Addiction: Are women at greater risk?

Q & A with addiction counselor and author Brenda J. Iliff, MA

Q: Is it true that women are the fastest growing demographic for substance abuse today?

A: It's true that more women are being identified and getting treatment. Historically, men have had the higher reported incidence of substance abuse and dependence, but women are closing that gap. Young women, in particular, have an almost equal percentage of abuse and dependence concerns as young men.

Q: Are women more at risk for developing addiction?

A: While addiction is an equal opportunity disease, it affects women differently. Women become addicted differently, start using for different reasons, progress faster, recover differently, and relapse for different reasons.

Many years ago, the Big Book of Alcoholics Anonymous told us that women progress faster. Now science is telling us why. It's purely physiological. The female body processes alcohol, and to a varying extent other chemicals, differently than does the male body. Women have less of a stomach enzyme that breaks down alcohol. This leads to greater blood alcohol concentration. Women also have more fatty tissue than men, so alcohol is absorbed more slowly and stays in the bloodstream longer. Therefore the brain and other organs are exposed to higher concentrations for longer periods. That's why one drink for a woman is said to have twice the physical impact as one drink for a man.

Q: What prevents women from getting help?

A: Shame and fear are major barriers. The stigma attached to addiction can be stronger for women than men. Particularly moms. It's difficult to seek help and to make that first phone call or tell that first person. It's even more difficult to get truly honest with oneself.

Sometimes women are diagnosed with a medical condition or mental health concern without being asked about drinking or drug use. Or, if asked, they may deny the problem. Other common barriers to getting help include child care responsibilities, lower wages/ less money, substance abuse by their partner family, fear of losing children, lack of access to resources, or feeling unworthy of help.

Q: What should women look for in addiction treatment programs?

A: First and foremost, a good program will focus primarily on treating the disease of addiction. For some women, gender-specific programs are helpful. Others may simply want programs that are sensitive to gender issues such as eating disorders, trauma, or hormonal concerns. For women with co-occurring addiction and mental health conditions, finding a program that offers differential diagnosis—what's the addiction? what are the mental health concerns?—would be important.

Above all, women need a program that offers real hope. I've seen women begin treatment full of shame and despair, with their heads down. As they progress in recovery, they become shining women of courage and hope for others. The recovery process is truly transformational.


Brenda IliffBrenda J. Iliff is the executive director of Hazelden in Naples, Florida, a part of the Hazelden Betty Ford Foundation. She has more than 20 years of experience in the addiction field, as both a clinician and health care executive, and is the author of A Woman's Guide to Recovery.
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