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Women and Men in Substance Abuse Treatment

Sex makes a difference in substance abuse treatment

You already know that there are major differences between men and women—you didn’t even need your high school biology teacher to tell you that! There are also differences in the sexes that apply to substance abuse treatment. Believe it or not, struggling with addiction is different for women than it is for men.

There are different social issues that affect women compared with men. Men are the usual soldiers in our culture, so they suffer from wartime post-traumatic stress disorder more than women. However, women are more often abused by their spouses or partners than are men. Women worry more about hearth and home—and their children—before they decide to go into treatment. Those are just a few examples, and there are many others.

Explaining Substance Abuse Treatment With the Jellinek Curve

E. Morton Jellinek was a biostatistician from the 1940s who focused on alcoholism during his career as a professor at Stanford University. While there are differences between alcohol and opiate abuse, the issues of addiction generally follow the same pattern no matter what substance is abused. Alcohol, opiates, and other drugs all stimulate the brain’s reward pathways. The person’s life spins out of control because the need to keep stimulating that reward pathway leads to addiction.

Jellinek’s research on substance abuse treatment was considered to be genius. He was a dedicated researcher who actually died while he was at work, sitting at his desk. He published an addiction and recovery template known as the Jellinek Curve that describes the fall into addiction. Researchers have used it to compare the biological differences between men and women during addiction.

The Differences in Addiction

In the context of substance abuse treatment, the sexes react to addiction based on societal roles and hormonal responses. For a woman, achievement means successful emotional connection to those she loves in the world around her. For a man, achievement depends upon his ability to protect and provide for those he loves.

You’ve heard of the fight-or-flight response, which goes all the way back to the days of cavemen when they had to fight the dinosaur or decide it was smarter to run. Women also experience the fight-or-flight urges, but often they fall into the trap of tend-and-befriend. They put other people’s needs ahead of their own, and as their addiction grows they fail to recognize that it has negative impacts on their loved ones.

Jellinek’s research showed that women who become addicted are often older than men at the time they recognize the need for substance abuse treatment. However, they slide down the “Curve” faster than men. They have fewer societal protections than do men, and so the consequences of addiction have a quicker impact on them.

During the descent into addiction, women are bothered by feelings of guilt at an earlier stage than men. Mothers feel guilty about not taking care of their children or, if they are not yet parents, they worry whether they are being good wives or daughters. They realize that they’ve lost their willpower, and they isolate themselves from friends and family as the addiction continues. Women just continue to use up every possible excuse before they face the need for substance abuse treatment. As women delay getting into treatment, their feelings of self-worth dissolve.

Men allow themselves to be dragged much further down the path of addiction without recognizing it. They quit socializing with old friends but they have new drug-using buddies they hang out with for quite a while before guilt taps them on the shoulder. Once they recognize their addiction, men are quicker to admit the need for treatment.

The Differences in Recovery

Right around the time that a man reaches out for help, a woman just begins to admit that she may have a problem. But each sex reacts differently to this knowledge. Men go into treatment and turn their attention outward to form positive relationship with the people they meet in recovery. Women will try to stop using and begin taking stock of their personal strengths, but they are not yet connecting with others.

The basic biological and hormonal differences again come into play when it comes to how the sexes respond to substance abuse treatment. Men will be the first to go to a doctor and accept good medical care. Women shy away from presenting themselves for medical treatment because they are ashamed of how they’ve let themselves go or embarrassed to talk about the physical changes caused by addiction. Women who engage in substance abuse treatment will instead focus privately, as best they can, on better nutrition and getting enough rest.

As men develop new relationships, their self-esteem returns. Women cannot regain their self-esteem until after they’ve got their health under control and they know their family and friends still love them. Once they begin to regain the trust of those they love, they will, like men, develop new friendships among people who are stabilized. But only then, as their relationships flourish, will they rebuild their own sense of self-worth.

Did Jellinek Believe His Own Research?

Jellinek developed his Curve after distributing questionnaires to people in recovery at Alcoholics Anonymous. Approximately 87 percent of the questionnaires showed similar patterns in addiction behavior. Jellinek’s initial reaction was to throw away the remaining 13 percent, and he then discovered that what those questionnaires all had in common was the fact that they had been completed by women.

He later rejected the Curve, because he felt that his research was not scientifically sound—remember, he was a genius statistician. Nevertheless, his teachings are recognized by substance abuse treatment professionals the world over even today, and the Jellinek Curve offers a predictable course of addiction and recovery for people in treatment for substance abuse of all types.

The Lines Are Blurred Today

Jellinek’s research was based on questionnaires from alcoholics who had received treatment back in the late 1940s. Remember that only 13 percent of those questionnaires were completed by women. That statistics reflects the cultural norm of the times back in those days, that few women went into substance abuse treatment.

Today, substance abuse treatment centers recognize that women have needs different from men. About half of all women in treatment have suffered physical abuse, and up to 80 percent of them report sexual abuse. Thankfully, many of today’s methadone programs offer group sessions specifically addressing women’s issues. Some offer babysitting, and all substance abuse treatment centers prioritize treatment for pregnant women.

If you’re a woman who needs substance abuse treatment, it’s time to make contact with a methadone program that can put you back on track. You are at a place and time when it’s right to call.

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