'You can't teach them hope' women face greater addiction risks, less promise of recovery

Mary Meehan

Treating female alcoholics or drug addicts often requires unraveling the damage of physical and mental abuse that began long before the first drink or drug.

"When you are dealing with women who are addicted, it''s typical to see issues of sexual abuse, lack of education, poverty, lack of parenting skills, the presence of children," said Barbara Ramlow, director of the targeted assessment program at the Center on Drug and Alcohol Research at the University of Kentucky.

Women coming into treatment often have untreated closed-head injuries from domestic violence, or debilitating depression made worse by drugs or alcohol. Some suffer from post-traumatic stress disorder, the same cluster of symptoms -- anxiety, nightmares, flashbacks, difficulty sleeping and a feeling of detachment -- that afflicts many soldiers returning from war zones.

One study showed that 70 percent of alcoholic women seeking treatment had experienced some kind of sexual abuse. (That compares with about 12 percent of men.) Many had suffered trauma as a child or teenager, including high rates of incest.

Others end up in dangerous situations because of their drug or alcohol abuse.

A woman using illegal drugs is "a good target for a predator," said T.K. Logan, a researcher with the Center on Drug and Alcohol Research at UK. "They know that you are either not going to report it or you are not going to be believed."

The result of all this trauma can be "a woman broken into pieces," Ramlow said.

''Overwhelmed and immobilized''

Those pieces don''t magically mend just because someone puts down the drink or the drug. In some cases, the withdrawal of the substance can cause all of those old psychological wounds to begin to fester anew. And those issues, Ramlow said, have implications as to how much a person is able to recover. The grief and trauma can come on like a wave, and then "it''s easy to become overwhelmed and immobilized," she said.

Because of the way their bodies metabolize alcohol, women become drunk faster; get addicted to alcohol more quickly; and develop alcohol-related diseases such as hypertension and damage to the liver, brain and heart more rapidly than men do, according to Sue Foster, vice president and policy director at the National Center on Addiction and Substance Abuse at Columbia University.

Women are also 48 percent more likely than men to have drugs prescribed that can lead to addiction, and twice as likely as men to become addicted to those drugs, according to Women Under the Influence, a book published by the center in 2006.

Historically, Foster said, addiction treatment was created based on the male experience. The standard 30-day inpatient treatment model was originally based on work with male heroin addicts, and it often relies on confrontational group meetings that d...