the age of 40 or members of ethnic minorities or other marginalized groups.
Women-focused rehab and treatment options will often have considered these barriers and may offer some solutions.
Resources for women seeking addiction treatment
Women seeking addiction treatment might not always be able to access treatment right away, especially if they have caregiving responsibilities or if they need to wait for space to become available.
There are resources available to support you while you find the right treatment for you.
Peer support groups, such as Women for Sobriety, can be a valuable resource to help you feel less alone. These will be groups of women who recognize many of the struggles you are facing. Your doctor or healthcare provider may be able to offer other organizations in your area.
Regardless of whether they are behavioral health providers or other medical providers, healthcare professionals are another resource you can turn to when you are struggling with SUD. Even if they don’t specialize in addiction, they may be able to offer support in a crisis, signpost you toward other services, or help accelerate the process of finding treatment.
If you are experiencing domestic violence as well as SUD, most refuges will be familiar with the complex needs of women in your situation. Reaching out for support and finding a safe place to stay can be an essential first step towards treatment.
Finding the right women's rehab for you
There is no one rehab approach that is right for all women. You will need to consider your personal needs and ask how potential treatment options will be able to meet those needs.
Here are some questions you might want to consider.
- Do you want or need trauma-informed care?
- Do you have practical considerations, such as childcare?
- Do you have other mental health conditions that will need to be taken into consideration?
- Are you looking for inpatient or outpatient treatment?
- What are your restrictions in terms of distance and cost?
Comparing multiple treatment options can help you find the right choice for you. The Recovered Rehab Directory lets you search for providers in your area.
