addiction and obsession 7

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Addiction Treatment: A Strengths Perspective 4th Edition

Katherine van Wormer Diane Rae Davis

Chapter 12

Gender, Sexual, and Sexual Orientation Differences

Gender Issues

Recent trends—voices of women, gays, and lesbians are increasingly heard regarding treatment and research.

Some emphasis on gender-sensitive treatment

Class and cultural differences in drug use

Male/female ratios differ in drinking quantity ratios from 13:12 in Italy to 28:11 in Canada, 46:5 in Mexico, and 15:3 in Russia.

In American high schools, substance use rates about the same.

Adult men, twice the rate of women for marijuana and cocaine use and gambling, meth and tranquilizers about the same

More eating disorders in women

Gender Differences

Shame factor for women in treatment

Women in treatment more likely than men to have a substance-dependent partner

Treatment less accessible for mothers than fathers due to child care responsibilities

Many women lose custody of children over substance misuse.

Abstinence demands unrealistic

Lack of treatment availability for pregnant women

Good results with recovery coaches and family courts

Gender Differences continued

Meth addiction rates high among women

One study showed that 80% of female meth addicts were victims of domestic violence.

Violence - three of four intimate partner murders are of women.

Women alcoholics - 47% in treatment molested as children in study of 472 women (Downs). Treatment needs to focus on PTSD issues. Women smoke to control weight, males to relieve boredom. Escape gamblers (women). Women start gambling later in life than men do.

Biological Differences

Women get intoxicated quicker than men.

Women have a higher mortality rate with heavy drinking.

Lives are shortened by fifteen years on average with alcoholism—heart and liver damage

Women’s Treatment Needs

Address barriers to treatment that many women experience: lack of transportation, child care, and treatment availability.

Changing program goals and processes to accommodate women’s needs for more support, less confrontation, job skill training, and parenting skills.

Embracing an empowerment model of change

Female counselors who can attend to shame and stigma issues

Need to celebrate any significant decrease in substance use

Sexual Orientation

Heterosexism and homophobia: U.S. studies of schools shows suicide is fourteen times the heterosexual rates.

Lesbians—lowest rate of AIDS of any group, but double the drug use of other women, 55% smoke at some point in their lives; 28% are obese.

Reasons for high drinking rate—gay bar, fewer are mothers…G/L AA.

Gay males—high risk of sexual abuse in jail cells.

Religious fundamentalism correlated with suicide…alcohol problems persist across life span.

Transgender...See Do’s and Don’ts…table 11.2

Resources: Pride Institute and PFLAG