Women less likely to seek substance use treatment due to stigma, logistics Penn State University

Anger and hostility mediate the association between experienced stigma and substance use among African American adolescents and their parents, respectively (Gibbons et al., 2010). Several articles explored how societal expectations of women’smorality (6; 17%) [41,43,59,65,68,73], cleanliness and attractiveness (3; 9%)[41,45,48], and roles as mothers (8; 23%) [44,4553,60,65,68,69,73], shapedexperiences of drug use-related stigma for WWUD. These studies described how druguse-related stigma can be amplified for WWUD due to the higher moral standardssociety has for women compared to men.

Definitions, Key Concepts, and Processes

Similarly, many housing agencies have policies denying services for people engaging in active drug use or with histories of drug use (Lopez & Reid, 2017). Such policies are legal under the Fair Housing Law, and contribute to housing insecurity and homelessness among people with SUDs. Within neighborhood contexts, the not in my back yard (NIMBY) movement has been leveraged to oppose local SUD treatment centers and harm reduction efforts via protest, petition, and harassment of people who use drugs (Tempalski et al., 2007). ‘Many drug-using women reported negative experienceswith medical providers and only sought health care when they were so illthey had no choice. The women generally felt that medical personnel werehostile and did not take their problems seriously … Many womenreported feeling pain and discomfort during vaginal exams because doctorsused the wrong size speculum or conducted the exam in a rough or rushedfashion. Others reported that providers refused to provide care once theylearned of their drug use.’ (Oliva, 1999, California, US, pg. 9, [72]).

Post-January 6th deplatforming reduced the reach of misinformation on Twitter

Experiences of stigma manifestations elicit psychological responses that may lead to substance use among targets. From a stress and coping perspective (Miller & Kaiser, 2001), stigma manifestations are characterized as significant stressors that may elicit both internalizing (e.g., depression, anxiety) and externalizing (e.g., anger, hostility) symptoms among targets. In turn, targets may engage in substance use as a form of distraction coping to draw their attention away from distressing or uncomfortable thoughts and feelings. Supporting this perspective, depressive symptoms mediate associations between experienced and internalized stigma with multiple indicators of substance use among people living with HIV (Earnshaw et al., in press). Depressive and anxiety symptoms similarly mediate associations between experienced stigma and heavy drinking among multiracial gay and bisexual men (English et al., 2018).

1. Many of the other women could not access such resources, and some were told that as “former drug users” they could not use any psychotropic medication.
2. [30] Stigma results in prejudice and discrimination against the stigmatized group, reinforcing existing social inequalities, particularly those rooted in gender, sexuality and race.
3. Others reported that providers refused to provide care once theylearned of their drug use.’ (Oliva, 1999, California, US, pg. 9, [72]).
4. Findings provide deeper insight into barriers that may be contributing to racial/ethnic disparities in the use of substance abuse treatment among women.

Trauma-Informed Care for Substance Use in Pregnancy

The United States is currently experiencing an opioid epidemic, with deaths due to opioid overdoses persisting in many communities. This epidemic is the latest wave in a series of global substance use-related public health crises. As a fundamental cause of health inequities, stigma leads to the development of substance use disorders (SUDs), undermines SUD treatment efforts, and drives persistent disparities within these crises. Given their expertise california’s best 12 step based alcohol and drug rehab center in mental and behavioral health, psychologists are uniquely positioned to play a frontline role in addressing SUD stigma. The goal of this paper is to set an agenda for psychologists to address SUD stigma through clinical care, research, and advocacy. To set the stage for this agenda, key concepts are introduced related to stigma and SUDs, and evidence is reviewed regarding associations between stigma and substance use-related outcomes.

Treatment Response

The findings of the impact of stigma on women drug users might be compared to men who use drugs in future studies. Finally, many of the women in this study had experienced violent abuse, which needs to be further analyzed to better understand its impact on their drug use and recovery. Being stigmatized marginalizes the discredited individual from mainstream society, and stigmatization by social services is often viewed as an attempt to exert social control (Palamar, Halkitis, & Kiang, 2013). Focusing on the stigmatization of drug users within society, Radcliffe and Stevens (2008) examine the categorization of “junkies,” which refers to long-term drug users.

Women In Recovery

Several studies have examined sex differences in stress response (e.g., subjective, autonomic) and relapse [53, 54]. Specific research in women who use drugs is very scarce and treatments are not gender-sensitive oriented. For these reasons, it is important to guarantee access to the appropriate treatment of women who use drugs and a need for a gender perspective in the treatment and research of substance use disorders. Providing comprehensive services and continuing care post-treatment (e.g. housing, transportation, education, and income support), is known to reduce substance use in both genders, but a higher number of women are in need of those services.

2. Overview of key barriers to specialty treatment among women with SUD

Also, women exhibit greater withdrawal response with abstinence compared to men and tend to exhibit relapse due to cue-induced craving more than men suggesting that there might be sex differences in stress reactivity and relapse to drug use [55]. Women often have lack of access to child care services, discouraging attendance or even preventing treatment entry. By providing childcare supports, programs can help women enter and stay in treatment, allowing women bath salts drug to help themselves, and therefore help their children. Women entering treatment are more likely to have primary responsibility for their children, where as the majority of fathers entering addiction treatment have another primary caretaker (e.g. mother) available. Historically, substance use disorder in women was considered a selfish, moral failure, that resulted in intentional harm to the family, child, and in terms of placing a burden on society.

Well, to me, prostituting was too demeaning and I was raped too many times, so I stopped doing it. If they don’t want people going back to jail they need to build their spirits up instead of breaking their spirits down, and that’s all they’re doing. I mean, “You’re always going to [go to jail]. You’re always going to be nothing but a whore. You’re always…” Ain’t nothing wrong with being what I’m being if I’m not hurting anyone. And if I sold drugs, I sure as hell wouldn’t sell it to somebody if it was going to kill them.

This qualitative analysis of the life histories of 20 women who used illegal drugs focuses on their social roles, the influences of initiating and using drugs, and the process of recovering from a stigmatized social identity. This study is significant in that stigmatization is examined at each stage of drug use with how family can play an important role in addiction recovery an in-depth focus on gendered social roles. The findings contribute to a better understanding of how stigmatization of women drug users impacts their recovery. Substance use was considered to be primarily a male problem, and many substance abuse studies are conducted with a predominance of male participants.

Other sex/gender-specific medical problems to mention, related to drug use, are infertility, abortion, vaginal infections, and premature delivery. Sexual health services should be offered to women to address unique health risks, as part of normal comprehensive physical exams provided to patients. These services may include attention towards family planning, protection and sexually transmitted diseases, and fluctuating hormonal levels.

Of the 40 articles that are included in this review of the quantitativeliterature, 27 (68%) assessed stigma from the perspective of non-substance usingindividuals (i.e., the interpersonal perspective), and 13 (32%) were from theperspective of PWUD (i.e., the individual perspective). Another important aspect is that women reported more gender-related abusive experiences during training, and these women were more likely to be problem drinkers; the possible explanation could be the use of alcohol to cope with traumatic experiences [115]. Also, men and women experiment with a different profile of withdrawal symptoms under detoxification [76]. And women with alcohol use disorder are known to become intoxicated with smaller quantities of alcohol, achieving higher blood concentrations than men and show a lower tolerance even with an equal alcohol blood level [25]. This brings up the theory that ovarian steroid hormones may influence the behavioral effect of drugs [34].

Pay gaps, lower wages, less income, or the higher likelihood of women living in poverty prior to substance use disorder onset, can limit the financial resources available to seek services and treatment. Women have often experienced greater levels of stigmatization around substance use as a result of their traditional societal roles as gatekeepers, mothers, caregivers, and often the central organizing factor in their family units. With the integration of women into the mainstream workforce in most middle and high-income countries like the U.S.,  women have also begun consuming alcohol at intensities and frequencies that are quickly catching up to that of their male counterparts. Participant comments about the challenges of gaining access to city services revealed both structural barriers such as lack of coordination among agencies and individual barriers related to their drug dependency.