The image of the typical heroin addict, years ago, did not include women as part of the stereotype. Women who abused opiates just did not happen. The typical heroin user was a long-haired street dwelling man, someone with pale, clammy skin, red-rimmed eyes, and needle marks spiking all the way up and back down their skinny arms.
Heroin addicts were teenagers or they were in their early twenties. They were broke and jobless, without prospects of any kind. And males dominated the pack: 82 percent of junkies were men, with women who abused opiates limited to only 17 percent of the total addicted population.
But times, as the song says, they were a’changin’. By the early years of this century, the ratio of men to women who abused opiates was 53.6 percent men to 46.4 percent women. And according to Kelsey Dallas and Sandy Balazac, writing for the Deseret News of Utah, today’s “new face of heroin addiction” is likely to belong to a young white woman who lives in an upper middle class neighborhood out in the suburbs. Since 2010, 51.6 percent of them are women.
Just to drive that statistic home, over 90 percent of today’s opiate addicts are white. The average age of their first use is 23 years old, compared with age 16 way back in the Sixties. And Ground Zero of this epidemic has moved out to the suburbs. It used to be that 80 percent of opiate addicts tried gateway drugs and progressed to heroin, but in recent years approximately 65 percent state that they got their start with prescription opioids and gradually moved on to heroin.
Why Is It Different for Women Who Abuse Opiates?
Demographics for women fit easily into this new equation. When you look at the health practices of women compared with men, you will see that women are far more likely to visit the family doctor to fix whatever ails them. Men may produce a higher volume of grumbling to their spouses when they do not feel well, but women are the ones who quietly seek out medical treatment. The family doctor pulls out his trusty prescription pad and writes an order to fix that backache or get rid of those nasty monthly cramps. Women are more likely to be prescribed higher doses of pain pills and for longer durations than are men, according to the National Institute of Drug Abuse (NIDA).
The biological implications also contribute to the numbers of women who abuse opiates. Women carry a higher amount of body fat and a lower volume of water. Their bodies metabolize drugs and alcohol differently than men’s bodies. During their periods they feel a decreased effect from the opiates that they take, and so they take more during that week of the month, which gradually spirals upward. Also, those emotional woes that we talked about develop more rapidly in women; men are just slower to recognize and complain about depression or anxiety. Again, that drives them to the friendly family doctor with his so-called compassionate white pad.
That also puts women who abuse opiates at greater danger of overdose, because they may well be taking simultaneous prescriptions for opioids and benzos such as Xanax, a deadly combination. In one graphic, NIDA shows 6,500 deaths of women who abuse opiates compared with about 2,500 deaths from benzodiazepines, both of which exceed deaths from antidepressants, cocaine, and heroin. Every three minutes in this country, a woman goes to an emergency department for abusing opiates.
Emotional Factors in Addiction for Women
While there are many relationships in which women abuse the men who love them, in point of fact women are far more likely to be the victims in an abusive relationship. Shame of trauma will keep them from going for help and, if they do seek it out, they find difficulty opening up about lifestyle issues. Lesbian women and women who have worked as exotic dancers or prostitutes are also less likely to find help through treatment, because most treatment groups simply do not address those multiple concerns.
Women also resist going into treatment because they worry about who will take care of their children or, an even greater risk for women who abuse opiates, whether Children’s Services will take away their children.
Only small amounts of research have focused on women who abuse opiates. The greatest reason is because male scientists look for groups of subjects with consistent biological characteristics—and they cannot know for certain or control when women have their periods. Only 8 percent of all current research addresses addicted women’s issues and even less of that deals with women who abuse opiates.
There Is a Bright Side
The good news is that women seem to absorb more quickly the things they learn in treatment. It might take them a while to get into treatment, but once they do they make good progress. Women abusing opiates reach a better understanding that addiction has a harmful effect on their relationships with others, and they will work harder to get back on track. Women benefit more from 12-step groups because they teach us how to connect with people, without focusing on leadership skills.
There are also increasing options for childcare for women who abuse opiates. Many methadone programs offer babysitting arrangements, at least during medication hours. There are many wonderful programs that offer women’s groups to address the issues that just don’t affect men.
If you are a woman and you worry about your prescription pain pill abuse, be on guard against moving from pain pills to heroin. For many heroin represents a cheap and available drug that will quiet the cravings and withdrawal symptoms that you experience when you cannot get your prescription drugs.
It’s better to consider methadone or Suboxone as a way to get your addiction under control. Once you undergo an initial assessment, you can begin a program in which you receive one dose per day of a medication that lets you take back your life so you can become educated about your addiction and learn how to manage it. But you have to pick up the phone and make that first, all-important phone call. Do it now.