ADDICTION AND HORMONES

Women Often Have Difficulty With Recovery Because Of The Role Played By
Menstruation

"Throughout history women have been set up to be addicts," stated Donna M.
Corrente last Tuesday during a lecture given at the 16th annual Addiction:
Focus on Women conference held at Kanuga Episcopal Conference Center.
Corrente is the director of the Center for Women's Recovery and manager of
the primary residential services at Hanley-Hazelden Center, West Palm Beach,
Fla.

According to Corrente, historically women were considered the weaker of the
sexes and unable to bear any form of pain. When discomfort of any sort was
experienced, they were immediately given a pill, potion or remedy to ease
the pain. Due to the legal use of opiates and cocaine, in combination with
this attitude, by the end of the 19th century close to two-thirds of addicts
were women.

Trends haven't changed. Results of a 1991 survey of all prescription
medication, revealed that 80 percent of amphetamines (for energy), 60
percent of psychoactive (to take the edge off) and 71 percent of
antidepressants (to feel better), were prescribed to women.

It is easy for women to fall into the addiction cycle due to stressors in
the household, competing in a male-dominated workforce and conforming to
society's view of the "slender" and youthful woman. Because of all the roles
a woman has to play, her failure rate (in one or more areas) is higher and
when failure occurs, she may feel that she is not good enough. To cope with
the failure, she may seek something to make her feel better, often times
turning to drugs or alcohol.

Women's addictions are more hidden throughout society. Often, one doesn't
think she has a problem because she gets up in the morning, takes care of
the kids, goes to work, maintains a steady routine and may feel that she
isn't hurting anyone with her addiction.

It seems that sexuality and drug use go hand-in-hand. Some women use drugs
or alcohol before sexual encounters. One reason is that it intensifies
satisfaction.

Another reason may stem from a traumatic sexual experience that she hasn't
worked through. Therefore she feels that she has to be "high" to emotionally
deal with the sexual situation.

Although addicts come from diverse races, geographic location and culture,
there is one common thread that binds all women addicts: they have
difficulty yielding to treatment.

"The saddest thing I've ever seen are the women who really want to get clean
but relapse time after time. These women go through the program, they work
through the steps, have one, two, three sponsors, go to meetings twice a day
and still relapse," Corrente said.

Corrente, from her personal experience (almost 23 years of sobriety) and in
her work with women addicts at Hanley-Hazelden, realized a connection
between the recovery process, relapses and the menstruation cycle.

She realized that when ovarian hormones surge and the menstruation cycle
begins, depression increases. The highest incidences of this hormonal shift
happens in women between the ages of 22 and 45.

Sometimes menstruation ceases in addicts. After being off the drugs for a
length of time, menstruation begins and depression is inevitable. The
changing levels of hormones may bring up old memories, accompanied by strong
emotions such as anger, shame or guilt.

Peri-menopausal women may also have major emotional instabilities due to the
hormonal shifts in the body. This is often mistakenly treated for clinical
depression.

These symptoms, hot flashes, weight gain, heart palpations, headaches, mood
swings and depression, can last as long as seven to 10 years, and are hard
enough on sober women.

When you add in the recovery factor, it makes it harder to deal with and
relapse occurs.

Searching for a tool to help with the recovery process, Corrente challenged
her treatment team to develop a questionnaire that gives background about
the menstruation cycle. The questionnaire covers the history (physical,
mental, emotional and education) to help the counselor determine if problems
stem from the cycle itself.

The questionnaire is a means to truly and holistically assess women in early
recovery. It validates experiences, provides a format for assessing trauma
or abuse, provides a link to assessing pain management and a connection to
the first intimate or sexual encounter and the emotions that are associated
with it.

At Hanley-Hazelden, clients are asked to keep a daily journal of cycle,
flow, mood swings and triggers.

This helps clinicians and clients work together to understand how the
personal hormonal shift affects individual recovery.

Once the problems are identified, an on-going relapse prevention care plan
incorporating individual hormonal shifts, can be developed and followed to
obtain recovery goals.

"This program is in the preliminary stages and even though there is no
actual steps in this program, like the 12-step program, the team at Hazelden
has started with the basics and will continue to expand on them as they
continue to study and work with clients. I hope to be able to bring a
step-by-step program back next year," Corrente explained.

For more information, call Hanley-Hazelden at (800) 444-7008 or visit
www.hazelden.org on the Web.