Public Issues and Private Problems: Women and Drug Use

Abstract

Despite the conventional wisdom that defining a problem is an essential step in determining a solution, social problem definitions often obscure strategies for ameliorating problems. A review of social research designed to illuminate our definition of substance abuse reveals the way in which historical and political factors have modified the definition of substance abuse problems over time. Treatment and prevention strategies based on these problem definitions are vulnerable to the same influences. A review of explanations of substance abuse among women shows that they have been limited by the same narrow prescriptions that have been applied to women's behavior more generally. This means, for example, that drug treatment programs have focused on improving vocational skills for men and social skills for women. This paper suggests an alternative starting point for the design of effective services. It is suggested that successive, limited comparisons of actual intervention efforts—particularly those designed with the participation of clients or ex‐clients—is a superior method for determining appropriate services for drug‐using women. Based on findings from evaluations of special drug treatment programs for women, three strategies are discussed for implementing this evaluation feedback approach to program design.