DRUG ABUSE TAKES ON UNIQUE QUALITIES FOR WOMEN

For so many, the winter holidays are a time of hope, rebirth and
renewal of commitments to our best selves and our communities. For the
community of families I work with, hope, rebirth and renewal are
essential gifts that are needed all through the year. Pregnant women
and mothers who struggle with drug use and alcohol do not stay on the
road to recovery until they can feel hope and imagine a rebirth and
renewal of their lives on a daily basis.

What is substance abuse like for women? How does it happen? Are there
special issues for women? Research tells us some things.

Women are likely to begin using and then abusing drugs through their
partners. They often begin after a traumatic event, such as physical
battering, rape, death or major loss. They are more likely than men to
misuse prescription drugs and to use multiple substances like pills,
alcohol and marijuana.

And women are more likely to use in isolation. Why is this? Coming
home to your room is safer than being out; it hides you from public
shaming; it allows you to put the children to bed before using. We
know that women judge themselves and find their worth through how they
fulfill obligations in their many relationships (as a mother, a wife,
a friend, a co-worker, a daughter, a sister, a church member), and we
know that there is much shame, guilt, depression and anxiety about
drug and alcohol abuse because they have not been able to live up to
their own standards in these relationships.

Finally, women are more likely to be discouraged from seeking
treatment than men, largely because of the disruption caused in their
caretaking roles.

The use and abuse of drugs and alcohol are one of those "secrets,"
like domestic violence, that many women hide from themselves and
others. Women may feel shame and guilt; they fear the unknown changes
that seeking help may bring. Oftentimes, they have had many unpleasant
and harmful incidents and many thwarted attempts at abstinence before
they face their situation and commit to change.

It takes tremendous courage for a woman to embrace the gift of
recovery. But women do, and they and their families make changes and
become healthier and stronger.

Treatment does work. Pregnant women in recovery have healthier babies
who are full-term and a good birthweight. Mothers repair broken
relationships with their children and other family members. They take
care of themselves.

Still many women and mothers suffer in silence; we, the helpers in
both our well-to-do and poor communities, from the obstetrician to the
marriage counselor to the minister, do not offer the gift of recovery
to women. We also maintain the silence by telling ourselves that this
is not an issue in our practice or congregation. We do not ask about
substance use in a safe and effective manner. We do not make it a
visible issue that we feel comfortable with and able to address.

What's our job? Let's learn how to ask about substance use. When we
see women in our medical or counseling practice, privacy and
confidentiality is essential. Substance use questions should be
included as part of any assessment, as one of many factors that affect
a woman's health and family life. An obstetrician may say, "We ask all
pregnant women about how much they have been drinking or smoking or
using other drugs, because it is a health concern for both you and the
baby." Not looking at the pregnant woman and saying, "You don't drink,
do you?" assures a negative answer.

Let's put out information on women and substance abuse; let's make the
problem visible. Use posters, brochures, articles in the waiting rooms
and bathrooms, sermons, and other educational materials to educate
women on the effects of use and abuse on their bodies and lives. You
may tell a rape victim or a woman grieving the loss of her mother, "I
want to let you know that you are at greater risk for abusing alcohol
and other drugs when you have suffered a trauma such as this."

Finally, let's learn about the many programs available in our
community. North Carolina actually has a very good network of
residential and outpatient programs geared to pregnant women and
mothers. Let's have referring relationships with counselors who can
meet with a woman and help her figure out where she is with this issue.

Women struggling with drugs and alcohol do take the gift of recovery
at some point. For our part, we need to offer that hope throughout the
year.