Taking Gender into Account in Prevention and Treatment
Reprinted from "Concurrent Disorders" issue of Visions Journal, 2004, 2 (1), p. 15
Increasingly we are seeing the importance of applying a gender lens, as well as attending to age and other types of diversity when working to prevent or treat addictions problems. A recent threeyear study1 undertaken by the National Center on Addiction and Substance Abuse (CASA) at Columbia University on the characteristics of girls and young women (ages 8-22) with substance use problems compellingly illustrates the benefits of taking into account sex differences and gender role influences in addiction.
The CASA researchers found unique risk factors for substance misuse by girls and women:
Physical Health Impacts
Girls and women have greater vulnerability to the physical health impacts of substance use in itself, which makes them more vulnerable to addiction and other health problems associated with use. The study explores specific adverse health consequences that are more serious for girls and young women related to alcohol, tobacco, ecstasy and prescription medications.
Transition and Risk
Key transitions such as moving from one neighbourhood to another, or moving from high school to college are times when girls and women are at higher risk for substance misuse. This is related to increase in levels of use and risky changes in attitudes such as seeing substance use as ‘cool’ or a way to be rebellious.
Girls and women tend to use tobacco, alcohol or drugs to improve mood, increase confidence, reduce tension, cope with problems, lose inhibitions, enhance sex or lose weight. These emotional and relational reasons can keep them in a destructive cycle, trying to find answers in drugs, rather than finding more adaptive supports and changes.
Links to Abuse
Sexual abuse and physical abuse, which are experienced more often by girls than by boys, are strongly related to abuse of substances. Girls who have been sexually abused are more likely to use and misuse substances earlier, more often and in greater quantities. Other studies published in 20032 confirm high rates of dating violence reported by adolescent girls and that girls who were victims of dating violence were more likely to be involved in other violent behaviours, to report extreme sadness and suicidal actions, to use illicit substances, and to engage in risky sexual behaviour.
In addition to having a higher chance of being sexually or physically abused, girls are more likely than boys to be depressed and to have eating disorders. All of these factors increase the chances for substance abuse.
The CASA researchers note that schools, professionals and public policy makers have failed to pay sufficient attention to the unique motivations for use and the accelerated consequences of use for this population in one-size-fits-all substance use prevention and treatment programming. Building from the findings of this report, the researchers highlight recommendations for action to a number of groups – including parents, schools, communities, health professionals, clergy, media, policy makers and the research community – so that the issues facing girls and young women can be addressed. The study, known as The Formative Years Report can be found online at www.casacolumbia.org
About the Author
Nancy is a researcg consultant on women and substance use for BCWomen's Hospital and BC Centre of Excellence for Women's Health
National Center on Addiction and Substance Abuse at Columbia University (2003). The formative years: Pathways to substance abuse among girls and young women ages 8-22. New York, NY: CASA.
Howard, DE & Wang, MQ. (2003). Risk profiles of adolescent girls who were victims of dating violence. Adolescence, 38(149), 1-14.