This accelerated impact also increases the risks of liver damage, heart disease, and other severe health issues at lower levels of substance use. Key attitudinal barriers that emerged were low problem recognition, low perceived treatment efficacy, and cultural barriers. Within the subjective norms domain, women in this study reported not going to treatment due to stigma and perceived lack of family support. Logistical barriers (e.g., cost, trouble finding services) were common barriers within the perceived controls domain.
The Link Between the Shame Condition and Public Stigma
Words such as “junkie,” “addict,” “alcoholic” and “tweaker” rarely help people feel uplifted to seek help – rather, they push people down further and instill a sense of guilt that only perpetuates negative feelings and emotions. This might seem to imply that self-stigmatization leads to treatment-seeking and even recovery (although we are not saying that Flanagan makes this bolder claim). To put this in Flanagan’s terms, the removal of public stigma would dissolve the pressure to pass society’s survey, but the pressure to pass one’s own survey, to live up to one’s own standards, might well remain. The risk of being honest may be lower when women are using legal or socially-accepted substances or when a woman has a trusting relationship with her medical provider.
Resilience Resources
Many publications indicated that stigma toward women suffering from drug addiction is the most frequently reported problem. Social beliefs expect women to be home caretakers, raise children, and be more family-oriented than men. Women who identify an addiction problem in themselves and consider seeking treatment often do not seek treatment precisely for fear of being stigmatized or, if they are mothers, for fear of being restricted or losing parental rights 44,45. It also happens that even the closest family members are opposed to them when seeking help, not believing in their powerlessness to undertake sustained abstinence on their own 45. Some women feel guilty about their loved ones and try to reduce their guilt by ignoring and hiding their substance use and rationalizing their behavior by claiming that the pleasurable effects of drugs are more attractive and more important than a drug-free life 46. Although data on the differences in smoking and marijuana use indicate higher prevalence among men, women are estimated to have more difficulty quitting, while marijuana use can cause severe premenstrual syndrome or premenstrual dysphoric disorder.
Less common were other substances including cocaine, methamphetamine, heroin and hallucinogens. These substances were far more likely to appear in women’s lifetime histories of substance use than to be mentioned in the three months prior to the most recent pregnancy. For example, 14 (46.7%) women reported lifetime use of hallucinogens, but only two (6.7%) women reported using hallucinogens three months prior to discovering their recent pregnancies.
Women seeking addiction treatment face significant barriers in accessing resources tailored to their needs. According to a study by the National Institute on Drug Abuse (NIDA), women are less likely to enter treatment programs compared to men, and when they do, they often encounter fewer gender-responsive programs. These programs are essential for addressing issues like trauma, childcare, and the specific ways addiction manifests in women. In fact, fewer than 10% of addiction treatment facilities in the U.S. offer programs specifically designed for women, making it difficult for women to find the right support (NIDA, 2020).
In this way, having children or being a parent can be a gender-sensitive barrier to entering treatment (Green, 2006). Evoking perceptions of controllability, personal responsibility, and criminality, people with SUDs are referred to as “dope fiends,” “pot heads” and “addicts”, who “abuse” drugs and have “dirty” urine tests (Broyles et al., 2014; Wakeman, 2013). People referred to as “substance abusers” are seen as more deserving of blame and punishment than people referred to as “having a SUD” by clinicians and members of why do women face more stigma for substance addiction the general public (Kelly et al., 2015).
The Impact of Stigma on Women Seeking Treatment
- To our knowledge, this is the first systematic review of the intersection ofgender- and drug use-related stigma.
- We also found that Latinas were more likely than White and Black women to not perceive specialty treatment to be effective.
- For example, the iconic “this is your brain on drugs” public service announcements imply that people’s brains are fried, cracked, or destroyed by substance use.
- The current study aimed to identify the barriers and needs of this audience, both when seeking help and during treatment.
- Goffman (1963) explains how the stigma of group identity is related to the stigma of race, nation, and religion, affecting a whole group rather than an individual.
This kind of informal social control focuses on the formation of bonds and relationships outside of drug using community that helps recovering individuals maintain a drug-free lifestyle within mainstream society. The findings support other research showing that new relationships in social environments are important factors to consider when trying to help former drug users maintain drug-free lives (Boeri, Gibson & Boshears, 2014; Moos, 2007; Zschau et al. 2015). Women who use drugs are stigmatized for their drug use behavior, which marginalizes them from mainstream society. Research shows that these strategies do not work well for discouraging drug use; whereas attempts to reduce the stigma related to drug use can encourage users to stop use.
Associated Data
Women who had detoxed, with or without medical assistance, reported that the process did nothing to address the triggers for their substance use. They spent up to a week in detox but then returned to the same environment and same social setting they had been in when they were using. Vicki was pregnant at the time of her interview and was yet to see if her strategy would be successful. Kim had stopped smoking marijuana before the birth of her daughter and was only using alcohol (albeit heavily), so she did not have any contact with CPS.
Some treatment programs may heighten internalized stigma among people in recovery from SUDs by encouraging them to focus on their character defects, retrospect on ways that they have wronged others, and acknowledge their own powerlessness (Corrigan et al., 2017). Yet, shame, the emotional core of internalized stigma, undermines recovery efforts (Hill & Leeming, 2014). In contrast, treatment approaches are needed that restore self-esteem, self-worth, and hope.
In recent years, researchers and healthcare providers have paid closer attention to how gender-based factors (biological, psychological, and social) impact the trajectory of addiction. The majority of the interpersonal perspective articles (15; 55%) werefrom North America, with fewer from Europe (4; 15%), Australia (3; 11%), Asia (3;11%), and Africa (1; 4%). One article (4%) did not specify the study location.Nearly all of the interpersonal perspective articles reported participant gender(26; 96%), though only 1 of these 27 articles (4%) moved past a binary measurementof gender to include persons who are transgender.
According to these authors, social identity is referred to as a multivalent process where individuals identify themselves in terms of being similar to some people and different to others. Individuals construct boundaries and identities that separate them from others who they view as having lower status. Although society assigns negative labels for drug users, their identity is also influenced by other drug using individuals who define distinctions between drug users.
- This is the case for both men and women, but women with a problematic use of drugs or alcohol seem also to experience that family and friends support this strategy of concealment to protect the woman from outsiders (Finkelstein, 1994).
- This stigmatization is rooted in cultural attitudes that view women’s addiction as a moral failing rather than a health issue, making it more difficult for women to access appropriate care (SAMHSA, 2019).
- While females who smoke are seen as “trash” and “sluts,” males who smoke are seen as “more masculine” and “attractive” (Nichter, 2006, 112).
- Showed that women even tend to develop addiction more rapidly than do men, accumulating the same number of symptoms as their male counterparts over a shorter period of time (Piazza et al., 1989).
- These experiences of social exclusion, victimisation, and systemic bias are not merely background challenges; they are central drivers of the elevated rates of mental health conditions and substance use seen within the LGBTQIA+ population (Moagi et al., 2021).
Meaningful solutions require more than surface-level interventions; they call for comprehensive medical, psychological, and social support systems that are inclusive and affirming of LGBTQ+ identities. The higher rates of substance use in this community are not just about addiction but reflect the weight of discrimination, isolation, and chronic stress. People do not turn to substances out of weakness; they do so to cope with a world that fails to create a space for them. Historically, queer identities have been pathologised, framed as disorders or deviant behaviours, and in many parts of the world, they remain criminalised. Even in regions where legal recognition and protections exist, LGBTQIA+ individuals continue to face marginalisation, discrimination, and overt hostility.
Morten Hesse, PhD, is Assistant Professor at the Centre for Alcohol and Drug Research, University of Aarhus, Denmark. Theorists and researchers have constructed a definition of stigma, articulated key concepts related to stigma, and described processes linking stigma with health inequities across the lifespan. Within this section, these definitions, key concepts, and processes are described in the context of SUDs, with a focus on the current opioid epidemic. A conceptual framework, which builds off of previous theory and research on stigma and health inequities (Earnshaw et al., 2013; Earnshaw & Chaudoir, 2009; Hatzenbuehler et al., 2013; Quinn & Earnshaw, 2011; Smith & Earnshaw, 2017), is included to guide this discussion (Figure 1). Breaking free of that trap is absolutely essential if you are struggling with a substance use disorder. Prevention programs that address distinct risk factors for men and women are more likely to avert substance misuse before it escalates.