Women and Substance Abuse

In the fight against substance abuse, women are battling tougher odds with fewer weapons. That was the message from a panel of behavioral scientists and community health advocates at a recent conference on gender differences and substance abuse.

“Of all those stigmatized with the burden [of substance abuse], women are probably getting the worst of it all,” said Nora D. Volkow, the conference’s keynote speaker and director of the National Institute on Drug Abuse.

After her opening remarks, Volkow joined the six-person panel, called “For Women Only: Gender Difference and Substance Abuse,” which was part of a conference sponsored by the National Center on Addiction and Substance Abuse at Columbia University.

The most important findings of late are that the gap has closed between male and female substance abusers (males used to use at higher rates); women have been shown to be more vulnerable to multiple substances; and women do as well in treatment as men do, despite the general belief otherwise.

“There’s a stereotype of alcoholics as male, so we’re more likely to miss females,” said Sharon Wilsnack, University of North Dakota. “If we can’t change those mental stereotypes, we’re going to have a hard time.”

Wilsnack discussed findings from her work with a national longitudinal study of women over the past 20 years. The sample includes 1,500 women from the United States who have been interviewed every five years about their health and behavior. So far, the largest predictor of substance abuse in women has been suffering sexual abuse during childhood. “As a society, we need to figure out how to decrease drug use in children and decrease the [number] of sexual victims,” Wilsnack said. “That would have the single biggest impact on substance abuse.”

Other significant predictors included having a partner who drank, having a violent partner, or working in a male-dominated occupation. A key trait of women who did not abuse substances was busy-ness. “In the ’80s, we thought multiple roles were bad for women,” Wilsnack said. “We thought role overload equals drinking more. Actually, in our data, it was the opposite. The busy didn’t drink.”

Having a child was the primary motivator spurring female abusers to quit, said Bruce Henry, who is the executive director of Covenant House in New York, a shelter for troubled youths. For that reason, it is important that female-specific treatment centers offer services like child care, said Shelly F. Greenfield, professor of psychiatry at Harvard Medical School.

“You do see that involvement of family, community and school all are hedges against substance abuse,” Greenfield said.

Among college-aged women, the average consumption of alcohol over the past 20 years has not changed much. What has changed is the purpose of drinking; now, Wilsnack said, campus females drink to get drunk.

The panel also included Kenneth Perkins, professor of psychiatry at University of Pittsburgh, and Robert Bazell,* a science reporter at NBC News who acted as moderator.

“If one thing could come out of this conference, it’s the importance of giving women factual health information,” Wilsnack said. “In our study, women were more likely to wonder if they had a problem. If we can give them information, that’s an enormous first step.”

* Robert Bazell will be a panelist on Michael Gazzaniga’s Presidential Symposium, “The Mind in the Media,” at the APS Annual Convention this May in New York.