Video: Values and Addiction

This video encourages us to think about our personal values while reflecting on our beliefs vs. the facts regarding women and substance use.

About this video

Production Date: October 16, 2013
Length: 59 minutes
Presenter: Kirsty Prasad

Kirsty has worked with Alberta Health Services (AHS) Enhanced Services for Women since 2002, where she works with women who use substances. In recent years Kirsty has been training other service providers in the strategies and techniques that she and her AHS colleagues have developed. Prior to coming to AHS, Kirsty worked for Streetworks and the Mental Health Unit in the inner city. Kirsty has a strong knowledge and passion for working with marginalized populations with substance use concerns.

Outcomes

This video will help you to understand:

  • our own beliefs about women who use substances
  • myths and facts – information to assist our practice
  • the topic of values, gender and addiction

Content

  1. Myths and facts – true or false (7:38)
  2. Values and attitudes (31:06)
  3. What’s unique about women’s substance use? (41:25)
  4. A comprehensive integrated approach (48:45)
  5. Why is it hard for us to talk about substance use? (52:10)

Myths and facts – true or false

  • alcohol has the same effect on women as men – false
  • women are prescribed mood-altering drugs more often than men – true
  • women who abuse substances often have history of physical or sexual abuse – true
  • women’s dependence on alcohol often develops earlier in life than for men – false
  • the health consequences of heavy drinking are similar for men and for women – false
  • men and women cite similar reasons for seeking treatment – false
  • cocaine is the recreational drug that, when a women takes it during pregnancy, can cause the most harm to her developing fetus – false (alcohol is most damaging)
  • FASD is a preventable disability – technically true, but addiction is extremely complicated
  • women are more likely to have a dual diagnosis than men – true
  • more female alcoholics will attempt suicide; more men will complete – generally true, but with addiction/substance use, women are more likely to complete

Values and attitudes

  • women in this population are good at reading people
  • guilt and shame created by a service provider can undermine a woman’s recovery
  • values and attitudes affect our practices
  • it is very important to be aware of our own values and attitudes

Questions to ask yourself:

  • “Can I act in support of a woman even when she is putting her baby at risk?”
    • to support the baby, you have to support the mother
  • “Can I work with a woman who” ...
    • abuses her children?
    • stays in a violent relationship?
    • earns a living through prostitution?
    • drinks or uses during her pregnancy?
    • is angry and violent?

What’s unique about women’s substance use?

Health factors:

  • many fear going to the doctor and have had inadequate health care
  • women are more likely to be prescribed medication for emotional issues
  • women’s bodies have more fat and contain less water than men’s; fat-soluble medications stay in a woman’s body longer
  • women are generally smaller than men and metabolize alcohol at slower rate
  • women feel effects of alcohol sooner, their bodies take longer to eliminate it, and they tend to develop problems and more severe symptoms within shorter time period than men
  • men have an enzyme to help break down alcohol that women do not: alcohol goes to women’s organs much more quickly than to men’s
  • menstrual cycle becomes irregular with substance use
  • a woman can become pregnant and not notice missed cycles

Guilt, stigma and shame:

  • number one barrier to treatment
  • women’s substance use is viewed more negatively than men’s due to societal double standards for men and women
  • there are cultural expectations that women should be more responsible given their multiple caregiver roles
  • this contributes to women’s feelings of guilt and shame as they continue to use
  • society stigmatizes people who misuse alcohol and drugs
  • stigma is magnified for women
  • women who misuse substances can be seen as: morally deficient, bad mothers, associated with prostitution

Experience of violence:

  • women who misuse alcohol and other drugs are more likely to report history of physical or sexual abuse and overall victimization
  • woman who has experienced violence may have resulting brain damage
  • women who abuse substances are more likely than men to have partners who are also dependent and often not supportive of their treatment efforts
  • these women are more often subjected to violence by their partners than are other women
  • co-occurring mental health problems
  • holistic approach is needed to address all issues
  • women who misuse substances are at high risk for suicide ideation and completion
  • eating disorders (particularly bulimia) frequently occur with substance misuse

Woman as mother:

  • society has certain expectations of women as mothers
  • lack of child care, fear of losing custody and unwillingness to leave children with others are primary causes of delay in seeking help for problems
  • having children and wanting a better life for them also serves as key motivator for women to seek help
  • lack of reliable and low cost child care is barrier to seeking treatment
  • during pregnancy the focus of interventions tends to be on a healthy fetus rather than on the health of the mother-child unit

Misinformation and denial among those in a position to help:

  • health, social and women’s service providers are often reluctant to address substance use or identify women in need of treatment
  • women often experience negative or punitive attitudes among those in position to help them
  • physicians may contribute to problems through their tendency to over-prescribe to women
  • they often misdiagnose patients with alcohol/drug problems
  • research has shown that social workers are often not adequately informed and trained to appropriately care for, assist and respond to mothers who use substances
  • there is a lot of misinformation about the effects of alcohol and drugs on an unborn child

A comprehensive integrated approach

1. Theory of addiction

Holistic health model:

  • look at the whole picture
  • not just the presenting problem

Women-centered approach:

  • participatory
  • empowering
  • respectful of diversity
  • safe
  • individualized
  • comprehensive
  • holistic

2. Theory of women’s psychological development

Relational model (from the Stone Center):

  • women’s relationships are integral to who we are, and we see ourselves in relation to others
  • trying to separate a woman from her relationships can be harmful
  • work on improving relationships

3. Theory of trauma

See:

Why is it hard for us to talk about substance use?

  • we need to reflect on and be mindful of our own feelings, fears and beliefs
  • we may need to work hard at managing our emotions so we can work calmly and effectively
  • make it part of the organization’s screening process
  • frame it as “use,” not “abuse” or a “problem”
  • regardless of how much or how little time we have to spend with the woman, our ability to be compassionate and understanding will be the one thing that she remembers
  • this is our bridge to an effective helping relationship in the future
Created:
Modified: 2015-09-09
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