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Dr. Emilie Attwell emphasizes the critical need for specialized services addressing the unique challenges women face with substance abuse. Women progress to substance dependence more rapidly than men and often experience more severe mental health issues. Substantial differences in biological responses to drugs during various hormonal phases further complicate treatment. Access to tailored mental health services and supportive programs is vital for improving outcomes. This approach addresses the entire scope of women's needs, including psychological distress, historical trauma, and familial responsibilities.
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Why Specialized Women’s Services are Needed Dr. Emilie Attwell Becker Medical Director Behavioral Health emilie.becker@dshs.state.tx.us
Do you have to go to medical school to know that women are different than men?
Substance Abuse ■ Biology • Compared to men, women • Progress to substance dependence more rapidly than men • Negative effects more “telescoped” • More depression, phobias, panic d/o, eating d/o
Substance Abuse ■ Biology • Compared to men, women • Higher rates “feeling good” after cocaine • Lower plasma levels • Higher rates “feeling good” after nicotine • Lower plasma levels • Higher HR/ BP
Substance Abuse ■ Biology • Follicular v. luteal phases • D- amphetamine had more positive subjective effects in follicular phase, compared to luteal • Cocaine effects more pronounced in follicular, compared to luteal • Does progesterone mask positive subjective effects of some drugs?
Substance Abuse ■ Biology Unknown response to antabuse, acamprosate, naltrexone, methadone, buprenorphine during cycle BUT…. • Known disruption of antidepressants, other meds • Opioids suppress gonadotropin secretion, which blocks ovulation • Consider long acting birth control not only for obvious reasons, but mood regulation/ medication metabolism
Substance Abuse ■ Psychology • Compared to men, women more likely to have • Greater psychological distress/ more mental health problems • More interpersonal conflicts • Greater exposure to childhood trauma • More problems with lack employment/ vocational skills
Substance Abuse ■ PsychologyTreatment implications • Compared to men, women more likely to have • Greater psychological distress/ more mental health problems Must have access to MH tx • More interpersonal conflicts • Greater exposure to childhood trauma • More problems with lack employment/ vocational skills Access to supportive employment/ teaching vocation/ social services
Alcohol ■Treatment Predictions Compared to men, women more likely to • Participate in self help groups, which predicts abstinence • Older women fare better than men (and fare better than younger women) • Spend longer time during the initial treatment phase
Substance Abuse ■Women only programs In women only programs, greater problem severity • Alcohol • Other drug • Family • Medical • Psychiatric
Substance Abuse ■Women only programs In women only programs, less drop outs of • Lesbians • Women with h/o childhood sexual assault • Women with dependent children
Maternal Depression ■Effects on Young Children • childhood depression (x13) • suicidal thoughts • antisocial, aggressive, socially withdrawn • Overarousal/ overinvolvement/ guilt • Language/ cognition • Mothers • Yell/ hit their children >reasoning/ loss of privileges as discipline • (low income) less nurturing, discussed personal problems more frequently
Further info www.erowid.com
