The National Survey on Drug Use and Health (NSDUH) provides a comprehensive look at drug use patterns in the US, including insightful information about gender differentials in substance abuse. The 2013 NSDUH results note several instances where there are marked difference between men and women in terms of drug abuse. The following 2013 NSDUH results highlight such differentials:
- In the 12 and older age group, the rate of current unlawful drug use among males (11.5 percent) is greater than among females (7.3 percent).
- Males are more likely than females to currently abuse several different unlawful drugs (i.e., poly-drug abuse).
- In terms of particular drugs of abuse, of those Americans aged 12 and older, there were a greater number of male marijuana users (9.7 percent) versus female (5.6 percent), cocaine (0.8 versus 0.4 percent), and hallucinogens (0.7 versus 0.3 percent).
- In the 12 and older age group, more males (10.8 percent) than females (5.8 percent) were substance-dependent or substance abusers.
The survey did note that the gender gap closes in the area of alcohol abuse among males and females aged 12-20. In 2013, this group experienced similar rates of alcoholism (males at 23 percent and females at 22.5 percent). There are a host of factors contributing to the parity in alcohol consumption, one of which may be that alcohol is legal; therefore, there is no criminal disincentive to use alcohol. The criminal element of illicit drug use may be a factor that influences females to engage with these drugs less frequently than males.
However, a recent study found that females are more likely than males to be prescribed prescription medications, such as narcotics and benzodiazepines (e.g., sedatives like Klonopin). Many of these prescriptions are refilled for years, which means more females than males use prescription pills.
In terms of abuse of prescription drugs, according to the National Institute on Drug Abuse, males are more likely than females to abuse prescription opioids and experience a greater likelihood of a fatal overdose. But the CDC advises that the gender gap in opioid abuse is narrowing. In 2010, more than 6,600 women died from prescription pain reliever overdoses, which was a 400 percent increase from 1999. A higher number of men are also dying from opioid abuse but the increase is not as dramatic as among females.
It is clear that both males and females require treatment for substance abuse or addiction. But the way they receive treatment and the types of rehab they attend may be factors in recovery success. For this reason, the option to enter a gender-specific drug rehab programs is becoming increasingly available.
Drug Rehab for Women
Proponents of female-specific rehab argue that females have specific needs compared to males and required specialized treatment approaches. For instance, the following are some unique considerations women present in recovery treatment:
- Research shows that sexual or physical trauma with resulting post-traumatic stress disorder (PTSD) is more common among females in treatment than males.
- Females are more likely to access treatment through a mental health provider or general doctor.
- Females are less likely than men to be financially independent.
- Only females are capable of pregnancy and need care around this condition as necessary.
Females are usually the primary care givers; therefore, they may have child care needs or concerns.
Female-specific rehab facilities will have institutional knowledge and experience working with women. For this reason, gender-specific rehab can be helpful to women. For instance, a female-only rehab facility may have expertise in navigating and accessing local social service programs that provide daycare or other services associated with being a parent, or the rehab facility may even offer such services on site.
Women in Recovery Reading List:
- A Woman’s Way Through the Twelve Steps Workbook by Stephanie Covington
- A Woman’s Addiction Workbook: Your Guide to In-Depth Healing by Lisa Najavits
- Women & Recovery: Finding Hope by Kitty Harris & Jodie Gould
- A Woman’s Guide to Recovery by Brenda Liff
It is important to note that many females succeed in coed drug rehab programs as well. In fact, according to the National Institute on Alcohol Abuse and Alcoholism, limited research shows that gender-specific rehab is not more effective than mixed-gender programs. But one important aspect of female-only rehab programs is that some women may not seek treatment if these gender-specific programs did not exist. In this way, the existence of female-only programs may not be significant as much for the treatment they provide but for the access they offer.
Although research supports that females face significant barriers to drug treatment, studies support that gender has no effect on initiation into treatment. That being said, even if gender does have an effect, females are more likely than males to initiate treatment. Females are at least as likely as males to complete treatment. (though women from certain racial or economic subgroups are at risk for leaving rehab before completion.) In terms of treatment outcomes, research suggests that females have treatment outcomes as good as, or better than, males.
One study made a comparison between females and males who completed treatment as compared to females and males who did not. Females who finished rehab were nine times more likely to maintain abstinence than those who did not complete the program. Males who completed rehab compared to those who did not were only three times more likely to maintain abstinence. In other words, the study supports that completion of a recovery program significantly improves a woman’s odds of maintaining abstinence.
According to Narcotics Anonymous World Service, local chapters of NA report that they have special interest meetings to serve male-only or female-only groups. Source: NA Worldwide Service
Drug Rehab for Men
At present, there appears to be inadequate research on the specific needs of males in rehab. Research on substance abuse and addiction traditionally focused on males, so it can be said that treatment models today are grounded in a male model. In fact, when researchers and clinicians talk about gender and treatment, the discussion usually focuses on females as if “gender” is synonymous with “female.” Absent scientifically based research on the particular needs of men in drug rehab, centers that offer male-only rehab will likely need to be innovative and blend research on the psychology of men with existing treatment protocols.
Film’s About Addiction With a Strong Male Character:
Leaving Las Vegas (1995)
Drugstore Cowboy (1989)
Clean and Sober (1988)
The Panic in Needle Park (1971)
Days of Wine and Roses (1962)
For instance, a study of more than 24,000 Canadian adult men found that men who experienced job insecurity or had little control over their demanding work environment were more likely than women to develop major depression. While women did experience stress, they did not develop major depression to the same degree as men. Research suggests that men and women process stress differently and with different health outcomes. Men who are under stress are more likely than women to develop type 2 diabetes, heart disease, high blood pressure, or have a heart attack. Research on stress effects on men can be used to design drug treatment protocols at male-only drug rehab programs. An effective drug rehab program for men will not simply separate males from females but incorporate existing research into treatment approaches.
In addition, men in drug rehab may have unique needs as a result of sexual abuse. Today, substance abuse and addiction treatment rely in great part on individual and group psychotherapy. A rehab center that focuses on male clientele would be well advised to have a therapist on staff who is experienced with the male experience of sexual abuse. As psychotherapist Kali Munro thoughtfully discusses, male sexual abuse can be overlooked in modern society because that experience does not match up to perceptions of the male experience. Even psychotherapists may fail to identify a history of sexual abuse in a male client, whereas they may not fail to do so with female clients.
According to Munro, males who have survived sexual abuse and disclose their experience to treatment professionals may share a core experience of shame, isolation, lack of clarity as to whether the abuse means they are homosexual, conflict over sexuality in general, and a tendency to minimize the painful effects of the abuse. Treatment protocols for males who have been sexually abused are still in development and evolving.
In her experience as a psychotherapist, Munro shares that she found individual therapy to be most beneficial in the initial stages of treatment. Munro found that group therapy was a particularly powerful healing tool. According to Munro, the group setting allows men to overcome much of the isolation that they were driven into as a result of the sexual abuse. In the drug treatment context, Munro’s insight could be translated into male rehab providing both individual and group counseling around any experience of sexual abuse.
Males who are contemplating an all-male drug rehab program can inquire with the specific rehab program to learn how its treatment protocols have been adapted to the male experience. For those individuals who identify closely with a subgroup, the key will be to learn whether a mixed-group rehab or all-male rehab is better equipped and experienced in working with that subgroup’s needs. Each individual carries many different social markers; gender is a significant one, but it is also only one among several.
A Solution to Rehab Romance?
When one thinks about gender-specific rehab, invariably one perceived benefit for heterosexuals is that the temptation to start a rehab romance with another recovering member is eliminated. The general consensus among rehab professionals is that it is never advisable to start a new romance while in rehab. Drug recovery treatment is an intensive process, whether at an outpatient or inpatient center, and is likely one of the few opportunities a person has ever had to focus exclusively on ending the substance abuse and rebuilding the platform for living. But desires persist, sexual ones included.
According to The Fix, the cessation of pleasurable drug use drives many members to seek the pleasure of sexual relations. While rehab policies prohibit such activities, they may still occur. For individuals who identify as heterosexual, and believe that temptation from the opposite may upset their rehab progress, selecting a
gender-specific program may be a good strategy. As The Fix discusses, there are myriad rehab romance stories involving heterosexual couples finding places to exchange intimacies. But neither a mixed rehab nor gender-specific rehab will provide a defense against relations with the same sex for those members who identify as homosexual or bisexual, or desire such an experience.
The solution may seem challenging, but it is obvious: individuals entering rehab are best advised to make a plan to commit to the process and set aside romance for the foreseeable future. It is true that some people have “rehab goggles” and may select a mate who they would not want to date on the outside. In the event, however, that a person meets someone compatible in rehab, just remaining friends through rehab and seeing where things go after rehab is always a possibility.
Gender-Specific Rehab vs. Gender-Sensitive Rehab
A gender-specific rehab program is one approach to address the varying unique needs of females and males. Another approach is for a mixed-gender rehab to provide treatment that is gender-sensitive. The following are some ways mixed-gender rehab programs can increase sensitivity to gender-specific concerns:
- Gender matching client and therapist
- Both male and female co-leaders
- Separate groups based on gender for treatment purposes
- Design and provide gender-specific treatment content
- Provide ancillary services, such as child care services, to the primary care giver, whether male or female
At present, there appears to be more research on how gender-sensitive rehab treatment impacts women than men. Most studies have compared female-only rehab services with mixed-gender programs. One such study found that females in a female-only program, compared to the mixed group, utilized more treatment services and had better drug- and legal-related outcomes at the nine-month follow-up mark. One difference between the female-only rehab and mixed-gender program was that the former offered services like childcare, psychological services for children, and HIV testing. The researchers surmised that the existence of these ancillary services helped treatment outcomes in the female-only rehab group.
However, in terms of rate of program completion, female-only programs showed no significant advantage over mixed-gender rehab programs. Researchers interpreted this result to suggest that certain treatment mechanisms (like availability of ancillary services) may influence recovery outcomes more than whether the rehab was gender-specific or mixed.
Additional Pros and Cons of Gender-Specific Rehab
Rehab is ultimately an entirely personal experience. Addiction professionals agree that one of the most important factors in rehab success is the recovering person’s commitment to the process and willingness to undergo personal change.
Another pro of gender-specific rehab is that programming can be tailored exclusively to the perceived needs of that group. Rehabs not only follow established treatment protocols but possess and build on institutional knowledge. It’s likely that every graduating class of female rehab participants impacts planning at the rehab center, which means that each new class receives the benefits of rehab for females inspired by females. At a female-only rehab center, discussion groups can also be tailored to hallmarks of the female experience, such as motherhood.
A potential con of a gender-specific rehab program is that it creates an artificial group. After rehab, recovering persons will re-enter the mainstream of everyday society where they will invariably interact with the opposite gender. Also, when communication skills are learned in a same-gender environment, one concern is whether those skills will seamlessly translate into the “real world.” Another concern is whether participation in a same-gender drug rehab program makes the transition into post-rehab life any more difficult.
Outside of rehab, a recovering person will need to build a sober support network that will necessarily be composed of males and females. It may be more psychologically convenient to experience a mixed-gender rehab that mirrors life outside of rehab. Aftercare is an essential part of the ongoing recovery and services, and sober living homes and group recovery meetings are often mixed. A graduate of a same-gender rehab program may engage some same-gender aftercare services, but this approach may become personally limiting over an extended period of time.
Both research and feedback on gender-specific rehab versus mixed rehab suggest that the decision remains a matter of personal choice. For example, in the case of a female substance abuser, if a female-only rehab center is more attractive than a mixed one, then such a center should definitely be pursued. Gender-specific rehabs may help individuals to overcome internal barriers to entry to treatment, and they are invaluable for this reason.
In terms of the recovery process after admission to a rehab, the types of services offered may be partially determinative of the recovering person’s success. Upon graduation from a structured inpatient or outpatient program, whether gender-specific or mixed, a recovering person can choose same-sex or coed options for aftercare services, such as residence in an all-female or all-male sober living home (as available). The existence of gender-specific or mixed service options in current addiction practice is a testament to how the treatment field is increasingly adapting to, and specializing in, clients’ individual needs.
 “Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings.” (2014). Substance Abuse and Mental Health Services Administration. Accessed June 25, 2015.
 “Prescription Painkillers are Claiming More Women’s Lives.” (n.d.). National Institute on Drug Abuse. Accessed June 25, 2015.
 Green, C. (n.d.). “Gender and Use of Substance Abuse Treatment Services.” National Institute on Alcohol Abuse and Alcoholism. Accessed June 25, 2015.
 Green, C. “Gender and Use of Substance Abuse Treatment Services.”
 Hornack, S. (Aug. 15, 2012). “Gender-Sensitive Procedures in Substance Abuse Treatment: Associated Costs and Effectiveness.” American University. Accessed June 25, 2015.