Women aren't like men: Differences need to be addressed in treatment for drug, alcohol addiction
By Scarlet Sims

They don't look like addicts -- not with clean faces and nice jeans. But here they were, eight women trying to stop using drugs and alcohol, and learning how to live.
"I see that you're still lying to yourself," Rita Lees, a women's group counselor at Freedom House, told a recovering, outpatient cocaine addict.

The woman, "Jane," said her triggers were boredom and isolation, but Lees pointed out she set herself up to be home alone, hang out with "druggies" and let her now former husband confiscate her car.

Time and time again, she'd let herself be walked on by men around her.

"I was letting this yahoo live with me that was not good for me," Jane admitted.

Lees is a certified counselor who has worked at Freedom House since 2003, specializing in residential treatment for women. She is a team player in treating addicts, one of six counselors who treat men and women, and is working on a degree in criminal justice.

"It's very rewarding work -- even for the ones that relapse -- you just have a special place in your heart for them," she said. "I have found my purpose; I found where I'm comfortable."

She knows all about addiction. She and her husband married as drug addicts and after remaining addicted for about 18 years they became clean and sober together -- four years and seven months ago.

"It's been something that's been teamwork for us," Lees said.

Her insight helps her identify with the eight women's groups she leads each week. Lees can see through the addicts' lies and writes down what she sees for each woman during sessions, giving her assessments to the women, even if it might upset them.
"They (women addicts) come in here (Lees' office) and yell and shout all they want, but I don't react," Lees said, noting she wasn't against emotion, but she was teaching the women to respond to stress without over-reacting to it. "We teach them community skills without using anger in a destructive way."

Jane is dealing with more than the addiction. She's dealing with rape and the death of loved ones. About 70 percent of women addicted to drugs or alcohol have experienced domestic abuse, according to the National Institute on Drug Abuse.

"They (men) are smooth, buddy," said an addict who had just completed 22 days as a residential patient. "Sweetest, nicest man you ever seen until you get with them."

Lees said many women addicts suffered incest, rape, beatings, starvation and emotional abuse before and during drug use. She said it took about two weeks for the women to start talking about what had happened to them and what they had done to others.

"A lot of women who come into rehab have always depended on others, men or family," said a heavy-set woman, noting women addicts tend to be drawn to men who abuse them. She is the largest woman in the group and, surprisingly, is a recovering methamphetamine addict.

A lot about the eight women is surprising. They range from housewives in their late 40s to former stock brokers with college degrees to 20-something, pregnant women out on their own.

Freedom House has a residential and outpatient, or independent living, program for women, but no long-term treatment programs for women with children. The program lasts 45 days, just long enough to dry out and give recovering addicts the basics to help themselves, Lees said.

"I get them learning to use things to relax," Lees said, adding that meditation was important. "If you can get them to sit for one hour -- if they can do something like that for one hour, that's an accomplishment for an alcoholic or drug addict, because they cannot sit still."

Currently, Freedom House has 25 beds available for men and women, 14 for men and seven for women. The waiting list to get into treatment can be anywhere from a couple of days to weeks.

Lees would like to change that.

"We need more funding and more women to get involved in specializing with women," she said. "It's so important for them (women) to get back out there and be productive women."

For the last several years, the Arkansas River Valley Area Council, Inc., which oversees Freedom House, has been studying plans to create a new women's center to alleviate the growing waiting list. Last month, the Planning and Evaluation Committee looked at proposals for raising funds for a center and possible areas to build.

Eventually, Lees would like to see a specialized center that can treat women with children and can teach better life skills in Russellville. "In Arkansas it's very hard," she said, noting many people seemed stuck back in the 1950s. "Women are high risk because of staying home all the time and taking care of the kids all the time. It's strictly a man's world out there."

Part of the high risk comes from women not talking to each other. Lees pointed out domestic abuse only became a public topic during the last 20 years. Even today, some women choose not to discuss women's issues, such as menstruation and sex, with their daughters.

According to NIDA research, women are more likely than men to have a parental history of alcohol and drug abuse. Many women addicts grew up watching their mothers drink and use drugs, Lees said.

"Their mothers had the same kind of life," she said.

Women addicts need to further their education, learn parenting skills and build their self-esteem back up, Lees said.

During the six-week criteria for the program, the women's group discusses co-dependency, medical aspects to the disease of addiction, setting up a mental evaluation or getting a General Education Degree (GED), how to set up boundaries and how to have fun without drinking or drugging.

"I see that they (women) have been deprived of so many things, and they don't realize they can reach out and get these things for themselves," Lees said. "It's okay to be assertive."

Women also need more support than men and tend to make a stronger connection with their treatment counselor.

"Women are more attached to a particular counselor," Lees said, adding that women were also more manipulative than men and tended to trick even themselves.

Traditional drug treatment may be inadequate for most women, because those programs tend to fail to provide such things as job counseling, legal assistance, literacy training and educational opportunities, couples counseling, assertiveness training and family planning services, according to the NIDA. Women are not men and need different treatment.

For example, alcoholic women seem to be at a high risk for relapse because of marriage, while marriage protects alcoholic men from relapse, according to a 2006 research review appearing in Clinical Psychology Review.

Women particularly need the support of the community and those closest to them, even after completing a drug treatment program, to successfully rejoin society.

Right now, drug treatment for women is about 50 percent effective, which means four of Lees girls may remain addicts and continue to cycle downward possibly to death. Lees said she never knew who would make it and who wouldn't.

The women in Lees group said residential treatment, in particular, helped them, teaching rules, getting them accustom to routine bathing and teaching structure. Maintaining a routine helped them cope and taught life skills.

"You stop developing when you start drugs," Jane said. "So, even though I'm 46, mentally I'm 16."