Womens Intervention Heather R. Hayes Joyce Sundijne Francesca McCarter

1
WomensInterventionHeather R. HayesJoyce
SundijneFrancesca McCarter
2
Dr. Benjamin Rush ( 1745-1813 )

• Dr. Rush - the Father of American Psychiatry -
  was the first American doctor to propose that
  intemperate individuals be treated medically

3
In the 19th Century, physicians began to view
addiction as a disease, rather than a moral
failing
4

• Treatment facilities sprang up across the nation
  to basically Detox
• Most didnt accept women.
• Too difficult to treat
• Addiction was far more progressed because of
  social pressure on women to hide their drinking

5

• Martha Washington Societies were 1staddiction
  treatment centers specifically designed for
  women.
• Founded in early 1840s.
• Treatment organized by women, for women with
  alcohol/drug problems.

6

• Womens temperate groups called industrial
  homes
• Most treatment centers called inebriate
  asylums or farms
• Women not treated until latter part of 19th
  century.

7

• Uterus and ovaries sometimes recommended
  removing surgically as a cure of last resort for
  alcoholic women.
• Practice of sterilization continued until 1950s

8

• Late 19th and early 20th century women faced
  some obstacles that todays women continue to
  face like shortage of treatment and stigma

9

• Viewed that they were different and a threat to
  men
• Initial exclusion from AA
• In the 1940s, separate womens groups of AA
  emerged
• Women often accused of being lesbian or wild -
  kept many women from attending AA.

10
WHY WOMEN SOULD NOT BE ALLOWED IN AA

• In a 1946 AA newsletter, a male member noted the
  following reasons why women should not be allowed
  in AA meetings
• The percentage of women who stay in AA is low.
• Many women form attachments too intense
  bordering on the emotional.
• So many women want to run things.

11

• Too many women dont like women.
• Women talk too much.
• Women are a questionable help working with men
  and visa versa.
• Sooner or later, a woman-on-the-make sallies
  into a group, on the prowl for phone numbers and
  dates.
• A lot of women are attention-demanders.

12

• Few women can think in the abstract.
• Womens feelings get hurt too often.
• Far too many women cannot get along with the
  non-alcoholic wives of AA members.

13
Women and Opioid Addiction
14
Women and Opioid Addiction

• In 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
• Most of the nations 250,000 opiate addicts are
  white, middle-to-upper-class women, often
  housewives and socialites

15

• Believed a cure for masturbation, violent
  hiccoughs and female troubles like morning
  sickness, nervousness and nymphomania.
• Prescribed opiates for conditions sounding like
  todays PMS

16
The Civil War (1861-1865)

• Morphine was given to injured and/or dying
  soldiers as well as to the anguished wives and
  mothers
• back home.

17

• Unpleasant gastric side effects taking opium
  orally so devised other methods like enemas,
  suppositories, skin patches, crude syringes.

18
Dr. Alexander Wood perfected a hypodermic needle.
Enthusiastically promoted because it worked
quickly and thought to not be addictive many
became morphine addicts.
19

• Dr. Woods (inventor of morphine) wife died of a
  drug overdose by hypodermic needle.

20
Patent Medications

• The Patent Medicine industry advertised drugs
  containing opiates as womens friends or
  mothers helpers
• It also promoted medicines for symptoms of
  teething, regulating infants bowels, as well as
  to pacify wailing babies and irritable children

21

• During the early 1900s, there were
  approximately 50,000 patent medicines containing
  opiates available in stores or by mail order in
  the United States.

22

• The Harrison Act restricted the use of narcotics
  and made illegal the non-medical use of narcotics
• Repercussions were immediate with addicts
  flocking to sanatoriums and hospitals
• Women received little sympathy, concern or help
• 1950s tranquilizer Miltown

23

• End of the 1960s, 2/3 of users of psychoactive
  drugs - Valium and Librium - were women.
• In 1960s, amphetamines were heavily promoted as
  appetite suppressants for weight conscious women.
  Later switching to cocaine.
• Marijuana use dramatically increased among women
  in the 1060s as well as LSD.

24

• The 1980s brought crack /cocaine followed by
  synthetic drugs and currently methamphetamines.
• The 1980s brought crack/ cocaine onto the
  scene, followed by the synthetic drugs of the
  rave scene in the 1990s (XTC).

25
Vancouver Massive death rate found for women
with addiction

• 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.
• Spittal PM, Hogg RS, Li K, et al. Drastic
  elevations in mortality among female injection
  drug users in a Canadian setting. AIDS Care,
  2006. Feb18(2) 101-8

26
National Center on Addiction and Substance Abuse
(CASA, Columbia University)

• 6 million women are addicted in the US
• 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

27

• Men and women have different needs in treatment
  for addiction

28
CASA Study Columbia University

• Women have more guilt and shame over their
  addiction
• Women do not believe that addiction is an
  illness
• Women are more likely to have been a victim of
  incest
• Men can get forgiveness much easier than women
• Double standards on sexual behaviors for men and
  women

29

• Alcohol is processed slower in females,
  therefore causing more physical damage
• Fetal Alcohol Syndrome and effects create a
  daily reminder of the shame and fear in the
  addicted woman
• Women are more apt to have been exploited by
  men, sexually, psychologically and emotionally,
  making choosing treatment more problematic
• 9 out of 10 Women stay with addict husband...
• 1 out of 10 men stay with the addicted wife

30

• Issues of abortion, miscarriage, adoption are
  serious problems for the addicted woman
• Women addicts are more isolated, therefore have
  little or no support group
• Women addicts face social chastisement of a
  greater magnitude than men
• Alcoholic women experience an increased
  magnitude of sex-biased attitudes, social stigma,
  double standards. Women from other cultures are
  oppressed as a group

31

• Myths around alcoholic womens promiscuity place
  women at increased risk for sexual assault and
  rape. Blaming the victim is alarming in its
  proportions.
• Women are especially susceptible to being
  influenced by their peers, significant others and
  their families.
• Women are often the primary caretakers of
  children...that must be addressed.

32

• Admission following an intervention requires
  sensitivity on the part of the treatment staff

33
The Center for Substance Abuse Treatment (CSAT)

• In 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.

34
Over the years womens roles have been redefined,
providing them more autonomy and more opportunity
than ever before.

• Todays modern women are in a constant
  balancing act between their careers and family
• In boardroom by day and the family room by
  night, many women do it alone as single parents
• The tides of change have also brought about the
  equality of substance abuse and addiction

35
Tolerance

• Women can become addicted faster, even though
  consuming smaller amounts.
• As women mature, their tolerance for substances
  decreases

36
Womans Issues

• Self-esteem issues
• Body image issues
• Gender-based discrimination
• Balancing recovery with parenting (especially
  the single parent)
• Difference in physiologic response of women
  patients to drugs (i.e. Tolerance differences)

37
Internalization of stress

• Women are more likely to internalize the stress
  of life events, causing them to become more
  depressed and anxious
• Girls are more likely to divert stress though
  substance use and this can ultimately lead to
  substance abuse
• It is this combination of a womens stress and
  self-image that can predispose women to
  depression and the use of substances to self
  medicate the symptoms

38
Child Abuse

• Child abuse can predispose children to substance
  abuse
• 1 in 4 college women report haven been sexually
  abused
• More than one in five high school girls have
  reported some form of abuse, being either
  physical and/or sexual in nature

39

• 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

40

• A comprehensive assessment will help the
  interventionist develop the foundation and map
  for a healthy beginning

41
Womens Issues

• Increased likelihood of Depression and other
  co-occurring disorders
• Internalization of stress/ high anxiety
• Higher incidence of trauma
• Pregnancy issues/breastfeeing/Post-partum
• Abortion/miscarriage
• Hormonal issues
• STDs/HIV
• Doctors more likely to prescribe women patients
  medications, less likely to diagnose as addicted

42
Womens Issues

• Body image issues/Eating Disorder
• Internal consequences
• Balancing recovery with parenting (especially
  the single parent)/childcare issues
• Difference in physiologic response of women
  patients to drugs (i.e. Tolerance differences)
• Lack of financial independence

43
Cultural Issues

• Cultural knowledge of systems (closed vs open)
• Gender issues within culture
• Proper and appropriate behaviors
• Sensitivity
• Shame
• Religious Considerations

44
Trauma

• Interventionist should able to work with PTSD
  and Dissociative Disorders
• Grounding techniques
• Danger of re-traumatization
• Gender of Clinician
• Eating Disorder assessment
• Self-mutilation assessment
• Appropriate treatment placement
• Dangers of the Surprise Model

45
Domestic Violence

• Victims safety must be the first consideration
• Abused person must agree to a safety plan if
  the Batterer refuses treatment (i.e. Safe House)
• Placement of patient in a treatment facility
  equipped to handle rage/violence issues
• Placement of a facility that treats
  PSTD/Battered womans syndrome
• Both issues MUST be treated

46
Safety

• Withdrawal Issues
• Suicidality
• Violence
• Run Away potential
• Child endangerment

47
Know the mandatory reporting laws

• Suicide
• Homicide
• Child Abuse/Neglect
• Elder Abuse

48
Adolescent Girls

• As young womens bodies begin to experience the
  hormonal changes brought on by puberty and
  natural growth, their risk of substance use is
  heightened.

49

• Young woman who mature faster than their peers
  are at an increased risk for negative outcomes
  including substance use and abuse
• 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
• The 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

50

• Teenage girls who report low self-esteem are
  much more likely to report substance use or
  abuse.
• Body image plays a significant role in the
  development of self-esteem of younger girls.
• Younger girls tend to associate weight loss with
  being prettier and popular whereas older girls
  specifically associate it with being more
  attractive.

51
Treatment of Adolescent Girls

• Habilitation vs. Rehabilitation
• Eating Disorder/Body Image
• Self-esteem Nurturing
• Sexuality/Relationship Issues
• Self-mutilation
• Abusive Relationships
• Educational/vocational issues

52

• Any Questions?

53

• Heather R. Hayes, M.Ed., LPC
• 110 Veterans Memorial Boulevard
• Suite 250-J
• Cumming, Georgia 30040
• 770.335.5004
• HRHHeatherhayes_at_AOL.com

54

• Joyce Sundin, CCDC II, NCAC II, CPGCIntervention
  Specialist
• 4649 Sunnyside Avenue North 342Seattle WA 98103
• 206-634-0434
• FAX [phone]eM
• sundinje_at_comcast.net
• Web www.interventionhelp.com

55

• Francesca McCarter
• Intervention Resources
• Francesca McCarter AIS
• P. O. Box 125
• Buckeystown, Maryland 21717
• Office??301-831-8910
• Cell 240-409-1637
• Fax [phone]
• FGMInterventions_at_aol.com