Working With Substance Abusing Women

1. Working With Substance Abusing Women SOWK 7273:Clinical Work with Addictive Disorders Zachary Trent Sylvia Lloyd

2. Objectives • How Society Views Women • Differences in Men and Women • Prevalence • Risk Factors for Misuse • Barriers for Treatment • Treatment Considerations • Treatment Plan

3. Societal Views • Roles • “Pedestal” Perspective • Double Standard

4. Substance Abuse: Differences Between Woman and Men • Women experience more severe health and social consequences • Women are more vulnerable to adverse consequences • Alcohol dependence progresses faster in women • Women are more apt to start drinking due to stressful events • Escape and Self Medication

5. Prevalence • More than 4 million women in the United States abuse drugs • Almost half of women between the ages of 15-44 have used drugs at least once in their lifetime • 2 million have used cocaine and 6 million have reported using marijuana. • Most women have reported using more than one drug • Number of variables that influence use

6. Prevalence Continued….Differences Among Cultural Groups • Alcohol use more prevalent among white women • Black women are reported to drink heavily, and use crack cocaine • Hispanic women are likely to drink more than black and Caucasian women • Native American women also have very high rates of alcohol use, that leads to higher rates of fetal alcohol syndrome, and alcohol related deaths

7. Women and Alcohol • In the United States: • 2 in 5 women drink alcohol • 4 million women are heavy drinkers • 2.5 million women are alcohol-dependent • 1 in 10 pregnant women drinks alcohol

8. Substance Abuse and Pregnancy Forty-four States reported the pregnancy status of substance abuse treatment admissions to the Treatment Episode Data Set (TEDS) in 2002.1 Out of the more than 363,000 treatment admissions of women of childbearing age (15 to 44 years old) for which pregnancy status was recorded, 15,300 (4 percent) were pregnant at the time of admission (SAMSHA).

9. Fetal Alcohol Syndrome (FAS) • FAS is the leading known cause of mental retardation. • In the United States: • Prevalence of FAS, or 1 percent of all births= 40,000 per year Prevalence of Women who drink while pregnant (Race) White/Non-Hispanic- 11.8% Hispanics-11.0% African Americans-9.6%

10. Women and Nicotine • One of the most highly addictive drugs in the United States. • Studies have shown that women find it harder to stop smoking than men. (The National Institute on Drug Abuse)

11. Women Illicit Drug Abuse • Marijuana- Women between the age of 19 and 40 years old are as likely as men to have used Marijuana. 20% of those who have tried the substance become daily users. • Crack Cocaine- 40% of all crack addicts are women. • Heroine- Increased rates in use among women “Men sell drugs, while women sell themselves” (Straussner,2004)

12. Process Addictions: Eating Disorders • 80% of American women are dissatisfied with their appearance • 40% of newly identified cases of anorexia are in girls 15-19 years old • The incidence of bulimia in 10-39 year old women TRIPLED between 1988 and 1993. • New research shows that up to 35% of substance abusers have eating disorders, and up to 50% of those with eating disorders also have a problem with drug or alcohol abuse. "Food For Thought"

13. Risk Factors • Genetic Influences • Early Initiation of Drinking • Violent Victimization • Early Sexual Abuse • Physical Abuse During Adulthood

14. Barriers for Treatment • Lack of Child Care • Lack of Transportation • Lack of Insurance or other Financial Resources External Barriers Male-oriented Treatment Models Involvement with Substance Abusing Partners Lack of Diagnosis or Misdiagnosis Internal Barriers High levels of Shame and Guilt

15. Barriers Continued… Internal Barriers Fear of leaving or losing children Low Self-Esteem Lack of Information about Services (Straussner, 2004, p.357)

16. Treatment Considerations • Clinicians Should Address… • Special Medical, Psychological, and Social Needs • Childhood Sexual Abuse • Possible Eating Disorders • Domestic Violence • Depression • Anger • Shame • Lack of Parenting Skills • Anxiety

17. Treatment Considerations Continued.. • Suicide Attempts • Post Traumatic Stress Disorder Webcast

18. Treatment • Model of treatment must provide comprehensive services for multiple problems and…. • Encourage women to take responsibility for their own treatment. • Identify positive and negative consequences of changing behaviors. • Deal openly with doubts and fears about change. • Choose their treatment goals. (Straussner, 2004, p.361)

19. Websites • SAMHSA: http://www.ncadi.samhsa.gov • NEDA: www.nationaleatingdisorders.org Information and Referral Helpline: 1-800-931-2237 • CASA: http://www.casacolumbia.org/

20. References Center for Disease Control http://www.cdc.gov National Eating Disorder Association http://www.nationaleatingdisorders.org National Institute on Drug Abuse http://drugabuse.gov Straussner, S.L. (Ed.). (2004). Clinical work with substance-abusing clients. 2nd ed. New York: The Guilford Press. Substance Abuse and Mental Health Services Administration http://www.samhsa.gov http://www.ncadi.samhsa.gov Women Under the Influence. (2009, May 28). New York City, NY: Columbia University. Retrieved July 24, 2009 from, http://www.casacolumbia.org/absolutenm/templates/Publications.aspx?articleid=421&zoneid=52

21. Case Examples Sharon 41 yr old Alcoholic Lucy 21 yr old Cocaine Addict Beth 25 yr old Heroine Addict Doris 34 yr old Alcoholic