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Lauren Davis, MS, LPC, Director of Admissions
Kristen Render, LMSW, Assistant Director of Admissions 

When it comes to getting treatment for substance use disorder, women are generally more likely to be faced with obstacles and are overall less likely to seek treatment than their male counterparts. This is true nationwide, regardless of sexual preference or marital status, although heteronormative family structures do perpetuate it. At MARR, our Clinical Assessment Team observes this trend every single day. We see, on average, more than twice as many admissions to our Men’s Recovery Center compared to Traditions Recovery Center for Women, even though the structure of these two programs is very similar. 

We hear from family members and loved ones every day who are all facing the same challenges in getting treatment for the women in their lives. This may not be your experience, but it is important to acknowledge this overarching trend and some of these specific obstacles, especially if you have a female loved one who may need treatment for substance use. Knowing some of these barriers up front can foster more productive conversations in the process of considering treatment.

Common Obstacles

Oftentimes in women, it is not as obvious that a substance abuse issue exists. Women are generally more open and honest about things like depression, anxiety, disordered eating, and medical problems than men are, so substance abuse is often masked by these other issues. These struggles are also generally more accepted and deemed as more “normal” in females. It is normalized for women to suffer from anxiety or disordered eating without getting treatment, but when men are suffering from the same issues it is deemed a more pressing issue. 

Due to the barriers to accessing treatment, it typically takes women longer in their disease before becoming willing to enter treatment. In that time, women tend to develop stronger skills of being secretive and manipulating those around them. Many of our female clients enter treatment with personality disorder symptoms that result in excessive manipulation and difficulty regulating their emotions. Women are used to just saying, “It’s okay.” They quell the worry of those around them and they even convince themselves that they do not need help. Even if a female client begins to acknowledge her suffering, it is often so radically minimized and delusional that it is difficult to determine whether she even sees it as an issue.

Women also often hold and internalize a lot of shame. Oftentimes in addiction, this shame grows and manifests as denial, both for themselves and for their families. The family members of women that we talk to have often spent months or even years feeling like they are walking on eggshells. Families are scared of how the women they love are going to react, afraid that they will be met with anger or intense emotion that they won’t know how to navigate.

Women are also more likely to have suffered from some sort of biological trauma in their history. They may have had a physically, sexually, or emotionally abusive relationship that led them to using substances. They also may have suffered from reproductive issues like infertility or miscarriage . While these traumas may have initially led them to start using, they often become a justification to loved ones: Just leave me alone because I am dealing with ___________. And families silently allow the substance abuse  to continue because they feel pity or guilt.

 One of the biggest obstacles for women getting into treatment is the dynamic and well-being of their household. The thought of leaving their children for any period of time can be a huge strain on women. If they are the ones taking care of the household–cooking, cleaning, watching the kids–they question how these things would be maintained in their absence. Also, families are often less likely to spend money on treatment for a woman if she is not working, because they do not have the incentive of trying to preserve a job and an income through treatment. However, if a woman works and runs the household, this turns into a different challenge, because the family would be losing income as well if she left for treatment. These obstacles are all a reflection of this reality: women tend to not put themselves first. They prioritize others, even when it ultimately means not getting what they need to be healthy.

Family dynamics often pose a huge challenge to women getting treatment as well. In general, families are more dependent on women to maintain a sense of normalcy, and therefore less likely to push them to get treatment. In heterosexual relationships, husbands tend to have some level of codependency with their wives and are not often willing to hold boundaries and push them into treatment. Families are more willing to accept a substance abuse issue in a son or husband than in a daughter or wife. Substance abuse issues in women are often written off as stress, anxiety, or depression.

COVID & Treatment

In the past six months, COVID-19 has changed a lot of things in our society, including the dynamics of entering treatment for substance abuse. 

For many women, this transition has caused a lot of stress and has created an environment in which they can no longer keep up with everything that is being asked of them: being a full-time mom, a teacher, and possibly still keeping up with their own career. The normal busyness and “go-go-go” schedules have ceased. More time at home has created more stillness and caused women to sit with feelings of discomfort that they have ignored in the past. In many cases, this leads to an increase in drinking or using as a way to cope with all the feelings that are emerging. In other cases, their “hiding place” has been taken away–with spouses and other family members at home, their substance use becomes more noticeable or obvious.

On the flip side, we are seeing that COVID has actually created some unique circumstances that are allowing some women to enter treatment who otherwise would not have done so. Having a spouse or other family member at home consistently lessens women’s fear of leaving the household, because someone else will be there to take care of it. A halt in social obligations and activities has actually created space and possibility for many women to consider taking a break to go to treatment. Before, the thought of being away from home for three months may have caused a lot of shame, guilt, and embarrassment, but this shift in social obligations makes it a lot more feasible. 

What’s Your Story?

These dynamics and examples are not relevant for every family, but it is important for us to recognize some of the overarching trends that we see happening every day in the families that we work with. If you or your loved one is experiencing something different, we will walk with you through your unique circumstances, regardless of your history or family structure.

The most important thing to know is, regardless of your journey, you  are not alone. Our Clinical Assessment Team is here to support you and walk with you through the process of getting the best treatment possible, even if that’s not at MARR.

Getting yourself or a loved one into treatment can often be a messy and complex process, but it can also be the best decision you’ve ever made.


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