TIP 51: Substance Abuse Treatment for Women
Gender makes a difference when looking at the physical effects of substance use and specific issues related to substance use disorders.
SAMHSA’s new Treatment Improvement Protocol 51 (TIP 51), Substance Abuse Treatment: Addressing the Specific Needs of Women, reviews gender-specific research and best practices. The TIP’s primary goal is to assist substance abuse treatment providers
in offering effective, up-to-date treatment to women with substance use disorders.
This TIP provides clinical and administrative information to assist counselors, clinical supervisors, program administrators, and others on how to best respond to the specific treatment needs of female clients. It also provides researchers and clinicians with a guide to sources of information and topics for further inquiry.
TIP 51 proposes that substance abuse treatment for women be approached from a perspective that encompasses the contexts of women’s lives: a woman’s social and economic environment; her relationships with family, extended family, and support systems; and the impact of gender and culture.
Women often report that stress, negative affect, and relationships precipitate initial substance use.
Relationships, relationship status, and the effects of a partner’s substance abuse significantly influence women. In addition, women dependent on substances are more likely to have partners with substance use disorders.
Although substance use is more prevalent among men than women, women are as likely as men to develop substance use disorders after initiation.
For women, general alcohol and drug screening that determines current or at-risk status for substance use during pregnancy is essential. Considering women’s likely involvement with health care providers, screening for substance use and abuse should be standard practice for women of any age.
As with the risk for substance abuse and its consequences, optimal processes for treatment and recovery differ by gender, race, ethnicity, sexual orientation, and other factors. Women are as likely as men to stay in treatment once it is initiated. Factors that encourage women to stay in treatment include supportive therapy, a collaborative therapeutic alliance, onsite childcare and children’s services, and other integrated and comprehensive treatment services.
Diagnoses of post-traumatic stress and other anxiety disorders, postpartum depression and other mood disorders, and eating disorders are more prevalent among women with substance use and co-occurring mental disorders than among men in treatment for substance use disorders.
Women have comparable abstinence rates with men and are as likely to complete treatment. Even so, women are more likely to have positive treatment outcomes in terms of less incarceration, higher rates of employment, and more established recovery-oriented social support systems. TIP 51 describes some relapse risks unique to women. Those risks include severe untreated childhood trauma, low self-worth connected to intimate relationships, and greater difficulty in severing ties with other people who use drugs and alcohol.
Gender-responsive treatment involves a safe atmosphere, where staff holds a hopeful and positive attitude toward women and shows investment in learning about women’s experiences, treatment needs, and appropriate interventions.
To order print copies of TIP 51, call 1-877-SAMHSA-7 (1-877-726-4727). Request publication number SMA09-4426. Download a full-text PDF version (382 pages) at http://kap.samhsa.gov/products/manuals/tips/pdf/TIP51.pdf.