Substance-abusing Women Research Articles

Relations between posttraumatic stress symptom dimensions and substance dependence in a community-recruited sample of substance-abusing women.

The factor structure of posttraumatic stress disorder (PTSD) symptoms, and correlations between PTSD dimensions and substance dependence, were examined in 295 substance-abusing women. Participants completed self-report measures of trauma exposure, PTSD symptoms, and alcohol dependence and underwent interviews regarding dependence on prescription anxiolytics and analgesics. Overall, PTSD symptoms were moderate in intensity, and 46% of the sample met criteria for PTSD diagnoses. A principal-components analysis on PTSD item scores revealed a correlated 4-factor solution (i.e., Intrusions, Arousal, Numbing, and Avoidance factors). Alcohol dependence correlated with PTSD Arousal scores, anxiolytic dependence with Arousal and Numbing scores, and analgesic dependence with Arousal, Intrusions, and Numbing scores. Implications for understanding functional relations between PTSD and substance use disorders are discussed, as are suggestions for intervention with comorbid patients.

Maternal Substance Abuse: Infant Psychiatric Interest: A Review and a Hypothetical Model of Interaction

Substance abuse problems have strongly increased among Finnish women during the last decade. The negative effects that maternal substance abuse is thought to have on the quality of early mother-baby interaction are an area of interest and concern to specialists in infant mental health. During pregnancy and the newborn period of the infant, substance-abusing women have been shown to be especially willing and able to reduce use once the problem is identified. The desire to stop abusing substances appears to be predicated on a strong desire to be a good mother to the child. Interventions that focus on abstaining during pregnancy and on the early mother-child relationship have shown promise in helping these mothers improve the developmental prognosis of the child and become better parents through sobriety.

Relations between posttraumatic stress symptom dimensions and substance dependence in a community-recruited sample of substance-abusing women.

Relations between posttraumatic stress symptom dimensions and substance dependence in a community-recruited sample of substance-abusing women.

Moving Substance-Abusing Women from Welfare to Work

Substance abuse and welfare reform are among the nation's highest priorities, and research that examines linkages between the two is of extreme importance to both government policy and the community. Welfare reform will have serious implications for substance abusers as well as for the various professionals who treat them and work to move their clients into functional recovery and self-sufficiency. Within the context of welfare reform and the special needs of substance-abusing populations, the present study examines current welfare status, work status, and barriers and facilitators to gaining and maintaining employment among 100 low income women who participated in a long-term residential substance-abuse treatment program in Miami, Florida. Participants completed a face-to-face interview to assess a detailed employment history and current sources of income as well as the Addiction Severity Index. Results indicate that completers of the treatment program were more likely to be working post-discharge than non-completers. Similarly, the longer the length of stay in the program, the more likely the client was to be working post-discharge. Multivariate analysis indicates a high-school education, participation in the treatment center's aftercare program, and treatment duration of more than one year were independently related to work status. These data suggest that as welfare reform becomes a reality, continuing support of various types, particularly drug treatment, is needed to assist substance-abusing women in gaining and maintaining employment.

The Effectiveness of Parent Education for Substance Abusing Women Offenders

ABSTRACT The investigators evaluated a parent education program in a state prison for women in which 63% of the participants reported high use of drugs and/or alcohol. They found no difference in the measures used between alcohol and drug-abusing women and the other participants. However, the presence of a history of personal victimization, reported by a high percentage of substance abusers, did influence scores.

Gender differences in the relationship of antisocial personality disorder criteria to Psychopathy Checklist-Revised scores.

The relationship among adult, child, and full antisocial personality disorder (APD) criteria with the Psychopathy Checklist-Revised (PCL-R) (Hare, 1991) scores, an alternative to the Diagnostic and Statistical Manual of Mental Disorders' APD diagnosis, is examined in 395 men and 121 women substance abusers. Based on prior research, it was hypothesized that the correlations among childhood, adult, and full APD criteria and PCL-R Total, Factor 1 (Psychopathic Personality Traits), and Factor 2 (Antisocial Lifestyle) scores would differ for men and women. There was no difference between men and women in the correlations between full APD and PCL-R scores. Adult APD, however, had a stronger relationship to the Total and Factor 1 PCR-R scores in women compared to men, whereas child APD criteria were significantly related, although weakly, to Factor 1 scores for men, but not for women.

Cluster Analysis of HIV Intervention Outcomes Among Substance-Abusing Women

The study described here presents an innovative approach to analyzing intervention outcomes among women substance abusers participating in a national HIV prevention research study funded by the National Institute on Drug Abuse. We used cluster analysis to divide the women in our sample (N = 557) into four distinct subgroups predominantly characterized by differences in drug use, injecting risk, sexual behaviors, and drug and sexual risk combined. The four subgroups resulting from this process were primary crack-using women, primary needle-using women, high-frequency needle-using women, and women with multiple drug and sex risk behaviors. Our analysis focuses on change; in self-reported risk behaviors from baseline to 6-month follow-up.In general, the results clearly indicate that the women are heterogeneous; that is, the subgroups exhibit varying patterns of drug use, injecting risk, sexual behavior, and HIV serop-The two smaller subgroups of women-high-frequency needle users and those in the multiple-risk behavior subgroup-reported the highest rate of high-risk behaviors and seropositivity but also showed the greatest change at follow-up. A particularly important finding resulting from our analytical approach is that well over half the women in our sample were primary crack users (n = 313). This finding is even more significant in light of the fact that the Cooperative Agreement specifically tried to include 70% or more participants who were injectors. Although the rate of HIV seropositivity is not as high for this crack-using subgroup as for the two smaller needle-using subgroups, a greater number of “women who are HIV positive” are in this primary crack-using subgroup than in all the other subgroups. Most of the crack-using women reported that they were not currently injecting drugs and never shared needles, but 10% were seropositive for HIV, suggesting that their risk comes primarily from sexual behaviors. Behaviors in this larger subgroup of women did not change as dramatically as those of women in the smaller subgroups; however, the women did show improvement in areas related to indirect risk (e.g., alcohol and crack use) and in several areas where change is most needed (e.g., trading sex for drugs and using condoms). The results demonstrate a promising alternative approach to analyzing substance abuse and HIV risk behaviors, and they suggest the need for further research on alternative interventions for women with different patterns of risk behaviors. ositivity. Significant outcomes were found in many areas, indicating positive changes in risk behaviors.

Treatment Needs and Initial Outcomes of a Residential Recovery Program for African-American Women and their Children

The current research was designed to assess the treatment needs of 42 substance-abusing women and the efficacy of a women-based, culturally influenced, multifaceted residential treatment program for women and their children. Women presented with multidimensional treatment needs, including limited educational/employment histories, significant child-care needs, and histories of victimization and psychological distress. Women remained in residence for an average of 259 days. In all, 88% of the women remained substance-free at discharge; 49% had jobs or were enrolled in school/job training. This integrated, gender/culture-based approach provides a model for more effective substance-abuse treatment for women and their families.

Treatment Needs and Initial Outcomes of a Residential Recovery Program for African‐American Women and their Children

The current research was designed to assess the treatment needs of 42 substance-abusing women and the efficacy of a women-based, culturally influenced, multifaceted residential treatment program for women and their children. Women presented with multidimensional treatment needs, including limited educational/employment histories, significant child-care needs, and histories of victimization and psychological distress. Women remained in residence for an average of 259 days. In all, 88% of the women remained substance-free at discharge; 49% had jobs or were enrolled in school/job training. This integrated, gender/culture-based approach provides a model for more effective substance-abuse treatment for women and their families.

Pharmacological Management of Neonatal Opioid Abstinence Syndrome

Substance abuse in women of childbearing age is a global public health problem. The most common drugs of abuse are cocaine, diamorphine (heroin) and alcohol. Fetal drug exposure can be identified by maternal history (which is not always reliable), maternal and infant urine toxicology screening, and meconium and infant and maternal hair analysis.

The Link Between Substance Abuse and Posttraumatic Stress Disorder in Women

Research has documented a high incidence of comorbid posttraumatic stress disorder (PTSD) and substance abuse. Women substance abusers, in particular, show high rates of this dual diagnosis (30% to 59%), most commonly deriving from a history of repetitive childhood physical and/or sexual assault. Rates for men are two to three times lower and typically stem from combat or crime trauma. Patients with both disorders are characterized by high severity on a multitude of psychological and treatment variables and use of the most severe drugs (cocaine and opioids). Treatment research on women is limited but suggests the possibility of retaining patients and achieving positive outcomes.

Integrating Employment Assessment in Substance Abuse Treatment for Women

This paper discusses trends in women's substance abuse and its effects, including assessment of employment needs, and the development of treatment modalities. It also highlights the importance of employment or work needs and discusses the integration of these needs as a framework for assessing substance abuse treatment for women. The hierarchy of needs approach is provided as the conceptual framework.

Understanding Women With Dual Diagnoses

The most common types of psychiatric diagnoses linked with substance abuse or dependence in women are defined and discussed. A framework is described to facilitate the nurse provider's understanding of the various relationships psychiatric symptoms can have to substance-using patterns. Guidelines are provided to assist the nurse in identifying problems of dual diagnoses and providing care to women with dual diagnoses in general care settings.

All My Buddies Was Male: Relationship Issues of Women With Addictions

There is a common perception that women who abuse drugs and alcohol do not like women. How does this attitude relate to women's abuse of drugs, and what difference might it make to the nursing care of addicted women. The importance of relationships to self and others has been emphasized in nursing theories, recent theories of women's psychologic development, and the social models used to explain substance abuse. This article examines what is known about the interpersonal relationships of women with addictions, including those with men and with other women, and explores how those relationships are associated with women's substance abuse behaviors. A brief explanation of current theories of women's psychologic development is followed by a review of the literature regarding the relationships of women with addiction problems, highlighting their attitudes toward themselves as women and the importance of the adult mother-daughter relationship. Implications for the treatment of addicted women by nurses are discussed.

Behavioral Interventions: Effective and Adaptable for the Treatment of Pregnant Cocaine-Dependent Women

We examined the effectiveness of behavioral interventions in the treatment of cocaine-dependent pregnant women. The study was carried out in four stages: (1) the unique needs of substance-abusing women were examined to identify effective treatment factors, (2) behavioral interventions found to be effective in other cocaine-dependent populations were identified, (3) strategies from these two elements were combined in an ongoing treatment-study of cocaine-dependent pregnant women (the Pregnancy Project), and (4) outcome data in a group of 35 women who participated in the Pregnancy Project were examined. The rate of retention in treatment was high, as was compliance with prenatal care for those women who remained in treatment. A high rate of compliance with prenatal care was associated with good perinatal outcome. There was a relatively high rate of cocaine abstinence during treatment, at birth, and in the early period following birth of the baby. Many of the patients especially appreciated the individually based, self-empowering aspects of the behavioral counseling interventions. We concluded that behavioral interventions, within a woman-friendly treatment program, are an important treatment option to consider.

WOMEN AND SUBSTANCE ABUSE

Chemically dependent women face special problems. This article reviews the epidemiology, screening, clinical consequences, and treatment of substance-abusing women. Alcohol, opiate, and cocaine abuse are often linked in women, and the individual and overlapping effects of these drugs are described. Gender difference also are highlighted.

Comparison of the Alcohol Dependence Scale and Diagnostic Interview Schedule in Homeless Women

The Alcohol Dependence Scale (ADS) is a 25 item self-report instrument designed to evaluate the degree of severity of alcohol dependence. Although previous studies have reported on the validity of the ADS, no studies using the ADS have been done on the homeless population, a special and rapidly growing population. To assess the utility of the ADS in a population of homeless, substance-abusing women, the ADS questionnaire was compared with the DSM-III-R alcohol use disorder diagnosis as measured by the Diagnostic Interview Schedule (DIS). Both the ADS and the DIS were administered to 149 homeless, substance-abusing women by trained, lay interviewers. There was good agreement between the ADS and the past-year DIS diagnosis of alcohol use disorder. The level of agreement between the ADS and DIS, as well as sensitivity and specificity, for various ADS cutoff scores are reported to facilitate selection of cutoff scores by clinicians and future researchers.

Victimization Among Substance-Abusing Women

Although women with a history of victimization are known to have increased somatic symptoms, health care utilization, and substance abuse, the health effects of victimization on substance-abusing women are uncertain. To examine whether a history of victimization among substance-abusing women is associated with more medical problems or emergency department visits. Interview data were collected from 2322 women seeking publicly funded addiction treatment from September 1992 to January 1996. We compared women with a lifetime history of physical or sexual abuse with those without such a history by bivariate and multivariable analyses. Variables included episodic medical disease, chronic medical disease, recent emergency department visits, substance abuse characteristics, and demographic data. The prevalence of victimization was 42%. In bivariate analyses, the following variables had significant association with victimization histories: episodic medical disease, recent emergency department visit, chronic medical disease, primary care physician's awareness of substance abuse history, ethnicity, and lower income. Alcohol and crack cocaine users had higher prevalence of victimization compared with heroin or noncrack cocaine users (P = .001). In the logistic regression, the following variables remained independently and significantly associated with victimization: episodic medical disease (odds ratio [OR], 2.15; 95% confidence interval [CI], 1.70-2.73), physician awareness of substance abuse (OR, 1.78; 95% CI, 1.42-2.23), emergency department visit (OR, 1.57; 95% CI, 1.22-2.03), chronic medical disease (OR, 1.51; 95% CI, 1.19-1.92), and lower income. Victimization in urban, poor, substance-abusing women is associated with more medical disease and health care utilization. Interventions that focus on the interconnected problems these women face may more effectively affect this challenging population.

Victimization among substance-abusing women. Worse health outcomes

Victimization among substance-abusing women. Worse health outcomes

Southcentral Foundation--Dena A Coy: a model program for the treatment of pregnant substance-abusing women.

This article discusses the societal implications of substance abuse by pregnant women and women of child-bearing age and reviews their treatment needs as documented in the literature. It then provides a treatment model for pregnant women, using the Southcentral Foundation-Dena A Coy Residential Treatment Program as a model program. It outlines a number of components that are critical to successful substance abuse treatment of these women; specifically, medical interventions, social service provision, educational/vocational services, psychoeducational programs, psychotherapy, substance abuse interventions, and family preservation and involvement. These components are superimposed on a therapeutic community model that stresses gender and cultural relevance, as well as supportive structure and direction.