Sex-specific treatment is changing the fight against female addiction.
When Tanya Barie, 33, relapsed after almost a year of sobriety, she says it was a wake-up call.
“I’m tired of living a crazy life,” she says. “I’m trying to do things differently with this relapse, because I’m just tired of being tired.”
It wasn’t Barie’s first slip since she quit Percocet in 2013, but it was the first since she became a mother several months ago.
“I want to be different,” she says, bouncing her infant son on her lap. “I want to be the best mother I can be for him.”
That brought her to a church basement in suburban Philadelphia that hosts one of the hundreds of 12-step meetings held each week across the region. In most ways, it feels just like any other recovery group. There’s coffee, people smoking in the parking lot and a set script that almost everyone in the room knows by heart.
But one thing that makes this meeting different: It’s all women. Barie, who says she’s always felt anxious speaking in front of groups, says that makes a big difference.
“My first time here was last week, and I immediately was like, I’m making this my home group,” she says. “I didn’t feel embarrassed, and I didn’t feel judged.”
In the past four years, Barie says she didn’t feel the same comfort level when she attended mixed-gender meetings.
“There are certain things that I won’t bring up in front of a male-dominated room,” she says. “Because they don’t know what else a woman goes through.”
What women go through has become a growing focus in addiction treatment. While more men overall abuse drugs and alcohol, women’s heroin use has doubled in recent years, and their overdose deaths from prescription painkillers have increased by 400 percent, compared with 265 percent among men.
In terms of the overall number of people, the gender gap may be closing, but for women, the impact of substance abuse isn’t the same. Recent research shows that biological differences between men and women can have a major impact on how addiction — and ultimately treatment — play out.
“The issue with women is that women escalate more rapidly to more use, and have more problems related to use,” says Teri Franklin, a neuroscientist at the University of Pennsylvania’s Center for Addiction Studies. “And lately some of the newer literature is showing that [women] have more problems with withdrawal.”
Franklin has studied substance abuse in women for the past 18 years. She says it’s only recently that science has started understanding male-female differences. That’s because for a long time, she says, researchers avoided female test subjects.
There was a practical reason.
“These darn hormones keep getting in the way,” she says. “It was complicated, and that was the reason for a lot of different researchers to go another direction and stick with males.”
It may be those very hormones at the heart of what makes female addiction different. Franklin and other researchers say that women’s tendency to fall faster and harder into addiction may be linked to estradiol, a kind of estrogen that spikes during ovulation. During that time of the month, drugs can cause the brain’s pleasure center to light up even more than usual, causing higher highs, and stronger cravings.
“Are clinicians using this information to tailor treatment strategies? Most likely not,” Franklin says.
Adam Brooks, who leads addiction research at the Public Health Management Corporation, says for the most part, mainstream addiction treatment caters to men.
“The help for addiction was, for the most part, a self-help movement that was largely populated by men,” he says.
When Alcoholics Anonymous started in the 1930s, women were only welcomed as the wives of addicts. In the decades after, 12-step groups opened up to women, and addiction help expanded into professional treatment centers. But even there, Brooks says, the focus on men’s experiences continued to dominate.
“Women felt like fish out of water,” he says. “Like that their needs weren’t being talked about, or that treatment and problems of addiction were rendered in kind of a sexist way.”
Another option has emerged recently: gender-specific treatment. And studies show that approach works well for women.
The Kirkbride Center, a drug and alcohol rehab in West Philadelphia, offers gender-specific therapy.Kirkbride treats both men and women, but houses them in single-sex wings to avoid messy rehab romances.
Director of Long-Term Care Leslie Horowitz says separate quarters provided the basis for Kirkbride’s recent foray into gender-specific treatment.
“We decided that we wanted to specialize in women’s recovery, and specifically women’s trauma,” Horowitz says.
While a lot of the biological research findings about female addiction haven’t yet made their way into mainstream treatment, there has been a growing focus on gender, which the National Institute on Drug Abuse defines as “culturally defined roles for men and women.” One major factor related to gender is trauma.
An estimated 80 percent of women in treatment have experienced sexual or physical assault, which Horowitz says is a huge risk factor for addiction.
“Why do people use drugs? Because there’s a function with it,” she says. “It reduces trauma symptoms. It numbs you from everything that has happened.”
Horowitz says the program aims to help women process that trauma and develop healthy coping skills through a curriculum based around small-group work. Together, women talk about their experiences, what gender means and how that has influenced their personal histories, ranging from sexual violence to the trials of motherhood.
Which brings us back to Tanya Barie, the young mom who just started at an all-women’s recovery group. She says her most recent relapse was triggered by the kind of gender-specific pressures a lot of women face.
“I’m not a single parent but I feel like a single parent and I got extremely overwhelmed with life in general,” she says. “Like, I go to work full time, but I don’t get to come home and sleep. I have to take care of the baby I have to clean the house I have to cook dinner. I have to do everything.”
Barie says she didn’t always feel comfortable sharing those pressures in mixed-gender meetings. In the all-woman setting, she says lots of women understand what she’s going through, because they’re going through the same thing.
“I could’ve gone to any meeting last Sunday, but I chose this one because I know that I need more women in my life that are going to be there and support me, and help me through the tough times,” she says.
So far, it already seems to be helping.
Barie says last Sunday, she texted the other women in the group to thank them for a good meeting, and conversation — and support — took off from there.
“We’ve all been talking all week long,” she says, sounding almost giddy. “I’ve never been a part of something like that before.”