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Dr. Benjamin Rush ( 1745-
1813 )
Dr. Rush - the
³Father of
American
Psychiatry´ -
was the first
American
doctor to
propose that
³intemperate
individuals´ be
›n the 19th Century, physicians began to
view addiction as a disease, rather than a
moral failing
Ö ]reatment facilities sprang up across
the nation to basically Detox

Ö Most didn¶t accept women.

Ö ]oo difficult to treat

Ö Addiction was far more progressed

because of social pressure on women
to hide their drinking
Ö Martha Washington Societies were
1staddiction treatment centers
specifically designed for women.

Ö Founded in early 1840¶s.

Ö ]reatment organized by women, for

women with alcohol/drug problems.
Ö Women¶s temperate groups called
³industrial homes´

Ö Most treatment centers called

³inebriate asylums´ or ³farms´

Ö Women not treated until latter part

of 19th century.
Ö Òterus and ovaries sometimes
recommended removing surgically
as a cure of last resort for alcoholic
women.

Ö Practice of sterilization continued

until 1950¶s
Šate 19th and early 20th
century women faced
some obstacles that
today¶s women continue to
face like shortage of
treatment and stigma
Ö miewed that they were different
and a threat to men
Ö ›nitial exclusion from AA
Ö ›n the 1940¶s, separate women¶s
groups of AA emerged
Ö Women often accused of being
lesbian or wild - kept many women
from attending AA.
WHY WOMEN SOҊD NO] BE
AŠŠOWED ›N AA:
Ö ›n a 1946 AA newsletter, a male member
noted the following reasons why women
should not be allowed in AA meetings:

Ö ]he percentage of women who stay in AA is

low.

Ö Many women form attachments too intense ±

bordering on the emotional.

Ö So many women want to run things.

Ö ]oo many women don¶t like
women.
Ö Women talk too much.
Ö Women are a questionable help
working with men and visa versa.
Ö Sooner or later, a woman-on-the-
make sallies into a group, on the
prowl for phone numbers and
dates.
Ö A lot of women are attention-
demanders.
Ö Few women can think in the
abstract.

Ö Women¶s feelings get hurt too

often.

Ö Far too many women cannot get

along with the non-alcoholic wives
of AA members.
Women and Opioid Addiction
 Women and Opioid Addiction
Ö ›n the 19th and 20th Centuries, huge
numbers of women are exposed to opioid
medications, either through prescription by
doctors or through the marketing of patent
medications

Ö Most of the nation¶s 250,000 opiate addicts

are white, middle-to-upper-class women,
often housewives and socialites
Ö Believed a cure for masturbation,
violent hiccoughs and ³female
troubles´ like morning sickness,
nervousness and nymphomania.

Ö Prescribed opiates for conditions

sounding like today¶s PMS
]he Civil War (1861-1865)
Morphine was
given to injured
and/or dying
soldiers as well
as to the
anguished
wives and
mothers
back home.
Ònpleasant gastric side effects taking
opium orally so devised other methods
like enemas, suppositories, skin
patches, crude syringes.
 Dr. Alexander
Wood perfected
a hypodermic
needle.
Enthusiastically
promoted
because it
worked quickly
and thought to
not be addictive
many became
morphine
addicts.
Dr. Wood¶s (inventor of morphine) wife
died of a drug overdose by hypodermic
needle.
Patent Medications

]he Patent Medicine industry

advertised drugs containing
opiates as ³women¶s friends´
or ³mother¶s helpers´

›t also promoted medicines

for symptoms of teething,
regulating infants¶ bowels, as
well as to pacify wailing
babies and irritable children
Ö During the early 1900¶s, there
were approximately 50,000
patent medicines containing
opiates available in stores or by
mail order in the Ònited States.
Ö ]he Harrison Act restricted the use of
narcotics and made illegal the non-medical
use of narcotics

Ö Repercussions were immediate with addicts

flocking to sanatoriums and hospitals

Ö Women received little sympathy, concern or

help

Ö 1950¶s tranquilizer Miltown

Ö End of the 1960¶s, 2/3 of users of
psychoactive drugs - malium and
Šibrium - were women.

Ö ›n 1960¶s, amphetamines were heavily

promoted as appetite suppressants for
weight conscious women. Šater
switching to cocaine.

Ö Marijuana use dramatically increased

among women in the 1060¶s as well as
ŠSD.
Ö ]he 1980¶s brought crack /cocaine
followed by synthetic drugs and
currently methamphetamines.

Ö ]he 1980¶s brought crack/ cocaine

onto the scene, followed by the
synthetic drugs of the rave scene in
the 1990¶s (X]C).
 m

    

 
 

›Women in the study were 47 times more likely to

die than the average woman in B.C.
›Men in the study were 22 times more likely to die
than the average man in B.C.
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› 6 million women are addicted in the ÒS

› More than 7.5 million women abuse prescription
pills
› More than 2.5 million women abuse illicit drugs
› Heavy drinking teen girls:
› 5 X more likely to have sex
› 1/3 less likely to use protection
› Alcohol is involved in 73% of all rapes and 70% of
domestic violence
Men and women have
different needs in
treatment for addiction
 CASA Study: Columbia Òniversity

Ö Women have more guilt and shame

over their addiction
Ö Women do not believe that addiction is
an illness
Ö Women are more likely to have been a
victim of incest
Ö Men can get forgiveness much easier
than women
Ö Double standards on sexual behaviors
for men and women
Ö Alcohol is processed slower in females,
therefore causing more physical damage

Ö Fetal Alcohol Syndrome and effects create a

daily reminder of the shame and fear in the
addicted woman

Ö Women are more apt to have been exploited

by men, sexually, psychologically and
emotionally, making choosing treatment more
problematic

Ö 9 out of 10 Women stay with addict

husband...
Ö 1 out of 10 men stay with the addicted wife
Ö ›ssues of abortion, miscarriage, adoption are
serious problems for the addicted woman

Ö Women addicts are more isolated, therefore

have little or no support group

Ö Women addicts face social chastisement of a

greater magnitude than men

Ö Alcoholic women experience an increased

magnitude of sex-biased attitudes, social
stigma, double standards. Women from other
cultures are oppressed as a group
Ö Myths around alcoholic women¶s promiscuity
place women at increased risk for sexual
assault and rape. Blaming the victim is
alarming in its proportions.

Ö Women are especially susceptible to being

influenced by their peers, significant others
and their families.

Ö Women are often the primary caretakers of

children...that p
 be addressed.
 Admission following an
intervention requires sensitivity
on the part of the treatment staff
 ]he Center for Substance
Abuse ]reatment (CSA])

³›n view of the possibility that the client

may have experienced sexual abuse, it
is preferable, for the first point of
contact...be with a female.´
 Over the years women¶s roles have been
redefined, providing them more autonomy and
more opportunity than ever before.
Ö Ö]oday¶s modern women are in a constant
balancing act between their careers and
family

Ö ›n boardroom by day and the family room by

night, many women do it alone as single
parents

Ö ]he tides of change have also brought about

the equality of substance abuse and addiction
 ]olerance

Ö Women can become addicted faster,

even though consuming smaller
amounts.

Ö As women mature, their tolerance for

substances decreases
 Woman¶s ›ssues
Ö Self-esteem issues
Ö Body image issues
Ö Gender-based discrimination
Ö Balancing recovery with parenting
(especially the single parent)
Ö Difference in physiologic response of
women patients to drugs (i.e. ]olerance
differences)
 ›nternalization of stress
Ö Women are more likely to internalize the stress
of life events, causing them to become more
depressed and anxious

Ö Girls are more likely to divert stress though

substance use and this can ultimately lead to
substance abuse

Ö ›t is this combination of a women¶s stress and

self-image that can predispose women to
depression and the use of substances to self
medicate the symptoms
 Child Abuse
Ö Child abuse can predispose
children to substance abuse

Ö 1 in 4 college women report haven

been sexually abused

Ö More than one in five high school

girl¶s have reported some form of
abuse, being either physical and/or
sexual in nature
 Adult women who were abused as
children are significantly more likely to
drink to intoxication, experience alcohol-
related problems such as alcohol
dependency and to abuse both
prescription and illicit drugs
A comprehensive assessment will help
the interventionist develop the
foundation and map for a healthy
beginning
 Women¶s ›ssues
Ö ›ncreased likelihood of Depression and other co-
occurring disorders
Ö ›nternalization of stress/ high anxiety
Ö Higher incidence of trauma
Ö Pregnancy issues/breastfeeing/Post-partum
Ö Abortion/miscarriage
Ö Hormonal issues
Ö S]Ds/H›m
Ö Doctors more likely to prescribe women patients
medications, less likely to diagnose as addicted
 Women¶s ›ssues
Ö Body image issues/Eating Disorder
Ö ›nternal consequences
Ö Balancing recovery with parenting
(especially the single parent)/childcare
issues
Ö Difference in physiologic response of
women patients to drugs (i.e. ]olerance
differences)
Ö Šack of financial independence
 Cultural ›ssues
Ö Cultural knowledge of systems (closed
vs open)
Ö Gender issues within culture
Ö Proper and appropriate behaviors
Ö Sensitivity
Ö Shame
Ö Religious Considerations
 ]rauma
Ö ›nterventionist should able to work with
P]SD and Dissociative Disorders
Ö Grounding techniques
Ö Danger of re-traumatization
Ö Gender of Clinician
Ö Eating Disorder assessment
Ö Self-mutilation assessment
Ö Appropriate treatment placement
Ö Dangers of the ³Surprise Model´
 Domestic miolence
Ö mictim¶s safety must be the first
consideration
Ö Abused person must agree to a safety
plan if the Batterer refuses treatment
(i.e. Safe House)
Ö Placement of patient in a treatment
facility equipped to handle rage/violence
issues
Ö Placement of a facility that treats
PS]D/Battered woman¶s syndrome
 Safety

Ö Withdrawal ›ssues
Ö Suicidality
Ö miolence
Ö Run Away potential
Ö Child endangerment
now the mandatory reporting
laws
Ö Suicide
Ö Homicide
Ö Child Abuse/Neglect
Ö Elder Abuse
 Adolescent Girls

As young women¶s bodies begin to

experience the hormonal changes
brought on by puberty and natural
growth, their risk of substance use
is heightened.
Ö Young woman who mature faster than their
peers are at an increased risk for negative
outcomes including substance use and abuse

Ö Girls that attain sexual maturity earlier have

an increased possibility of engaging in
substance abuse earlier and in greater
quantities then their peers who reach sexual
maturity later

Ö ]he link between increased testosterone

levels and substance use may also explain
the tendency for early maturing girls to spend
more time with older, more risk taking peers
Ö ]eenage girls who report low self-esteem
are much more likely to report substance use
or abuse.

Ö Body image plays a significant role in the

development of self-esteem of younger girls.

Ö Younger girls tend to associate weight loss

with being prettier and popular whereas older
girls specifically associate it with being more
attractive.
]reatment of Adolescent Girls
Ö Habilitation vs. Rehabilitation
Ö Eating Disorder/Body ›mage
Ö Self-esteem Nurturing
Ö Sexuality/Relationship ›ssues
Ö Self-mutilation
Ö Abusive Relationships
Ö Educational/vocational issues
Any Questions?
Ö Heather R. Hayes, M.Ed., ŠPC
110 meteran¶s Memorial
Boulevard
Suite 250-J
Cumming, Georgia 30040
770.335.5004
HRHHeatherhayes@AOŠ.com
Joyce Sundin, CCDC ››, NCAC ››,
CPGC›ntervention Specialist
4649 Sunnyside Avenue North
#342Seattle WA 98103
206-634-0434
FAX: 206-634-0263eM:
sundinje@comcast.net
Web: www.interventionhelp.com
Francesca McCarter
›ntervention Resources
Francesca McCarter A›S
P. O. Box 125
Buckeystown, Maryland 21717
Office:uu301-831-8910
Cell: 240-409-1637
Fax: 301-695-0406
FGM›nterventions@aol.com