Women's Substance Use Disorders

Mental Health
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What is Substance Use Disorder?

A substance use disorder can be described as the repeated misuse or abuse of drugs or alcohol. This disorder often occurs comorbidly with other mental disorders, such as anxiety, depression, or PTSD. According to a national survey on drug use and health conducted by the National Alliance on Mental Illness in 2020, 17 American adults experienced substance use disorder in combination with another disorder. Although substance use is less prevalent in pregnant women compared to non-pregnant women, a significant number of pregnant women use substances.

What Are the Symptoms of Substance Use Disorder?

It is important to note that because of the endless combinations of dual diagnosis, symptoms vary widely.

According to Mayo Clinic, some general symptoms include but are not limited to:

  • Withdrawal from friends and family

  • Extreme mood changes

  • Having intense urges and thoughts about the substance that triumphs other thoughts

  • Engaging in risky behaviors

  • Developing a high tolerance, or requiring more of the substance to get the same effect

  • Experiencing withdrawal symptoms

  • Spending money on the substance, whether feasible or not

  • Feeling like you need a substance to be able to function daily

  • Always maintaining a supply of the substance

  • Confused thinking

  • Problems concentrating

  • Dissociation

  • Suicide ideation

  • Not meeting work or family obligations

  • Unsuccessful attempts to stop using the substance

What Causes Substance Use Disorder in Women?

There are many theories about causes for substance use disorder. As mentioned, the negative symptoms associated with the presence of at least one mental illness are most commonly associated with substance use disorder. Additionally, there are both genetic and environmental risk factors for substance use disorder according to Mayo Clinic:

  • Genetics:

    Genetic factors include family history of addiction or substance abuse disorder.

  • Environment:

    In terms of environmental risk factors, they include but are not limited to:

    • History of abuse (childhood, physical, emotional, sexual)

    • Existing mental illness

    • Exposure to environment where drugs are misused by peers or family

    • Lack of family involvement and guidance

    • Peer pressure

    • Experience of trauma

    • Early use

    • Taking a highly addictive drug (e.g., for pain management)

How Does Alcohol Use Disorder Affect Women?

Although women are less likely than men to misuse alcohol and have substance use disorder, women are more likely to experience harmful health effects from substance use disorder. Some of these include:

In addition, women who drink or use drugs during pregnancy also put their babies at risk for fetal alcohol spectrum disorder (FASD), which can cause physical, mental, and behavioral disabilities for the baby during and after pregnancy.

Treatment of Women’s Substance Use Disorder

When it comes to treating women for substance use disorder, several considerations should be taken into account, especially for women experiencing perinatal and postpartum stress.

  • Integrated interventions:

    It is best to use a variety of interventions in combination with each other to address both the substance use disorder and the potential underlying mental health disorder. This can include any or all of the following in combination: detoxification/inpatient hospitalization, psychotherapy, medication, and self-help/support groups (i.e., Alcoholics Anonymous)

  • Pregnant women:

    There are additional factors to consider when treating pregnant women, primarily including the health of the fetus. There should be an assessment if the woman is in active addiction or is in recovery, which will then lead to the consideration of appropriate interventions for pregnant women. According to McHugh and colleagues, buprenorphine is the safest option in terms of medication to prevent substance use during pregnancy, while also protecting the fetus. But naltrexone and methadone are also medication options. In addition, a combination of behavioral interventions and psychotherapy should characterize the treatment.

  • Post-partum:

    Women can be more susceptible to relapse or substance abuse after pregnancy due to underlying mental conditions combined with the stress of becoming a new parent. In addition, women can develop Postpartum Depression and Anxiety as a result of residual hormonal imbalances, which poses additional risk. It is especially important that women have ample social support and follow treatment plans in place during the postpartum period.

Frequently Ask Questions

  • Often, it can be very difficult to recognize problematic substance abuse in loved ones. This can be particularly difficult with adolescents who may be going through developmental changes relating to physical appearance and emotional regulation. Here are some possible indications of substance use disorder:

    • Problems at school or work

    • Physical health issues

    • Lack of energy

    • Neglected appearance

    • Changes in behavior

    • Changes in social patterns and peer relationships

    • Money issues or requests

  • Some treatment considerations for pregnant women include:

    • Help pregnant women manage the additional stresses, demands, and guilt that pregnancy can cause in a woman struggling with a substance use disorder.

    • Educate clients who are pregnant about how the amount and timing of addiction (within trimesters) of substance use can impact the fetus

    Encourage women to remain abstinent during pregnancy and breastfeeding

  • According to the U.S. Department of Health and Human Services, it may be more difficult for women to seek help for substance use disorder. A woman may be pregnant or breastfeeding and unwilling to tell someone that they are addicted, because they fear losing custody of their child or because of fear of judgement on parental fitness. Women may be more likely to face additional barriers to treatment, such as needing childcare or elder care, to follow through with participation in long term treatment programs or impatient care.

Disclaimer

The information on this page, or elsewhere on this site, is not intended to take the place of diagnosis, treatment or informed advice from a qualified mental health professional. You should not take or avoid any action without consultation with the latter.

If you would like to talk to a counselor, please click here.

References

Alcohol use disorder, substance use disorder, and addiction. (2018, December 26). Office on Women's Health. Retrieved from https://www.womenshealth.gov/mental-health/mental-health-conditions/alcohol-use-disorder-substance-use-disorder-and-addiction

Mayo Foundation for Medical Education and Research. (2017, October 26). Drug addiction (substance use disorder). Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112

McHugh, R. K., Votaw, V. R., Sugarman, D. E., & Greenfield, S. F. (2018). Sex and gender differences in substance use disorders. Clinical psychology review, 66, 12–23.

https://doi.org/10.1016/j.cpr.2017.10.012

Substance Use Disorders. (2020, May). National Alliance on Mental Illness. Retrieved from

https://www.nami.org/About-Mental-Illness/Common-with-Mental-Illness/Substance-Use-Disorders

U.S. Department of Health and Human Services. (2022, March 26). Substance use in women drugfacts. National Institutes of Health (NIDA). Retrieved from https://nida.nih.gov/publications/drugfacts/substance-use-in-women

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