Advertisement

The Emergence of Problem-Drinking Women as a Special Population in Need of Treatment

Chapter
Part of the Recent Developments in Alcoholism book series (RDIA, volume 12)

Abstract

This chapter chronicles the development of advocacy for improvements in alcohol treatment services for women during the 1970s and 1980s, tracing its influence in terms of real change in treatment systems in the United States. We follow the development of a “women’s alcoholism movement” from its inception in the late 1970s through its transition during the late 1980s into a broader movement focused on drug abuse and perinatal addiction. We describe the new governing images of problem-drinking women that advocates presented, their claims about the nature of substance abuse problems in women, and their recommendations for a more “gender-sensitive” treatment system. We also review increased federal involvement in this issue over the course of the 1980s, as pressure mounted on policymakers to respond to the crisis over drug-exposed infants by making treatment services more accessible to women. The chapter concludes by considering these developments from the perspective of national treatment system statistics, finding modest growth in specialized and women-only treatment units, as well as moderate increases in the representation of women in substance abuse treatment caseloads.

Keywords

Alcohol Problem Alcoholic Anonymous Block Grant Alcoholism Treatment Alcohol Drug Abuse 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    National Council on Alcoholism: A Federal Response to a Hidden Epidemic: Alcohol and Other Drug Problems among Women. Washington, DC: National Council on Alcoholism, 1987.Google Scholar
  2. 2.
    Sandmaier M: The Invisible Alcoholics: Women and Alcohol Abuse in America. New York, McGraw-Hill, 1980.Google Scholar
  3. 3.
    United States Senate, Subcommittee on Alcoholism and Narcotics of the Committee on Labor and Public Welfare: Alcohol Abuse among Women: Special Problems and Unmet Needs. Washington, DC, US Government Printing Office, 1976.Google Scholar
  4. 4.
    Ferrence RG: Sex differences in the prevalence of problem drinking, in Kalant OJ (ed): Alcoholand Drug Problems in Women: Research Advances in Alcohol and Drug Problems. New York, Plenum Press, 1980, vol 5, pp 125–201.Google Scholar
  5. 5.
    Roman P: Women and Alcohol Use: A Review of the Research Literature. Washington, DC, US Department of Health and Human Services, 1988.Google Scholar
  6. 6.
    Fillmore KM: “When angels fall”: Women’s drinking as cultural preoccupation and as reality, in Wilsnack CC, Beckman LJ (eds): AlcoholProblemsin Women. New York, Guildford, 1984, pp 7–36.Google Scholar
  7. 7.
    Wiener C: The Politics of Alcoholism: Building an Arena Around a Social Problem. New Brunswick, NJ: Transaction Books, 1981.Google Scholar
  8. 8.
    Lewis J: Congressional rites of passage for the rights of alcoholics. Alcohol Health Res World 12:240–251,1988.PubMedGoogle Scholar
  9. 9.
    Noble AL: Law, Medicine and Women’s Bodies: The Social Control of Pregnant Drug Users. PhD dissertation, Department of Sociology, University of California, Davis, 1993.Google Scholar
  10. 10.
    Institute of Medicine: Broadening the Base of Treatment for Alcohol Problems. Washington, DC, National Academy Press, 1990.Google Scholar
  11. 11.
    Schmidt L, Weisner C: Developments in alcoholism treatment: A ten-year review, in Galanter M (ed), Recent Developments in Alcoholism. New York, Plenum, 1993, vol 11, pp 369–396.Google Scholar
  12. 12.
    United States General Accounting Office: Block Grants: Federal Set-Asides for Substance Abuse and Mental Health Services. Rockville, MD, US General Accounting Office, 1987.Google Scholar
  13. 13.
    OSAP youth and pregnant women grant applications. Alcohol Drug Abuse Week 1:6, April 1989.Google Scholar
  14. 14.
    United States Alcohol, Drug and Mental Health Administration: Assessing Future Research Needs: Mental and Addictive Disorders in Women. Washington, DC, ADAMHA News Supplement, July–August 1991.Google Scholar
  15. 15.
    Gomberg EL: Special populations, in Gomberg EL, Whilte HR, Carpenter JA (eds): Alcohol, Science and Society Revisited. Ann Arbor, University of Michigan Press, 1982, pp 337–354.Google Scholar
  16. 16.
    Lewis J: Washington report. J Stud Alcohol 37:1383–1392, 1976.Google Scholar
  17. 17.
    An illustrated booklet… Alcohol Rep 8:10, May 1980.Google Scholar
  18. 18.
    NCA says women’s set-aside a success, urges extension. Alcohol Rep 15:2–3, April 1987.Google Scholar
  19. 19.
    The first fetal alcohol syndrome awareness week proclaimed. Alcohol Rep 8:7, February 1980.Google Scholar
  20. 20.
    Field groups backing Kohl bill for drug/alcohol programs for women and children. Alcohol Drug Abuse Week 2:2–3, May 1990.Google Scholar
  21. 21.
    A national women’s congress on alcohol and drug problems was formed. Alcohol Rep 8:9, May 1980.Google Scholar
  22. 22.
    NAWAODD focuses on women’s issues. Alcohol Rep 8:8, May 1980.Google Scholar
  23. 23.
    Drive begins to allow medicaid to pay for pregnant addicts’ residential treatment. Alcohol Drug Abuse Week 9:2, 2–3, August 1990.Google Scholar
  24. 24.
    The Second Annual Women in Crisis Conference, with “Women and Alcohol” as one of the four major themes. Alcohol Rep 8:8, April 1980.Google Scholar
  25. 25.
    The emerging female alcoholic. Alcohol Rep 9:7, February 1981.Google Scholar
  26. 26.
    The woman who has a problem with alcohol. Alcohol Rep 8:9, November 1980.Google Scholar
  27. 27.
    Kaskutas L: Women for sobriety: A qualitative analysis. Contemp Drug Problems vol 16, pp 177–199, 1989.Google Scholar
  28. 28.
    Beckman LJ: Alcoholics anonymous and gender issues, in McCrady BS, Miller WR (eds): Research on Alcoholics Anonymous: Opportunities and Alternatives. New Brunswick, NJ, Rutgers Center of Alcohol Studies, 1993, pp 233–248.Google Scholar
  29. 29.
    Youcha G: A Dangerous Pleasure: Alcohol from the Woman’s Perspective—Its Effect on Body, Mind and Relationships. New York, Hawthorn Books, 1978.Google Scholar
  30. 30.
    A bill to require retail vendors of alcoholic beverages. Alcohol Rep 13:7, November 1985.Google Scholar
  31. 31.
    Morrissey ER: Contradictions inhering in liberal feminist ideology: Promotion and control of women’s drinking. Contemp Drug Problems 13:65–88, 1986.Google Scholar
  32. 32.
    Sandmaier M: Women helping women: Opening the door to treatment. Alcohol Health Res World 2:17–23, 1977.PubMedGoogle Scholar
  33. 33.
    Reed BG: Linkages: Battering, sexual assault, incest, child sexual abuse, teen pregnancy, dropping out of school and the alcohol and drug connection, in Roth P (ed): Alcohol and Drugs Are Women’s Issues. Metuchen, NJ, Women’s Action Alliance and Scarecrow Press, 1991, Vol 1, pp 130–149.Google Scholar
  34. 34.
    Gomberg EL: Alcohol and Women. New Brunswick, NJ, Rutgers University Center of Alcohol Studies, 1989.Google Scholar
  35. 35.
    Wilsnack SC: The needs of the female drinker: Dependency, power or what? in Chafetz, Morris E (ed): Proceedings of the Second Annual Alcoholism Conference of the National Institute on Alcohol Abuse and Alcoholism. Washington, DC, US Department of Health, Education and Welfare, 1972, pp 65–83.Google Scholar
  36. 36.
    Wilsnack SC: Femininity by the bottle, in Eddy CC, Ford JL (eds): Alcoholism in Women. Dubuque, IA, Kendall/Hunt, 1980, pp 16–39.Google Scholar
  37. 37.
    Van Den Bergh N: Having bitten the apple: A feminist perspective on addictions, in Van Den Bergh N (ed): Feminist Perspectives on Addictions. New York, Springer Publishing, 1991, pp 3–30.Google Scholar
  38. 38.
    Peluso E, Peluso LS: Women and Drugs: Getting Hooked and Getting Clean. Minneapolis, MN, CompCare Publications, 1988.Google Scholar
  39. 39.
    Senseman LA: The housewife’s secret illness: How to recognize the female alcoholic. R I Med J 49:4–42, 1966.Google Scholar
  40. 40.
    Celentano DD, McQueen DV, Chee E: Substance abuse by women: A review of the epidemiologic literature. J Chron Dis 33:383–394, 1980.PubMedCrossRefGoogle Scholar
  41. 41.
    Forth-Finegan JL: Sugar and spice and everything nice: Gender socialization and women’s addiction—a literature review, in Bepko C (ed): Feminism and Addiction. New York, Haworth Press, 1991, pp 19–48.Google Scholar
  42. 42.
    United States National Institute on Alcohol Abuse and Alcoholism: Proceedings from First National Alcohol Conference. Washington, DC, US Department of Health, Education and Welfare, 1973.Google Scholar
  43. 43.
    Gomberg ESL: Alcoholism in women: Social and psychological concomitants. Q J Stud Alcohol 18:588–623, December 1957.Google Scholar
  44. 44.
    Vanicelli M: Treatment outcome of alcoholic women: The state of the art in relation to sex bias and expectancy effects, in Beckman LJ, Wilsnack SC (eds): Alcohol Problems in Women, 2nd ed. New York, Guilford Press, 1984, pp 369–412.Google Scholar
  45. 45.
    ANNIS HM: Treatment of alcoholic women, in Edwards G, Grant M (eds): Alcoholism Treatment in Transition. London, Croom Helm, 1980, pp 128–139.Google Scholar
  46. 46.
    Beckman LJ, Kocel KM: The treatment-delivery system and alcohol abuse in women: Social policy implications. J Soc Issues 38:139–151, 1982.CrossRefGoogle Scholar
  47. 47.
    Nol J: Selfobject search: The role of addictions in a patriarchal culture, in Van Den Bergh N (ed): Feminist Perspectives on Addictions. New York, Springer Publishing, 1991, pp 31–44.Google Scholar
  48. 48.
    Glover-Reed B: Drug misuse and dependency in women: The meaning and implications of being considered a special population or minority group. Int J Addict 20:13–62, 1985.Google Scholar
  49. 49.
    United States National Institute on Alcohol Abuse and Alcoholism: Advances in Alcoholism Treatment Services for Women. Rockville, MD, US Department of Health and Human Services, 1982.Google Scholar
  50. 50.
    Dowin C: Sex role setups and alcoholism, in Van Den Bergh N (ed): Feminist Perspectives on Addictions. New York, Springer Publishing, 1991, pp 47–60.Google Scholar
  51. 51.
    Smith C: Healing the feminine: A feminist residential model for treating chemical dependency, in Van Den Bergh N (ed): Feminist Perspectives on Addictions. New York, Springer Publishing, 1991, pp 115–124.Google Scholar
  52. 52.
    Sandmaier M: Alcohol Programs for Women: Issues, Strategies and Resources, Washington DC, National Clearinghouse for Alcohol Information, National Institute on Alcohol Abuse and Alcoholism, 1977.Google Scholar
  53. 53.
    Wilsnack SC, Klassen AD, Schur BE, Wilsnack RW: Predicting onset and chronicity of women’s problem drinking: A five-year longitudinal analysis. Am J Public Health 81:305–318, 1991.PubMedGoogle Scholar
  54. 54.
    Ames G, Schmidt C, Klee L, Saltz R: Indicators of Women’s Drinking Problems: A Report of Research Findings. Sacramento, CA, California State Department of Alcohol and Drug Problems, 1988, Contract A-0010-6.Google Scholar
  55. 55.
    Weisner C, Schmidt L: Gender disparities in treatment for alcohol problems. J Am Med Assoc 268:1872–1876,1992.CrossRefGoogle Scholar
  56. 56.
    Beckman LJ, Amaro H: Patterns of women’s use of alcohol treatment agencies, in Wilsnack SC, Beckman LJ (eds): Alcohol Problems in Women. New York, Plenum Press, 1984, pp 319–348.Google Scholar
  57. 57.
    Thom B: Sex differences in help-seeking for alcohol problems—1. The barriers to helpseeking. Br J Addict 81:777–788, 1986.PubMedGoogle Scholar
  58. 58.
    Thom B: Sex differences in help-seeking for alcohol problems—2. Entry into treatment. Br J Addict 82:989–997, 1987.PubMedGoogle Scholar
  59. 59.
    Schuckit MA, Pitts FN, Reich T, Winokur GL: Alcoholism. I. Two types of alcoholism in women. Arch Gen Psychiatry 20:301–306, 1969.PubMedGoogle Scholar
  60. 60.
    Schuckit MA, Rimmer J, Reich T, Winkour G: The bender alcoholic. Br J Psychiatry 119:672–678,1979.Google Scholar
  61. 61.
    Blume SB: The female alcoholic: Is she different? Physicians’Alcohol Newsletter 22:4, 1974.Google Scholar
  62. 62.
    Bissell L: Testimony, in Alcohol Abuse Among Women: Special Problems and Unmet Needs. Washington, DC, Government Printing Office, 1976, pp 47–55.Google Scholar
  63. 63.
    Survey finds barriers to women’s alcoholism treatment. Alcohol Rep 16:6, October 1988.Google Scholar
  64. 64.
    Reed BG, Leibson E: Women clients in special women’s demonstration programs compared with women entering co-sex programs. Int J Addict 16:1425–1466, 1981.PubMedGoogle Scholar
  65. 65.
    Copeland J, Hall W: A comparison of women seeking drug and alcohol treatment in a specialist women’s and two traditional mixed-sex treatment services. Br J Addict 87:1293–1302,1992.PubMedGoogle Scholar
  66. 66.
    Annis HM, Liban CB: Alcoholism in women: Treatment modalities and outcomes, in Kalant OJ (ed): Alcohol and Drug Problems in Women. Research Advances in Alcohol and Drug Problems. New York, Plenum Press, 1980, vol 5, pp 385–422.Google Scholar
  67. 67.
    Institute of Medicine: Report of Conference on Assessing Future Research Needs: Mental and Addictive Disorders in Women. Washington, DC, National Academy of Sciences, 1990.Google Scholar
  68. 68.
    Dawson DA, Grant BF: Gender effects in diagnosing alcohol abuse and dependence. J Clin Psychol 49:298–307, 1993.PubMedGoogle Scholar
  69. 69.
    Duckert F: Predictive factors for outcome of treatment for alcohol problems. J Subst Abuse 5:31–44,1993.PubMedCrossRefGoogle Scholar
  70. 70.
    Jarvis TTJ: Implications of gender for alcohol treatment research: A quantitative and qualitative review. Br J Addict 87:1249–1261, 1991.Google Scholar
  71. 71.
    O’Connor PG, Horwitz RI, Gottlieb LD, et al: The impact of gender on clinical characteristics and outcome in alcohol withdrawal. J Subst Abuse Treat 10:59–62, 1993.Google Scholar
  72. 72.
    Sanchez-Craig M, Spivak K, and Davila R: Superior outcome of females over males after brief treatment for the reduction of heavy drinking: Replication and report of therapist effects. Br J Addict 86:867–876, 1991.PubMedGoogle Scholar
  73. 73.
    United States General Accounting Office: Block Grants: Overview of Experiences to Date and Emerging Issues. Washington, DC, US General Accounting Office, 1985.Google Scholar
  74. 74.
    The March Reagan budget, in Alcohol and Drug Abuse Report. Washington, DC, National Association of State Alcohol and Drug Abuse Directors, Dec–Jan, 1982, p 2.Google Scholar
  75. 75.
    Women’s program director cites lack of insurance as barrier to treatment. Alcohol Rep 16:2–3, June 1988.Google Scholar
  76. 76.
    The majority of women’s alcoholism treatment programs survived the initiation of the block grant. Alcohol Rep 11:7, May 1983.Google Scholar
  77. 77.
    NCA urges continuation of women’s set-aside. Drug Abuse Rep 2:2–3, April 1987.Google Scholar
  78. 78.
    United States National Institute on Drug Abuse Subgroup on Access and Utilization: Planning Meeting 1 of Health Services. Washington, DC, January 27–28, 1994.Google Scholar
  79. 79.
    United States General Accounting Office: ADMS Block Grant: Women≿s Set-Aside Does Not Assure Drug Treatment for Pregnant Women. Washington, DC, US General Accounting Office, 1991.Google Scholar
  80. 80.
    NCA study says women’s set-aside effective. Alcohol Rep 15:6, August 1987.Google Scholar
  81. 81.
    National Council on Alcoholism: Recommendations for the Improvement of Prevention and Treatment Efforts for Women with Alcohol and Other Drug Related Problems. Washington, DC, National Council on Alcoholism, 1987.Google Scholar
  82. 82.
    House told states show little commitment to helping addicted women. Alcohol Rep 18:3–4, May 1990.Google Scholar
  83. 83.
    United States General Accounting Office: Drug Exposed Infants: A Generation at Risk. Washington, DC, US General Accounting Office, 1990.Google Scholar
  84. 84.
    United States Department of Health and Human Services: Report of Hearings: Born Hooked: Confronting the Impact of Perinatal Substance Abuse. Washington, DC, US Government Printing Office, 1989.Google Scholar
  85. 85.
    United States House of Representatives: No Place to Call Home: Discarded Children in America. Washington, DC, US Government Printing Office, 1991.Google Scholar
  86. 86.
    Reeves JL, Campbell R: Cracked Coverage: Television News, the Anti-Cocaine Crusade and the Reagan Legacy. Duke University Press, 1994.Google Scholar
  87. 87.
    Hearings for federal policy on pregnant women and infants held. Alcohol Drug Abuse Week 1:7, August 1989.Google Scholar
  88. 88.
    Maternal cocaine use raising criminal issues. Alcohol Drug Abuse Week 1:7, May 1989.Google Scholar
  89. 89.
    Bills proposed for pregnant addicts, mothers, families and prisoners. Alcohol Drug Abuse Week 2:1, May 1990.Google Scholar
  90. 90.
    Chavkin W: Drug addiction and pregnancy: Policy crossroads. Am J Public Health 80:483–487,1990.PubMedCrossRefGoogle Scholar
  91. 91.
    Crack babies overwhelming child welfare system, panel told. Alcohol Drug Abuse Week 2:4–5, March 1990.Google Scholar
  92. 92.
    Participants at a conference on policy. Alcohol Rep 15:6–7, 1986.Google Scholar
  93. 93.
    ASAM takes stance against criminal sanctions for pregnant addicts. Alcohol Drug Abuse Week 1:10, November 1989.Google Scholar
  94. 94.
    New ADAMHA program for pregnant addicts authorized. Alcohol Drug Abuse Week 1:5, October 1989.Google Scholar
  95. 95.
    Cocaine babies new worry for treatment centers. Drug Abuse Rep 3:4, February 1988.Google Scholar
  96. 96.
    OSAP youth and pregnant women grant applications available. Alcohol Drug Abuse Week 1:6–7, April 1989.Google Scholar
  97. 97.
    Weisner C: The merging of alcohol and drug treatment: Apolicy review. J Public Health Policy 13:66–80,1992.PubMedGoogle Scholar
  98. 98.
    Sokolow L, Welte J, Hynes G, Lyons J: Treatment-related differences between female and male alcoholics. J Addict Health 1:42–56, 1980.Google Scholar
  99. 99.
    Blume SB: Women and alcohol: A Review, J Am Med Assoc 256:1467–1470, 1986.CrossRefGoogle Scholar
  100. 100.
    Yahr H: A national comparison of public-and private-sector alcoholism treatment delivery system characteristics. J Stud Alcohol 49:233–239, 1988.PubMedGoogle Scholar
  101. 101.
    Weisner C, Room R: Financing and ideology in alcohol treatment. Soc Problems 32:167–184, 1984.CrossRefGoogle Scholar
  102. 102.
    Bosk CL: The rise and fall of social problems: A public arenas model. Am J Sociol 94:53–78, 1988.Google Scholar
  103. 103.
    Alford AR: Health Care Politics: Ideological and Interest Group Barriers to Reform. Chicago, IL, University of Chicago Press, 1975.Google Scholar
  104. 104.
    Taylor C: The politics of recognition, in Taylor C, Gutmann A (eds): Multiculturalism and “the Politics of Recognition.” Princeton, NJ, Princeton University Press, 1992, pp 25–73.Google Scholar
  105. 105.
    Levine H: Temperance and women in the 19th-century United States, in Kalant OJ (ed): Alcohol and Drug Problems in Women: Research Advances in Alcohol and Drug Problems. New York, Plenum Press, 1980, vol. 5, 25–67.Google Scholar

Copyright information

© Kluwer Academic Publishers 2002

Authors and Affiliations

  1. 1.Alcohol Research Group and Department of SociologyUniversity of CaliforniaBerkeley
  2. 2.Alcohol Research Group and School of Public HealthUniversity of CaliforniaBerkeley

Personalised recommendations