Are Women More Stigmatized for Substance Abuse?

Women face many challenges, and a drug or alcohol addiction is an added struggle that’s surrounded in societal stigma — especially for females.

Women are frequently viewed as the gentler sex throughout many cultures around the world. In society’s eyes, women are expected to be dainty, fragile and made of sugar and spice and everything nice. From birth, swaddled in pink blankets, women are expected to adhere to their strictly outlined gender role, and when they don’t, they are judged harshly for breaking the norm.

Women face societal stigmas in every area of life: at work, home, school, in the community and even regarding drug and alcohol use. Having a drug addiction or living with a mental health disorder is highly stigmatizing, but a woman who struggles with these conditions may face more societal backlash than a man would.

The Double Standard of Substance Abuse

Substance abuse isn’t necessarily praised among either gender, but women are ridiculed more harshly than men for the same drug and alcohol use behaviors.

For example, although smoking cigarettes is legal, women may be labeled as trashy and lacking morals if they smoke in public while men may be viewed as attractive and more masculine. The same comparison can be made with alcohol use. Before World War II, women who had an alcohol addiction were perceived as closet drinkers, homeless or living with severe mental illnesses.

Women who break societal norms and defy gender roles — especially by doing something illegal — risk being labeled as bad or immoral. While substance use disorders are still considered moral failings, a woman with addiction faces additional discrimination because of her gender. Mothers may frequently receive ridicule for resorting to substance use and may be seen as failures while fathers may be excused for having a few beers after a hard day’s work.

Women and Opioid Addiction

Opioid addiction is one of this country’s most pressing health crises, and it does not discriminate based on gender. While more men than women die of drug overdoses related to opioids, the rates of opioid drug overdose deaths among women are skyrocketing. The CDC reports that more than 71,800 women in this country have died from prescription opioid overdoses since 1999. Between 1999 and 2010, the overdose fatality rate among women grew 400 percent compared to 237 percent for men.

The Growing Impact on Families

Young and expectant mothers also struggle with opioid addiction. The National Institute on Drug Abuse reports that every 15 minutes, a baby is born with opioid withdrawal. In 2014, an estimated 32,000 infants were born with neonatal abstinence syndrome. Opioid addiction among women has also led to an increased strain on the foster care resources in many states, with more children being removed from homes.

Why Women Are More at Risk

Not only are women more likely than men to experience chronic pain, which can facilitate a prescription for opioids, but they also tend to use opioids differently than men. Women are more likely to take opioids for longer periods and at higher doses, which can cause dependence quickly. Women also have higher risk factors for addiction that include such things as depression and other psychological issues. Now that opioid prescriptions are being limited by various state and local programs, many women who have become addicted to prescription pain medications have turned to heroin as a substitute.

Barriers to Treatment

In the 1970s and 1980s, medical practitioners and researchers began to recognize how little was known about providing adequate treatment to women with substance use disorders. Research suggests that women are less likely to develop a substance use disorder compared to men. However, women often develop drug and alcohol addictions faster than men do, and they frequently face more barriers to treatment.

Men and women may use substances for similar reasons, like to self-medicate or to cope with social pressures, but according to the book “Women Under the Influence,” men and women have significantly different experiences in treatment for substance use. Some reasons why women may be more reluctant to seek addiction treatment include:

•  A 2011 study in the American Journal of Drug and Alcohol Abuse revealed that women being treated for opioid addiction were suffering from more medical issues than men.
• Women who are in treatment for substance use disorders are five times more likely to have a history of sexual abuse. Their past experiences may not be something they want to discuss in a group setting.
• The reasons women start using substances may prevent them from seeking treatment because they don’t want to address the issues in treatment. For example, divorce, losing a child, unemployment, being the victim of domestic violence and other significant crisis situations may prevent women from getting rehab.
• If a woman is a mother, she may feel like she can’t leave her familial role. If a woman is a primary caregiver in her family, she may feel guilty or selfish going to rehab to care for herself. She may also fear that her children will be taken from her if her addiction is exposed.

In addition to these barriers, women experience barriers to treatment that are related to societal stigma. Where they seek treatment can be influenced by stigma as well as who they seek help from, whether it’s a health professional, self-help group or a religious source.

Differences in Addiction Treatment

Due to the barriers to treatment for women, researchers have suggested that women are less likely to seek, begin or complete treatment for addiction.

Gender-Specific Addiction Treatment

While researchers affirm that once a woman initiates treatment there are no significant differences between the treatment process for men and women, women can benefit from gender-specific treatment because they feel more comfortable. If a woman with a substance use disorder is also a victim of sexual or domestic abuse, they’re more likely to have a better outcome as part of a gender-specific sub-group during treatment. Some researchers suggest that women with substance use disorders may not even seek treatment if women-only treatment programs are not available.

Gender-Specific Therapy Options

To improve treatment for all genders, some specialized, gender-sensitive programs may be beneficial for some women. For example, Project MATCH incorporates the approach of matching a therapist and client’s gender as well as the therapeutic modality of treatment. This particular approach found no effect on the outcomes of addiction treatment, but further research may show that women benefit from specialized, gender-specific programming during rehab.

Related Topic: Individual vs Group Therapy

Addiction Recovery Resources for Women

Recovery from addiction is possible for every woman and compassionate help is available for women in many areas of the country. Women who want to find specific treatment and recovery resources both locally and nationally can use the behavioral health treatment locator map from the Substance Abuse and Mental Health Services Administration.

This interactive map lets people narrow their options for substance abuse and mental health treatment and facilities with many filters, including programs for women who are:

• Adults or seniors
• Adolescents
• Pregnant or postpartum
• In the LGBTQ+ community
• Veterans or active duty military
• Victims of intimate partner violence, domestic abuse or sexual trauma
• American Indian or Alaskan natives
• Deaf or hard of hearing
• Not fluent in English

At The Recovery Village, a team of professionals can design an individualized treatment program for each client, regardless of gender, to address substance use and co-occurring disorders. If you or someone you know is struggling with a substance use disorder, call us today to speak with a representative to learn more about which program could work for you.

Editor – Camille Renzoni

Cami Renzoni is a creative writer and editor for The Recovery Village. As an advocate for behavioral health, Cami is certified in mental health first aid and encourages people who face substance use disorders to ask for the help they deserve. Read more