How do women become addicted? Let’s start with history. For over a hundred years in this country, women and girls have been encouraged to self-medicate for emotional and physical symptoms of the hormonal cycle, which were labeled “hysteria” in the nineteenth century. In fact, physicians regularly prescribed opiates for moodiness, pain or fatigue, and Coca-Cola, then containing cocaine and served at soda fountains, was promoted in consumer advertising as an afternoon pick-me-up for ladies. According to the National Institute on Drug Abuse, today’s women receive twice as many more psychotropic medications from their doctors than men do, and these may be prescribed for decades. But a woman cannot take a psychotropic medication for years that that was originally prescribed for a temporary anxiety problem without a risk for physical addiction. As many a woman has said, “How can I be addicted to this? After all, my doctor prescribed it.” We call this accidental addiction, but it can escalate to a conscious self-medication effort on the part of the addict, as she elicits multiple prescriptions from multiple doctors and pharmacies.

There are complex factors involved in the development of an addiction, including hereditary susceptibility. Research and clinical experience also show that women may experience not only dramatic mood shifts but strong cravings during hormonal cycle shifts. Girls have traditionally been introduced to alcohol and drug use by their boyfriends, with inebriation a part of their first sexual experiences. Abuse plays a strong role in the course of addiction development in women, in fact, statistics for abuse, often sexual, are cited as high as 85 percent of all women admitted to treatment. Related to abuse are the high rates of PTSD we see in recovering women. In a recent and disturbing development, young women often engage in competitive binge drinking with their male counterparts, but physiologically they are less able to tolerate the quantities of alcohol without dangerous results. And while not often discussed, a degree of this male-female peer drinking has been true in mid to higher corporate management levels for decades, where women have struggled to be seen as equals and to be in on the power discussions. Women patients have told us that they felt the need to hold their own on many fronts, including macho drinking behavior, yet, come hell or high water, having to hide any ill effects. Losing “self” through addiction According to Dr. Stephanie Covington, author of A Women’s Way Through the Twelve Steps, the treatment manual, Helping Women Recover and other books, women tend to lose themselves and their relationships in a downward spiral of addiction.

Dr. Covington says that women tend to feel less empowered in our society anyway, because they are often viewed as more feminine, attractive and loveable if they have little or no power. Because many women have received societal messages that they did not have direct power or prestige, they instinctively developed manipulation skills. Rather than directly ask for what they need, these women flatter, flirt, please and play helpless to get what they want. In addiction, not only does a woman have no power over her disease, she lacks a sense of her own self. Addiction to alcohol, drugs, food, gambling or sex always provides some perceived benefit, not because it is pleasurable but because it is a way of coping, masking a woman’s feelings about herself and her emotional pain.

This denial is often unwittingly supported by the dysfunctional family, the workplace, the physician who does not ask the right questions, or the parents of a teen who can’t believe the extent to the drug or alcohol use. For a woman who manages multiple tasks in her professional job as well as at home, admitting that her life is actually unmanageable is extremely tough to come to terms with. In order to maintain this outward sense of order or perfection, the woman may attempt to micromanage everything to keep her anxiety at bay, while she actually has little control over anything. It is true that women are truly adroit multi-taskers in daily life, but often feel they must also be the go-between, the person who keeps others’ emotions under control and who keeps everything functioning perfectly. Letting go of those things beyond one’s control is the essence of AA’s Serenity Prayer:

God grant me the SerenityTo accept the things I cannot change,Courage to change the things I canand the wisdom to know the difference.

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