Women have different reasons than men for using drugs and tend to become addicted faster and after using smaller amounts of drugs than their male counterparts. They also have different reasons for relapsing. Here are the top five challenges that pose a threat to women in recovery:
Romantic relationships in the early stages are one of the most significant threats to recovery. If (or more likely, when) they go awry, the loss can send recovering addicts into an emotional spiral. Until their new coping mechanisms are securely in place, it is not unusual for relapse to follow every time a relationship goes wrong.
Researchers from the University of Nevada have found that women in particular are at risk of relapse as a result of interpersonal conflicts and low self-worth connected to intimate relationships. Early recovery is a time of self-discovery, when women are figuring out who they are and what they want, perhaps for the first time in their lives.
At a time when thinking can be clouded and emotions run high, women are at greater risk for attracting or becoming attracted to someone who is addicted, abusive or otherwise emotionally unavailable. A relationship during this time is likely to replace recovery as the primary focus, often with devastating results.
In some cases, being drawn to unhealthy romantic relationships in early recovery can be a sign of a larger problem. Both sex and drugs stimulate the reward circuitry in the brain, putting the person who struggles with drug addiction at greater risk of sex and love addiction, as well as other compulsions and addictions.
“Sex, love and relationship addictions commonly co-occur with substance abuse and are often an unrecognized cause of relapse,” explains Robert Weiss, LCSW, CSAT-S, an internationally known author, sex addiction specialist and educator, and the creator of The Center for Relationship and Sexual Recovery at The Ranch in Tennessee. “Women who stop using drugs or alcohol but have not fully addressed their underlying emotional challenges may find themselves ‘transferring’ their addiction to the obsessive pursuit of love, romance, sex or relationships. Some who used to be hooked on drugs may now obsessively search for a romantic or sexual partner, pick up strangers at AA meetings, masturbate compulsively, have multiple affairs, or spend much of their day looking at pornography or seeking out partners online.”
Early recovery may present new challenges for some women: the challenge of being alone, feeling worthless or unloved when not in a relationship, or needing the attention of prospective partners to boost self-esteem can all point to a deeper issue of sex and relationship addiction. Women may start using drugs with their partners or cruising for partners in bars, clubs and other places where drug and alcohol use is prevalent. Not only are these hook-ups distracting and dysfunctional, but they also put the recovering addict at increased risk of drug relapse.
More than half of people struggling with drug addiction suffer from co-occurring mental health disorders, such as depression, personality disorders and eating disorders. For women, negative feelings and depressed mood are particularly common before a relapse, whereas men are more likely to relapse as a result of positive emotional states, according to a University of Pennsylvania-Philadelphia study.
When co-occurring disorders are present, successful outcomes depend on accurate diagnosis and integrated treatment as well as specialized relapse prevention planning that teaches women to closely monitor their moods and depressive symptoms.
Women face unique barriers in getting treatment, including care-giving responsibilities, the stigma of being a female addict, lack of resources and inadequate support from loved ones. Whereas marriage seems to reduce men’s risk of returning to drug use, women are at greater risk for relapse as a result of marriage and marital conflict. This may be because women are more likely to be married to heavy-drinking men who continue to imbibe after their spouse completes treatment, while alcoholic men are more often married to light- or non-drinkers.
Studies also show that women are more likely to start drinking again when with a friend or romantic partner. A study by investigators at the University of California, Los Angeles, found that although women are more likely than men to maintain a social network, they are no more likely than men to receive the necessary emotional support or encouragement to stop using drugs.
As a result of this lack of social support, women may have difficulty severing the ties to their drug-using comrades and establishing a new sober network. They may feel pressure to return home and resume their roles, even though going back to the old drug-using environment too soon and failing to modify dysfunctional family roles are well-known contributors to relapse.
Women tend to demonstrate a weaker belief in their ability to handle difficult situations as well as poorer coping skills, according to researchers at University at Buffalo’s Research Institute on Addictions. Because depressed mood is a significant risk factor for women, relapse prevention strategies must emphasize skills that help them cope more effectively with unpleasant emotions and interpersonal problems. In the case of clinical depression or other psychiatric problems, medication may be a necessary component of treatment.
Despite these relapse risks, women in recovery take heart: Multiple studies have found that women are less likely to relapse to drug abuse than men, in part because they are more likely to engage in group counseling. Women are generally more willing to admit a problem with drug use and seek professional help, which removes two significant obstacles – denial and resistance – from the healing process. Combined with comprehensive assessments for co-occurring disorders, individualized treatment and specialized relapse prevention planning, the outlook for women in recovery is bright.
David Sack, M.D., is board certified in Addiction Medicine and Addiction Psychiatry. He is CEO of Elements Behavioral Health, a network of addiction treatment centers that include Promises Treatment Centers, The Ranch at Nunnelly, The Sexual Recovery Institute, and The Recovery Place.
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Last reviewed: 17 May 2012