W3 T1; Special Populations
Women
Alcohol
Women have about half the rate of addiction of men and half the rate of alcohol
intake per week
16-24 binge drink similar to men of that age, and older working women match men
also
Women accelerate into dependence at a faster rate; for alcohol, metabolism is
different
Women have smaller frames, lower proportion of water to fat and fewer enzymes
such as alcohol/aldehyde dehydrogenases
Therefore, liver damage happens earlier at smaller doses and faster progression to
cirrhosis; 6-10 years for man vs 2-3 for woman
Stopping drinking does not help the problem recede at this stage as it would in men
Other drugs
Rapid progression with nicotine seen too and higher levels of craving when stopped
Stopping smoking amplifies weight and self esteem issues; core at addiction in
women
Opioids and stimulants have accelerated development of use as substance use often
in context of relationships (use influenced by partner, friends etc) and intimate
violence can be a factor too
E.g. some opioid users that are women may go straight to IV use to relate to partner
or due to control
Important to look at whether substance use started at a young age due to an abusive
adult, bad parents or experiences as this can link
Substances are often coping strategies to self-medicate stress and help with self-
esteem for women much earlier than for men
Shame and secrecy around alcohol is also common in women and may drink more
than peers think; many that go on to develop dependence have pre-morbid mental
health issues
Stigma exists towards women with addiction; alcohol companies cater towards
young women and try to glamorise it
, Single, separated or divorced women are more likely to develop substance
dependence
Menstrual cycle can cause dysphoria, whereby some women try to cope with using
substances repetitively
Women working in male dominated jobs often match men in after work drinking, but
being more isolated from other women can cause issues earlier on
Many women stop substance use when pregnant or breastfeeding, even IV heroin;
natal services also exist to support women presenting with alcohol problems
However, services should be extended into early years; many women slip back into
use after birth but fear getting help or telling someone as they might lose their
children
Women-only services
Many women with addiction have past trauma, criminal history, social services; lack
of belief in yourself
Amy’s place and nelson trust are some spaces; many women are reluctant to come
at first and feel they are singled out but being in a woman only space can give the
feeling of sisterhood and be an asset
The number of women that would seek help increased after opening of woman only
unit
Women tend to show more complex needs in addiction; 1 in 3 women have been
sexually attacked, 1 in 4 experienced domestic abuse
In addiction services, those numbers can be 80-100%
Women services can provide family flats so children could come and visit
These services give increased awareness of women needs and improved treatment
Since 1970, women have expressed interest for same sex treatment
Most treatment studies are done on men as more are in treatment and small
samples so little has been understood about women
Getting women into an all-woman context can better our understanding of
treatment
Women experience a lot more stigmatisation, particularly heroin use and those with
children; this is a barrier to treatment
To deal with this, social services need to make women feel safer and more
supported in order to seek help; currently no one is the voice of the mother
Higher rates of alcohol addiction seen in gay women; coming out issues, isolation,
identity issues; women are more prone to anxiety and depression, using alcohol for
self-medication
Women
Alcohol
Women have about half the rate of addiction of men and half the rate of alcohol
intake per week
16-24 binge drink similar to men of that age, and older working women match men
also
Women accelerate into dependence at a faster rate; for alcohol, metabolism is
different
Women have smaller frames, lower proportion of water to fat and fewer enzymes
such as alcohol/aldehyde dehydrogenases
Therefore, liver damage happens earlier at smaller doses and faster progression to
cirrhosis; 6-10 years for man vs 2-3 for woman
Stopping drinking does not help the problem recede at this stage as it would in men
Other drugs
Rapid progression with nicotine seen too and higher levels of craving when stopped
Stopping smoking amplifies weight and self esteem issues; core at addiction in
women
Opioids and stimulants have accelerated development of use as substance use often
in context of relationships (use influenced by partner, friends etc) and intimate
violence can be a factor too
E.g. some opioid users that are women may go straight to IV use to relate to partner
or due to control
Important to look at whether substance use started at a young age due to an abusive
adult, bad parents or experiences as this can link
Substances are often coping strategies to self-medicate stress and help with self-
esteem for women much earlier than for men
Shame and secrecy around alcohol is also common in women and may drink more
than peers think; many that go on to develop dependence have pre-morbid mental
health issues
Stigma exists towards women with addiction; alcohol companies cater towards
young women and try to glamorise it
, Single, separated or divorced women are more likely to develop substance
dependence
Menstrual cycle can cause dysphoria, whereby some women try to cope with using
substances repetitively
Women working in male dominated jobs often match men in after work drinking, but
being more isolated from other women can cause issues earlier on
Many women stop substance use when pregnant or breastfeeding, even IV heroin;
natal services also exist to support women presenting with alcohol problems
However, services should be extended into early years; many women slip back into
use after birth but fear getting help or telling someone as they might lose their
children
Women-only services
Many women with addiction have past trauma, criminal history, social services; lack
of belief in yourself
Amy’s place and nelson trust are some spaces; many women are reluctant to come
at first and feel they are singled out but being in a woman only space can give the
feeling of sisterhood and be an asset
The number of women that would seek help increased after opening of woman only
unit
Women tend to show more complex needs in addiction; 1 in 3 women have been
sexually attacked, 1 in 4 experienced domestic abuse
In addiction services, those numbers can be 80-100%
Women services can provide family flats so children could come and visit
These services give increased awareness of women needs and improved treatment
Since 1970, women have expressed interest for same sex treatment
Most treatment studies are done on men as more are in treatment and small
samples so little has been understood about women
Getting women into an all-woman context can better our understanding of
treatment
Women experience a lot more stigmatisation, particularly heroin use and those with
children; this is a barrier to treatment
To deal with this, social services need to make women feel safer and more
supported in order to seek help; currently no one is the voice of the mother
Higher rates of alcohol addiction seen in gay women; coming out issues, isolation,
identity issues; women are more prone to anxiety and depression, using alcohol for
self-medication
