From Generic to Gender-Responsive Treatment: Changes in Social Policies, Treatment Services, and Outcomes of Women in Substance Abuse Treatment

Abstract

In the past three decades, there has been increased recognition of the role of gender in influencing the course of substance use and treatment utilization. Concurrently, a substantial body of research on gender-related issues and substance abuse and its treatment has developed. This article reviews (I) policy initiatives that led to the growth of "specialized" treatment programs and services for women and recent policy changes that influence the provision of substance abuse treatment to women;(2) gender differences in the pre valence of substance use disorders and admissions to treatment; (3) gender differences in treatment needs, utilization, and outcomes, including long-term outcomes following treatment; ( 4) organizational characteristics of substance abuse treatment providers for women and the types of services provided in these programs; (5) treatment outcomes in gender-specific programs for women; and (6) the effectiveness of evidence-based treatment practices that have either been modified, or have the potential to be adapted, to address the treatment needs of women. This body of research is viewed within the context of a series of paradigm shifts from a generic treatment approach to a focus on gender differe nces and gender specificity and, most recently, to an emergent focus on gender responsiveness.

Sex and Gender in Adverse Drug Events, Addiction, and Placebo

“…However, data on pain killer and tranquilizers abuse recognize some discrepancies across the different studies, some of them indicating that use of these drugs is approximately twice in women than men (Grella 2008), while other studies report equivalent rates between sexes or higher rates among men (Greenfield et al 2010).…”

A house of cards: The long-term recovery experience of former drug-dependent Israeli women

“…In this paper we examined the challenges and processes involved in sustaining LTR among women, in contrast to other studies that have been limited to recovery initiation and treatment issues of men, probably since so little is known about the LTR experience of women (White & Kelly, 2011). The general body of knowledge on drug addiction therapy has undergone a notable shift with regard to women, from neglect of this population to the development of gendersensitive therapies (Grella, 2008). These therapies are rooted in the seminal work of Gilligan (1982), which disputed the previous models of identity and focused on women's different voice and commitment to relationships.…”

“…However, despite this paradigmatic shift, robust conceptual models or practices that adhere to the conceptualization of addiction as a chronic disorder are still rather limited (Hser & Anglin, 2011). Furthermore, although previous studies have documented women's special needs, establishing the impressive body of research known as gender-sensitive treatment and contributing significantly to the understanding of women's recovery (Grella, 2008;Tuchman, 2010), little research has focused on women's experience and needs for long-term recovery (LTR) after they depart from treatment services and need to maintain their achievements (White & Kelly, 2011). We undertook the present study as a first step in filling these lacunae, by learning about the LTR experience of recovering Israeli women and taking into account social and cultural contexts of drug addiction and recovery.…”

What do women with substance use disorders want?

“…This is despite evidence that such programs typically provide more services that women often need related to mental health, employment and education, trauma exposure and parenting needs [10]. Moreover, women in women-only programs often have more severe problems than those in mixed-gender programs [11,12], suggesting that women with greater needs may self-select into these programs-or are more apt to be referred to them. Despite the greater severity of their patients' problems, women-only programs are associated with more favorable outcomes regarding drug use [13], treatment retention [14], criminal behavior [15], incarceration [16,17] and family reunification [18].…”