Men are historically more likely than women are to engage in substance abuse and subsequently to develop an addiction. However, a 2015 study1 found that women drinking alcohol excessively develop more medical problems than men. In addition, these women experience barriers to treatment, recovery, and remaining sober that many men do not.
How do women experience alcoholism? What barriers to recovery do they experience? More importantly, how can we address these barriers and overcome them? Read on for an overview of the current state of alcoholism and treatment for women.
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Alcoholism – whether frequent, heavy, or binge drinking, has long been considered a male problem. Women showing signs of intoxication, dependency on alcohol, or even withdrawal, were dismissed as “lightweights,” or simply more physically susceptible to alcohol’s effects. Meanwhile, more and more women over the last few decades have realized their dependence on alcohol is every bit as concerning as their male counterparts, but friends, family, and even professionals often dismiss such concerns.
It is true that women experience alcoholism differently than men, in part due to some of the very factors that led others to dismiss their symptoms. In particular, women progress in their alcoholism much more rapidly than men, partially due to this dismissal. Women may not realize they have a problem with alcohol until much further into addiction than men.
Physically, women respond to alcohol differently than men, as well. Due to their smaller stature and a lower level of the enzyme that breaks down alcohol, women feel the effects of alcohol much more quickly as it accumulates in the bloodstream.2 This means the brain and other organs experience the effects of the alcohol much sooner, and for much longer than they do in men.
Over time, increasingly long periods of exposure to alcohol can rapidly affect the brain, stomach, kidneys, and liver. This effect is greater in women because women have a higher percentage of fatty tissue in the body, which tends to hold on to alcohol. The physical effects of alcoholism take a greater toll on the female body than they do on the male body, resulting in death rates as much as 100% higher than male alcoholics.
What Barriers To Treatment Do Women Experience?
Women experience multiple barriers to receiving treatment, and even while in treatment. Some barriers are societal, imposed by the general attitudes towards those facing addiction and the expectations of friends, family, coworkers, etc., may impose on women. Other barriers may exist within the treatment and recovery systems and only show themselves once women enter a treatment program.
The following are barriers to treatment uniquely or commonly experienced by women:
Trauma. Women are much more likely than men to be victims of trauma such as domestic assault and violence, and sexual assault. Women living under such conditions may not feel they are “allowed” to proceed with treatment or may experience threats of reprisal for leaving the home. Additionally, alcoholic women with children may fear leaving their children with their abuser to pursue treatment.
Homelessness and financial dependency. Women are also much more likely than men to be financially dependent on others, or homeless. Women that experience these conditions may find themselves unable to afford treatment, or unwilling to leave children and other dependents in those circumstances while seeking treatment.
Shame. Due to societal expectations, while women are increasingly likely to suffer from substance abuse, they are much less likely than men to admit to addiction and may experience shame while seeking treatment. Many times, women feel they must explain absences from school, work, or friendships, and feel they cannot admit to addiction or needing help. As a result, women may avoid treatment altogether to avoid feeling the shame they assume comes with seeking help.
Mental health. Women experience mental health disorders such as eating disorders, body dysmorphia, and low self-esteem more frequently than men do. In addition, depression and anxiety can compound the effects of alcoholism and make women more resistant to seeking treatment.
Children. Women are often the primary caregivers for children in the home, providing a barrier to seeking treatment for many who feel they lack childcare options or are otherwise shirking the responsibilities of motherhood by seeking treatment. In addition, an actual lack of childcare options or the financial means to procure childcare prevents many women from seeking help. Finally, women may fear the loss of custody or access to their children if they admit to alcoholism.
Support of other family members. Besides children, women often provide care for aging parents, spouses, or other family members. Many times, women provide the family with meals, provide upkeep on the home, and engage in a number of responsibilities related to the overall functioning of the family unit. Women may delay or deny seeking treatment because they worry about what will happen in the home while they’re away or otherwise focused on themselves.
View of alcoholism. Unlike men, women tend to view alcoholism as a temporary crutch, or a response to stressors in their lives that may go away with time and a reduction of stress. As such, women may not view treatment as an option, preferring instead to wait for alcoholism to abate on its own.
Lack of knowledgeable referrals. As mentioned, alcoholism begins much more rapidly in women than in men. However, medical professionals, friends, and family may dismiss the warning signs of alcoholism as “being a lightweight” rather than physical addiction. This makes referrals to treatment centers and addiction programs less likely than if the same symptoms were present in men.
Lack of female-oriented treatment. Even though women acknowledge alcoholism and are willing to seek treatment, the majority of treatment programs focus on men, who are the primary users of such treatment. Women may experience barriers in attempting to find a treatment program they identify with, while in male-oriented treatment itself, or after treatment they may not have found effective.2
Alcoholism in Women: How Can We Address Barriers?
To address the barriers women experience while seeking treatment, it is important to discuss the treatment itself. According to Betty Ford, one of the nation’s first female-oriented treatment programs, women tend to respond better to supportive treatment where they can build relationships with other members as well as staff. Instead of feeling broken down, or at “rock bottom,” which only exacerbates the shame and guilt many women feel at the onset of treatment, women often need to feel supported in recovery.
Encouraging feelings of self-reliance, as well as the ability to depend on friends and family in times of need, can prove more helpful to women on the road to recovery. Similarly, medical providers must change the manner in which they address women experiencing symptoms of dependence on alcohol to increase access to treatment. Overall, education on how women experience alcoholism as well as the types of treatment that are most effective can lead to better results for women.
Next, addressing the barriers to seeking treatment itself can help provide increased access to recovery programs. Improving access to childcare as well as temporary and permanent housing or other financial resources can ensure more women are willing to receive care. Similarly, increased access to mental health resources can help address the emotional and psychological barriers frequently experienced by women.
Conclusion
As a society, we have a long way to go towards encouraging both men and women to seek and receive treatment.3 However, it must become more socially acceptable for women to admit they are experiencing problems with alcohol and need to seek treatment. Decreasing the stigma of women temporarily leaving the care of children and families to others to seek treatment can help encourage more women to pursue recovery.
Much as the barriers to alcoholism diagnoses and access to treatment are numerous, so are the ways we must pursue removing those barriers.4,5 There is no instant solution to alcoholism in women, just as there is no guaranteed effective treatment program. However, addressing the barriers in a thoughtful, constructive way while providing continued support to women experiencing alcoholism can result in better treatment options and outcomes.
This content has been reviewed and approved by a licensed physician.
Dr. Samuel Lee
Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente. He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.
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To address the barriers women experience while seeking treatment, it is important to discuss the treatment itself. According to Betty Ford, one of the nation’s first female-oriented treatment programs, women tend to respond better to supportive treatment where they can build relationships with other members as well as staff. Instead of feeling broken down, or at “rock bottom,” which only exacerbates the shame and guilt many women feel at the onset of treatment, women often need to feel supported in recovery.
