September 4, 2020

Treatment – the gender divide explained

women walk and talk

Men tend to use more alcohol and other drugs (AOD) than women – this is true both in Australia and internationally. But while some research suggests that around half as many women as men may have an AOD dependence, women are more likely to be socially criticised because of it.1

This criticism largely comes from the traditional gender-based roles assigned to women within our society. When people don’t stick to those roles, it can lead to the non-conforming person experiencing social and institutional stigma.1

Stigma and treatment

Experiencing stigma, or being worried about being stigmatised, can mean that women may be less likely to seek treatment for AOD issues or to talk about those issues.

This, in turn, reduces opportunities for research into gender-specific drivers of women’s AOD use and may also reduce the quality and effectiveness of available AOD treatment services for women.1, 2

For any individual, a number of personal and social barriers can impact their ability to access treatment. However, research suggests that in accessing treatment, social barriers are much more pronounced for women than for men.1

Why is it different for women?

Women may be less likely to access AOD treatment services because of experiences such as:

  • social stigma
  • discrimination
  • trauma
  • financial issues
  • custody and childcare concerns.1

While stigma is a concern for anyone with an AOD dependence, the social and institutional stigmatisation of women with AOD issues is more common.

This is because of commonly accepted views of women as society’s care-givers and the upholders of our ‘moral and spiritual values’.1, 2 When women act in ways that don’t stick to this ‘moral course’, there tend to be very negative stereotypes attached to them for certain behaviours such as illegal activities.

Consider how mainstream media tends to report on women who use alcohol and other drugs, particularly those who are parents or other caregivers, as being morally flawed or ‘bad mothers’. This type of reporting reinforces existing stigma and stereotypes, which can make it less likely that women will seek help or receive effective treatment.1

Family responsibilities are another significant barrier to treatment for many women. A lack of childcare options, the stigma associated with being a ‘substance dependant mother’, and the fear of being punished (for example, losing custody of their children) are major barriers to women seeking help.1

Treatment options for women

Women entering treatment have been identified as suffering high rates of:

  • domestic violence
  • mental health issues
  • complex family/childhood trauma
  • physical and sexual abuse
  • greater economic hardship
  • pregnancy and childcare issues.1

Research from AOD treatment facilities in NSW found that roughly 70-80% of the women at the facility had been victims of child sexual abuse, and 40% had experienced rape as an adult.2

This study also found that when women could see the link between their history of trauma and their AOD use, they were able to better understand their ‘coping’ behaviours such as drug use and engage more meaningfully with their treatment.2

The importance of addressing these issues as part of effective treatment plans highlights how treatment services also need to be equipped to deal with the fact that when women cease using substances, this can lead to the re-emergence of previous trauma that needs to be pre-empted and managed carefully.1

It’s essential that services are tailored to women’s needs, so that they can get the best care possible.

AOD sector support for women

While service models do exist to support women who have experienced physical, emotional and sexual violence, these services can be limited. Many women also experience disciplinary legal action because of their AOD dependence, which can have long lasting negative effects.1, 2

To combat the disparities experienced by women who use AOD, broader social issues also need to be examined. Research is now beginning to draw links between how gender inequality is connected to a lack of healthcare strategies and social policies, and how critical it is to reduce and remove the barriers women face in accessing treatment.1, 2

  1. NADA. Working with women engaged in alcohol and other drug treatment: second edition. Sydney: NADA; 2016.
  2. Slater M. Gender, use and abuse: Sexually abused women in alcohol and drug treatment. In: Breckenridge J, Slater M, editors. Gender-based violence and public health: International perspectives on budgets and policies. New York: Routeledge; 2012.

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