Gender roles influence how people perceive themselves and how they interact with others.1,2 Sex and gender can also interact with each other to create even more complex differences among people. While the NIH is working to strengthen research on sex/gender differences across domains of health, current evidence is limited; for the purpose of this report, male and female subjects identify as such across both sex and gender. Given their expertise in mental and behavioral health, psychologists are uniquely positioned to play a frontline role in addressing stigma within the current opioid epidemic as well as within co-occurring and future substance use crises. They can leverage what they’ve learned within other contexts, including theoretical blueprints and evidence-based stigma-reduction tools, to make swift and effective progress toward understanding and addressing stigma. To set this stage for this agenda, key concepts are introduced related to stigma and SUDs, and evidence is reviewed regarding associations between stigma and substance use-related outcomes.
V. A. Earnshaw
The same is true, by the way, in African countries, including Tanzania, where fear of social consequences, violence against women, and low access to prevention and treatment services seem to be more of a challenge than a need [38], especially since research and prevention initiatives seem to be rare in that country [41]. In addition, drug abuse and HIV risks are a “pressing problem” that should not be ignored [42]. Another African country where helping women who abuse drugs seems to be a challenge for policymakers is Kenya.
- This qualitative analysis of the life histories of 20 women who used illegal drugs focuses on their social roles, the influences of initiating and using drugs, and the process of recovering from a stigmatized social identity.
- So I was diagnosed [with borderline personality disorder] and I’m waiting – I’m on SSI and pending right now.
- Moderating factors shape the ways in which stigma is manifested as well as the processes whereby stigma impacts substance use outcomes.
- In addition, for women living in poorer neighborhoods, an indicated challenge is the so-called “domino effect,” i.e., despite the favorable completion of therapy, recurring difficulties in returning to fulfilling social roles related to past experiences [23].
Social Control and Social Services
To identify publications describing the barriers and needs of women suffering from drug addiction, we searched the PubMed database to find publications that met the adopted research objective. We set the data search period to the last ten years to examine the timeliness of the issue under study. The selected publications dealt medications and drugs that cause hair loss with the difficulties and challenges faced by women with addiction problems. Barriers to accessing treatment for this group, the needs, and the challenges of helping women suffering from addiction were identified. Results showed that the barriers are mainly stigma but also deficits in the therapeutic offerings for this group.
Stigma and substance use disorders: A clinical, research, and advocacy agenda
They explain how community-based residential treatment programs are key elements in increasing the likelihood to avoid relapse. However, women often faced difficulties accessing these programs, ultimately leading them back to drugs alcohol use disorder diagnosis and treatment or jail. Many women are very limited in resources even though society claims that there are a multitude of services available to them. Some of these women have no means of obtaining the resources in their current social situations.
Neurobiological Basis of Sex Differences
Theoretical sampling, used in grounded theory, involved the collection of data based on theory that emerged from the data while it was collected, designed “to maximize opportunities to discover variations among concepts and to densify categories in terms of their properties and dimensions” (Strauss & Corbin, 1998, p. 201). Theoretical sampling was used to insure a diversity of participant experiences, as well as to focus on recruitment of specific kinds of users that emerged from ongoing analysis of the data. Gendered perceptions of drug users exist in both mainstream and drug-using worlds. 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. Women as a gendered group face greater stigmatization than men for using drugs since they go against the character traits of perceived female identity. The stigma of drug use is also greater for mothers since they are expected to be the caregivers, raise children, and be more family oriented than fathers.
Women are usually aware of these double standards and try to present a good image to society by hiding their drug use if they are mothers (Goffman, 1959). Many women who use substances may have mental health problems (depression, post-traumatic stress disorder, eating disorders, or paroxysmal anxiety); according to statistics, women addicts often contemplate suicide or are victims of suicidal actions [2,64]. Mental illnesses, phobias, or depression can promote the abuse of mood-altering psychoactive drugs; there is a high degree of co-occurrence of drug abuse with psychiatric and mood disorders [44]. Evidence suggests that adolescent psychoactive substance use can cause psychotic symptoms and mental disorders in later years [65,66,67].
One woman with mental health problems talked about being unable to be housed in a shelter and being endlessly shuffled around the city, referred from one place to another because of her mental health problems. Although these women are drug users, they expressed care and love for their children. Lisa, a 30-year-old mother, revealed that the care she felt for her unborn child while she was pregnant motivated her to stop drug use during pregnancy. Society has set norms of behavior for individuals, which translates into the standards of being “normal.” Some of the women, especially the poorer women, did not feel as if they “fit in” with mainstream lifestyles and felt stigmatized. Using drugs, they were able to find an identity for themselves and, ironically, feel part of society, as discussed in the before stage. However, the difficulty they now faced was that as a drug user, they would still be stigmatized.
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). Implement policies and protocols that support families, facilitate parent–child attachment, and enhance the capacity of parents to care for their children. Emphasize and advocate for solutions to the negative effects of substance use, such as overdose prevention through harm reduction programming. In the case of nicotine addiction, the response is clearly worse for women [102], except for varenicline, which some studies showed some more benefits of this treatment in women [103, 104].
Targeted sampling involved ethnographic fieldwork in communities where drug use was prevalent and establishing relationships with community members to reach potential participants. Fliers were used to publicize a “methamphetamine study” with a study number for interested individuals to call for more information. Once potential participants for the study were located or made contact through the study phone number, Boeri discussed the study time commitment, how the interview would be conducted, anonymity and confidentiality issues, and reimbursement for their time.
The aim of this analysis, then, was to identify themes that describeand explain the intersection of gender and substance use stigma. Using screening tools can increase systematic information gathering while utilizing more consistent, deliberate language, potentially reducing the impact of stigma on screening and improving the ability to obtain health information from patients. Six screening instruments have been validated to screen for substance use in pregnancy. To conduct this narrative review, PubMed and Google Scholar databases were searched using the terms AND [ OR OR ] along with , , , or between 1980 and August 2021. Inclusion criteria were articles in English and those focused on the forms and effects of stigma toward pregnant people who use any substance.
This typically included social activities or new networks outside drug using environments. 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). In addition, studies among Vietnamese attention required! cloudflare women have identified low access to HIV testing and a lack of knowledge about sexually transmitted diseases (STDs) and viral hepatitis [30], and among Kenyan women, low accessibility to sexual health services [21], as well as stigmatization of HIV-positive women by other drug users [19]. Participants were recruited through Craigslist ads, which may have excluded women of with less resources and access to the Internet, which may have affected the barriers identified here. Our sample of women within each racial/ethnic group may not have been large enough to reach saturation of themes.
