FRN Research Report June/July 2012: One Year Post-Treatment Outcomes Among Women After Integrated Rehab at Michael’s House
Women with substance abuse issues have unique concerns that affect their gender. For one, women are more likely to suffer from past emotional trauma or mental health issues (Cohen & Hien, 2006). Environmental concerns, such as childcare, are a factor, and physical differences between men and women also are important. A drug treatment program that addresses a woman’s mental health status along with her addiction can effectively encourage lasting change, according to the National Institute on Drug Abuse.
Michael’s House offers a treatment program specifically designed for women. As part of the facility’s recovery process, women undergo a proven step-by-step process designed to help them conquer addiction.
- Detoxification – Rehabilitation begins with ridding the body of the harmful toxins accumulated from drugs and alcohol. This helps individuals begin treatment with a decreased chance of relapse.
- Individual therapy- Patients participate in individual meetings with trained counselors who help them identify the root causes of substance abuse and create a plan for the rehabilitation process.
- Group therapy – The final piece of rehabilitation involves all patients in group therapy sessions. The groups give individuals a chance to share their experiences with other people who are dealing with similar issues.
The center’s talk therapy programs are based on the 12-Step principles used by Alcoholics Anonymous, Narcotics Anonymous and Dual Recovery Anonymous.
Michael’s House Treatment Options
Michael’s House offers tailored therapy options for the unique needs of women. As part of the facility’s mission, staff members work with patients to ensure they can afford treatment.
Three centers make up Michael’s House. The facility treats men and women, ages 18 and older, who need help with substance abuse and co-occurring mental health disorders. The center is in the foothills of the San Jacinto Mountains in stylish Palm Springs. Staff members create integrated treatment programs that give patients the ability to recognize emotional triggers for substance abuse and find ways to change their thinking and behaviors.
Individuals who use illicit drugs often abuse other substances, most commonly alcohol. Meanwhile, women are more likely than men to abuse opiates and cocaine, even though men abuse most other drugs at higher rates (Drug and Alcohol Services Information System, 2005). At Michael’s House, the special needs of women are recognized and the most effective therapy options are offered.
Michael’s House offers the following programs:
- Medical and psychiatric care
- Group and individual therapy
- Cognitive Behavioral Therapy (CBT)
- Dialectical Behavior Therapy (DBT)
- Eye Movement Desensitization and Reprocessing (EMDR)
- DBT skills groups
- Experiential outings
- Challenge therapy
- Family programs
- Equine therapy
- Primary and extended care programs
The treatment programs at Michael’s House address the following:
- Drug and alcohol addiction
- Co-occurring mental health disorders
- Issues related to sexual orientation
- Emotional trauma
Gender Differences in Addiction
When it comes to addiction, there are important differences in how men and women respond to treatment. As editors of a book on how women respond to substance abuse treatments, Brady and Ashley note that adolescent men and women have similar drug abuse habits, but as the two sexes grow older, significant differences emerge.
At the most basic level, statistics show that women abuse drugs and alcohol at lower rates than men. The NSDUH found that from 2002 through 2010, men aged 12 and older abused substances at a rate twice as high as women.
Addicted Women and Children
Women are more likely to have childcare responsibilities, and this additional responsibility makes it more likely that negative behaviors due to an addiction affect children. Children are most seriously affected physically during pregnancy. Research shows that women who use drugs while pregnant harm the fetus and, after giving birth, often bring a child home to a chaotic and unstable environment (Brady & Ashley, 2005).
In combined data for 2009 and 2010, around 11 percent of women aged 15 to 44 reported alcohol use, while 4.4 percent of women in this age group reported using illicit drugs, according to the National Survey on Drug Use and Health published by the Substance Abuse and Mental Health Services Administration. Drug abuse during pregnancy affects both mother and child and can have long-term negative health and social outcomes for the baby.
Preferred Drugs of Women
In a report on the difference between male and female drug treatment admissions, men were more likely to report alcohol abuse as the primary addiction, according to the 2002 Treatment Episode Data Set. Women, however, were more likely to seek treatment for opiates or cocaine and less likely to seek treatment for alcohol or marijuana. Data from TEDS show that men made up 70 percent of the 1.9 million treatment admissions in 2002 (Drug and Alcohol Services Information System, 2005).
Women and Vulnerability to Substance Abuse
Women can be more psychologically vulnerable to addiction. An analysis of the 1985 National Household Survey on Drug Abuse (now the National Survey on Drug Use and Health) unearthed three theories about drug use and gender:
- Female vulnerability due to physical differences and social norms
- Styles of deviance theory that holds women are more likely to have internal reasons while men are more likely to have external reasons
- Convergence theory that states gender differences are less likely as time goes on due to less traditional roles
Researchers determined that the deviance theory accounts for the most common reasons people use drugs and alcohol. Women are more likely to have internal mental issues, while men are more likely to have problems with social functioning. In essence, women need more help overcoming mental roadblocks to achieve recovery (Robbins, 1989).
Talk therapy, such as Dialectical Behavior Therapy or Cognitive Behavioral Therapy, is effective because it helps individuals find reasons to change their behavior. Treatment at Michael’s House is built on the foundation of talk therapy, and it is recommended by SAMHSA. Since women often have different reasons for abusing drugs than men, it’s crucial to understand the best ways to help them overcome unhealthy choices.
Addicted Women and Talk Therapy
All types of women respond well to the psychological component of talk therapy. In one study of drug abusers in St. Louis, researchers found that substance-abusing women with co-occurring mental health conditions responded to treatment as well as women without mental health issues. Treatment response was even better for women diagnosed with phobias. Men, on the other hand, had poorer treatment outcomes if they had a co-occurring mental health disorder, including psychiatric disorders in general, major depression, and antisocial personality disorder (Compton, Cottler, Jacobs, Ben-Abdallah, & Spitznagel, 2003).
Women’s Physical Reaction to Substances
All women, for example, react to drugs and alcohol differently from men. A woman’s lower ratio of water to total body fat means she metabolizes substances at a different rate. Even when a woman and man are the same weight, a woman can end up with a higher blood alcohol level after consuming the same number of drinks at the same rate (Robbins, 1989).
Michael’s House: Treatment Philosophy
Michael’s House provides an integrated treatment program for women that tackles drug addiction and offers help for any co-occurring conditions, such as depression or personality disorders. Women who struggle with addiction commonly have mental health issues, and the emphasis on co-occurring conditions is especially important for this group.
Our Findings: Treatment Outcomes for Women at Michael’s House
This study examines data for female patients treated at Michael’s House in Palm Springs, Calif.
All of the women were part of an integrated treatment program at Michael’s House. Study participants had a minimum 30-day residential stay in order to manage any addictions and improve mental health. In addition, all respondents reported an addiction during the 30 days prior to admission. Substances covered in this paper include: alcohol, cocaine, heroin, opiates (not including heroin or methadone), sedatives and cannabis (marijuana) and amphetamines. Fewer than 10 percent of the women reported using non-prescription methadone, barbiturates, hallucinogens, and inhalants—statistics for these drugs are not included in this paper.
The women were followed from their initial visit through one year. The data, collected from November 2008 to July 2010, found that a majority of female patients who reported addiction avoided using drugs or alcohol after one year. During the research period, women initially reported the highest rates of usage for alcohol and sedatives.
Our Findings: Outcomes at One Year Post-Treatment
Staff at Michael’s House work on individualized treatment plans with patients. Treatment includes detoxification as well as individual and group therapy.
One year after an initial evaluation at the facility, female patients reported an average overall drop in usage rates. Women who reported problems with opiates, cocaine, and sedatives saw the greatest improvement for the average number of days of reported use during a 30-day period. At year’s end, the women’s opiate use fell 91 percent, while cocaine use fell 88 percent and sedative use dropped 85 percent; and the average usage rates for all three drug categories fell to less than one day a month.
On the whole, more women reported initial alcohol use than any other substance. There was a significant improvement for alcohol use, which dropped to three days a month, and drinking alcohol to intoxication, which dropped to 2.4 days a month. Both categories saw a 79 percent drop.
Meanwhile, abstinence rates for alcohol use saw the greatest overall improvement. The number of women who were abstinent from alcohol in a 30-day period improved by 41 percentage points to a 65 percent abstinence rate by the year’s end.
Our Findings: Mental Health Outcomes
Patients in this study also responded to questionnaires on their mental health status. Women who develop strategies to deal with overwhelming feelings are better able to overcome addiction and lead happier and fulfilling lives.
During the survey period, women at Michael’s House saw the most improvement with serious anxiety and tension and serious depression. Initially 91 percent of women reported serious anxiety and tension, which fell to 52 percent after one year, while the percentage of women who had reported serious depression dropped from an initial 75 percent to 40 percent at one year. The next most widely reported issue, trouble understanding, concentrating or remembering, fell from 61 percent to 32 percent. Other areas saw less dramatic improvement, but they were reported at low rates initially. The percentage of women who reported serious thoughts of suicide and trouble controlling violent behavior and fell to 9 percent and 4 percent, respectively.
Our Findings: ASI Composite Score Data
Women at Michael’s House were also given a mental health assessment to determine their feelings about everyday activities. Patients in this study responded to the addiction severity index (ASI), a widely used assessment instrument that allows respondents to rate their current medical and psychiatric status using scales. Categories in the survey cover the following: alcohol use, drug use, psychiatric symptoms, legal issues, family/social relationships, medical issues and employment issues. Patients score the severity of a problem on a scale, with 0 indicating no problem and 5 indicating an extreme problem.
Women with substance abuse issues at Michael’s House had positive outcomes. ASI scores for drug addiction fell 77 percent while scores for alcohol addiction fell 68 percent. The next best areas for improvement were scores for legal problems, which fell 65 percent, scores for family problems, which fell 53 percent, scores for medical problems, which fell 52 percent, and scores for psychological problems, which fell 46 percent.
Employment problems saw no improvement. Employment issues are often made worse by the time away from work individuals take for treatment. Also, the economy is worse than in past decades, making it more difficult to find and keep jobs.
Women with addiction often face more challenges than men. Commonly, they have the additional responsibility of children or may be pregnant. On a physical level, drugs and alcohol may have a more potent effect on them. Psychological issues from past abuse or trauma also may be a problem for these women.
On the positive side, many researchers have found that residential treatment programs with an extensive talk therapy component can help women reach long-term abstinence from alcohol and illegal substances.
The Women’s Center at Michael’s House gives addicted women an individualized approach. Their needs are met on an emotional, physical and spiritual level through an integrated treatment program led by caring staff. The facility’s commitment to including mental health concerns in a recovery plan gives women the tools they need to continue to make healthy decisions.
If you or a loved one struggle with an addiction and would like more information about our programs and research, please visit call us directly at 615-490-9376. Patient participation in our research allows us to help more people and give them the chance to live healthy and fulfilling lives.
Brady, T. M., & Ashley, O. S. (Eds.). (2005). Women in substance abuse treatment: Results from the Alcohol and Drug Services Study. Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies.
Cohen, L. R., & Hien, D. A. (2006). Treatment outcomes for women with substance abuse and PTSD who have experienced complex trauma. Psychiatric Services, 57 (1).
Compton, W. M., Cottler, L. B., Jacobs, J. L., Ben-Abdallah, A., & Spitznagel, E. L. (2003). The role of psychiatric disorders in predicting drug dependence treatment outcomes. The American Journal of Psychiatry, 160, 890-895.
Drug and Alcohol Services Information System. (2005). A Comparison of Female and Male Treatment Admissions: 2002. The DASIS Report. Office of Applied Studies, Substance Abuse and Mental Health Services Administration.
Robbins, C. (1989). Sex differences in psychosocial consequences of alcohol and drug abuse. Journal of Health and Social Behavior, 30 (1), 117-130.
Substance Abuse and Mental Health Services Administration. (2011). Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings. Retrieved July 20, 2012, from Substance Abuse and Mental Health Services Administration: http://www.samhsa.gov/data/NSDUH/2k10NSDUH/2k10Results.htm#2.5