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Women in Recovery by Roberta Greenwood

Change has been described as the right combination of discomfort and hope, but for women looking to break free of drug or alcohol addiction, finding that right combination can be difficult, particularly if they are uncomfortable discussing their problem alongside men. Women-only recovery programs are now helping women find a safe comfort zone in which to address their chemical dependencies.

In the past, society generally treated those who battled with addictions as flawed and morally weak individuals, and the stigma was greater for women with alcohol or drug problems than for men. Scientific research has since identified many biological and environmental factors that contribute to the development and progression of addiction, and for the most part it is accepted that addiction is a disease that affects both the brain and behavior. The emphasis is on preventative therapies as opposed to punitive or legalistic consequences.

Still, the path to personal recovery is difficult and often frightening. Sue Ross, director of community outreach at Residence XII, an alcohol and chemical dependency treatment center for women located in Kirkland, says women who make the decision to begin living an alcohol- or substance- free life are “courageous and worthy of our respect.” Too often, women face intense scrutiny and judgment from family, friends, employers and children, making their decision to begin recovery a painful, personal decision. “It takes courage, guts, a ‘stick to it’ attitude to face this disease,” explains Ross, “and women who take the journey to sobriety give their children one of the best gifts a mother can provide.”

USE, ABUSE, ADDICTION

Substance abuse has become a catchall phrase that characterizes a pattern of harmful use of any substance for mood-altering purposes, including alcohol, illegal drugs, inhalants, prescription medicines and even tobacco. For many women, the delineation between use, abuse and addiction isn’t clear. According to Seattle therapist and graduate-level educator Lisa Erickson, MS, LMHC, not everyone who uses drugs or drinks alcohol becomes addicted, but substance abuse can cause problems for individuals whether they are technically addicted or not. “Not all use is abuse,” she explains, “and not all abuse is addiction. People search for a clear line to demonstrate addictions, but one doesn’t exist. It’s different for everyone. And for women, it’s a unique challenge.”

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines abuse as a “disorder” when the use begins to cause continuing or growing problems in the user’s life. Chemical dependency often follows; users seek out drugs more often, withdraw from activities, demonstrate an increased tolerance to the substance and usually experience several failed attempts to quit. Addiction occurs when the compulsive, continued need to use outweighs all negative consequences.

For women, the negative consequences of continued use are far-reaching, often producing anxiety, guilt and shame. That shame, Erickson states, is the underlying emotion that drives addictions. “For many women, some type of risky behavior may have been an element of their substance abuse,” she says. “This behavior might be of a sexual nature or some act that put their children at risk; for example, driving with kids in the car while under the influence. The ensuing feelings of shame and guilt may initially keep a woman from seeking treatment. Gender-specific programs minimize that guilt and make it easier for women to seek help.”

Women are also more vulnerable than male users to the physiological effects of drugs and alcohol. Chronic health problems such as liver disease, Hepatitis C and cardiac problems are common issues among women users primarily because of the different ways in which they absorb, distribute, metabolize and eliminate these substances from their bodies. Women are also more susceptible to neurological consequences, and the death rate, including suicide, among female alcoholics is higher than that of men. Additionally, women substance abusers are more likely than men to experience psychiatric disorders such as depression, anxiety and phobias, often expressed as eating disorders and psychosexual disorders. “These issues suggest,” concludes Ross, “that programs tailored to women and their very specific needs offer the best hope of recovery.”

GENDER-SPECIFIC TREATMENT

As the gap between the number of male and female users has closed (there are more than 12 million women in the United States who are addicted to alcohol or drugs; more than half are alcoholics), the need for gender-specific treatment options has steadily increased. Behavioral scientists, community health advocates, therapists and counselors agree — women with substance abuse issues face complex challenges, and gender-specific treatment plans provide an environment in which women feel comfortable openly addressing their issues with gender-based problems.

Women substance abusers are more likely than men to have experienced trauma, rape or domestic violence, and gender-specific treatment plans provide opportunities for women to discuss these types of issues openly — often for the first time.

“Almost 80 percent of our clients have suffered some sort of trauma — often sexual — and women-only treatment centers provide safe and supportive systems,” says Ross. “These programs provide a safe environment where women can address their alcohol and drug addiction without the shame or stigma often found in coed environments.”

Participants in these programs speak of feelings of “sisterhood” and express relief for the safety in which they can discuss their addictive behaviors. “Being in a group with other women was so helpful; I never had any qualms about sharing,” Jenn, a recovering addict, begins. “As far as the problems I was dealing with, it wasn’t just my addictions. I was dealing with men issues, eating disorder issues — just so many things. I never would’ve felt comfortable talking about them in a mixed group setting.”

Erickson agrees that the comfort and support gender-specific treatment plans offer women play a significant role in recovery. She cites a variety of reasons that women-only programs are successful: mutual understanding, similar parenting issues, freedom to discuss sexual issues and less caretaking. “When a mixed group is working through recovery issues, we often see the women begin to shift their focus to the men in the group,” she explains. “They begin to play a caretaking role, worrying more about the men’s recovery than their own. A program tailored to women enables them to have fewer concerns about the perceptions of others.”

Catherine Trestrail, founder of A Positive Alternative in Seattle, says she started her women-only programs after looking at the research that consistently shows women do better in women-only groups. She also finds that men do better in men-only groups. “Relationships are a key issue in treatment, and people can be hesitant to say what is really going on in a mixed group.”

TYPES OF TREATMENT

Just as each woman’s path to recovery is different, so are the treatment programs available. Now, women can select from women-only programs and centers that are tailored to meet their emotional, physical and spiritual needs. Recovery options include attending Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) meetings on a regular basis; working with a therapist in an individual, family or group setting; participating in outpatient programs sponsored by hospitals or clinics; or checking in to inpatient treatment centers. A combination of strategies is not uncommon.

The majority of recovery programs are based on the AA model of working a twelve-step plan and include abstinence. This approach centers on meetings where people share their experience, strength and hope in order to help each other recover from alcoholism. At its heart are the Twelve Steps, which begins in Step One with the abusers admitting their powerlessness over alcohol and that their lives have become unmanageable. The plan continues with members turning their lives and wills over to a higher power of their choosing. AA, however, does not define itself as a religious program.

Alternative programs might focus on “aversion based” therapy, on personal motivation or emphasize a secular approach that does not focus on a higher power or the twelve-step program.

At A Positive Alternative, personal motivation therapy and motivational enhancement teaches clients how to stay focused on personal goals in the face of urges and triggers. “We spend time on psychological elements that are contributing to a person’s use. Situational elements and relationships also need to be addressed in a woman’s life or she is likely to return to drinking or drug use, says Trestrail.

While the recovery rate between outpatient and inpatient care is about the same, Erickson and Ross say that inpatient treatment can offer women a chance to take a break from daily routines and focus on their personal needs. “We look to assess whether a woman can be successful in outpatient care,” explains Ross. “Does she have significant concerns about needing extra ‘hands-on’ care and is she ready to focus on her recovery as her number one priority?” Inpatient treatment can be costly — ranging from $8,000–$40,000 — and while treatment is often covered by insurance, the cost of treatment is more often an obstacle for women, who generally earn less than men.

THE IMPORTANCE OF SUPPORT

The NIAAA reports that recovery generally includes not only a personal understanding of chemical dependency, but also an understanding by family members of the disease.

“Sober support” is one of the key factors for a successful recovery outcome, stresses Ross. “The family component is so important with women in recovery,” she says. “Change is hard. We counsel the families of recovering women that they might not like all the changes they observe; it’s important that families educate themselves about the disease.”

And while family support is important, child care concerns can also be an obstacle for many women. Evergreen Manor, located in Everett, offers a unique program for chemically dependent mothers with children; women may begin their treatment during pregnancy, deliver their babies and then return to treatment. Mothers with children under the age of five may keep their children with them during their stay in residential programs.

For Jenn, recovery was possible due to the support and fellowship she shared in her gender-specific program. “When I was drinking and using, I hated women,” she admits. “I thought they were my competition. Now, they’re my support.”

Roberta Greenwood is a frequent contributor to Seattle Woman.

The National Institute on Alcohol Abuse and Alcoholism offers these four questions to consider if you think you may have a drinking problem:

• Have you ever felt you should cut down on your drinking?
• Have people annoyed you by criticizing your drinking?
• Have you ever felt bad or guilty about your drinking?
• Have you ever had a drink first thing in the morning (as an “eye-opener”) to steady your nerves or get rid of a hangover?

For more information, visit www.niaaa.nih.gov

INTERESTED IN GETTING HELP?

Here are some resources and programs tailored to meet the needs of women in recovery:

Alcoholics Anonymous
Narcotics Anonymous
A Positive Alternative
Evergreen Manor
Residence XII
Lisa Erickson

©2009 Caliope Publishing Company