I think that if we were to help one another in the recidivism of our own lives is to become like – be peer educators and learn how to do some type of intervention for women who are transitioning… So we start this process 30 days to your discharge date and learn, okay, you get the people who like really want to change and do something different. When I got out of the pen, when I came home, I knew my grandmother was dying. Three respondents expressed a deep desire to reunite with their children, arguing that the need to be good role models for their children was what compelled them to quit using drugs.
“What surprised us the most was that the second category of women surveyed were more educated and more likely to be employed, but experienced more barriers than those who were not employed, or were less educated,” said Apsley. Other evidence showed that happy or close marriages predict improved treatment outcomes, meaning that marriage may be a source of social support for women needing treatment. “What surprised us the most was that the second category of women surveyed were more educated and more likely to be employed, but experienced more barriers than those who were not employed, or were less educated,” said Apsley. 1Boeri conducted the study on female methamphetamine users from 2008 to 2011.
The second theme that emerged from the coding is Social Control, which is divided into sub-themes of treatment services, religion, and social environment. These sub-themes represent social control agents in the sense that they influence the women to control their drug use (in this case methamphetamine) or become drug-free. The social environment refers to the living situations of the women while trying to recover from drug use, which included jail and drug courts (formal social control), and their own neighborhoods and social networks (informal social control). The findings describe these themes in more detail, with examples from the transcripts. Race/ethnicity is an important factor to consider within the context of gender disparities in treatment utilization.
Logistical barriers (e.g., cost, trouble finding services) were common barriers within the perceived controls domain. Important racial/ethnic differences in barriers to treatment emerged among women in this study, which are discussed in greater detail below. Katy was criticized for not being thin as she had been when she was using methamphetamine regularly.
Well, to me, prostituting was too demeaning and I was raped too many times, so I stopped doing it. Individuals in treatment acknowledge that when family members or friends have suggested they get treatment, the response would be, treatment is for losers and I’m not a loser and don’t need to sit around talking to druggies. The study was approved by the university’s Institutional Review Board and received a “certificate of confidentiality” from a federal agency to protect the study data.
He goes on to say the label “person in recovery” has a variety of definitions but usually is in reference to a person who is discontinuing or lessening their use to a healthier level. People in recovery can continue to take medications and receive biopsychosocial services (Botticelli, 2017). “It can you drink alcohol while taking amitriptyline is not enough to address logistical concerns like providing childcare or financial support to incentivize women to seek treatment,” noted Apsley. “It is not enough to address logistical concerns like providing childcare or financial support to incentivize women to seek treatment,” noted Apsley.
To explore similarities and differences in treatment barriers among women by race/ethnicity, we compared frequencies of coded themes within the domains of the TPB. Findings provide deeper insight into barriers that may be contributing to racial/ethnic disparities in the use of substance abuse treatment among women. We identified several key differences in barriers to treatment by race/ethnicity. Attitudinal barriers were more pervasive among the narratives of Latinas relative to Black and White women.
They were still criticized for having a “former user” label, and some women were not able to maintain the same level of productivity they showed when using meth. Another difficulty for those women who were drug users and mothers was trying to regain custody of their children. Some of the mothers stopped their drug use after being caught to be able to be with their children. However, as a “former drug user,” society still stigmatized them and formally controlled their status of motherhood with strict rules and requirements they often could not meet.
The During stage explains what the women perceive to gain from doing the drugs, even while hiding their use to appear “normal” to society. Lastly, the After stage explains the women’s situation after being exposed as a drug user and the challenges they face, especially mothers trying to regain custody of their children. These quotes reveal the difficult choices some women are forced to make in the face of the challenges they faced getting a job, housing, and recovering from drug use to achieve enough stability to become good mothers to their children. They also noted that there is little support to get clean and sober in their home communities. Men are more likely than women to use almost all types of illicit drugs,13 and illicit drug use is more likely to result in emergency department visits or overdose deaths for men than for women.
But it is still a coercive form of social control, which may not work for everyone, and without a structured social environment to go to when she leaves drug court, there is little hope that she will remain drug-free. As shown in her narrative, Tiffany became drug-free previously in drug court, but she relapsed after leaving because with nowhere to go, she returned to her old social environment. The ability to focus and to work on the smallest details also helped them to conceal their use of drugs from others who may stigmatize them once they find out. These women are able to carry on with their lives and portray that themselves as “normal” and even productive to others, while feeling normal themselves only when using drugs.
Currently, language usage for addiction medical care is dated in comparison to other standards. The “Moderate Logistics and Stigma” category, which included more than 18% of those surveyed, showed that the women had stigma and logistical concerns like whether seeking treatment might have a negative effect on their job or cause others to have a negative opinion of them. The group was also concerned with healthcare coverage and being able to afford SUD treatment.
Although all of the women who participated in this study had recently been released from jail, not prison, the stories they told demonstrated ways that even a short stay in jail can disrupt one’s life. Most of the women left jail unprepared to meet these challenges, some of which are related to regulations and practices that have inadvertently made successful community reentry more challenging. Few of the women we spoke to had received pre-release planning that helped them to find stable housing, find services or a job, or reunite with family members. Even women (usually only those who participate in programs in jail) who received an exit plan found that the plan was of little practical use on the outside. Prior to release, women should be linked with community service providers who can help address their needs (e.g., for housing, employment etc.) after release.
The World Health Organization noted that in 1999 to 2015 more than 183,000 people in the US died from Opioid overdose and in 2012 more than 250 million opioid prescriptions were written in the US. Canada has also seen alcohol and weed an increase in overdose deaths with them increasing fivefold in Ontario between 1991 and 2014 [12]. Stigma continues to be a barrier to individuals seeking help, entering treatment, and accepting medications.
Although Dolly thought that she has benefitted from the services that drug courts provided for her, she indicated that religion was what eventually helped her recover in her mind. Likewise, Beth revealed she was concerned about the home environment of her children. The people in Beth’s house, friends of her husband, were using drugs and influenced her to use drugs. After she stopped using, and in order to prevent her relapse, she encouraged her husband to ask them to leave. Lily’s mother criticized her for not meeting her expectations as a daughter and a student.
Parity legislation and the Affordable Care Act (ACA) in the United States requires insurance companies to cover substance use disorder treatment in the same way they cover similar medical conditions, including medications. Uncovering the Gaps II [13] found that over half of the states offered ACA plans in 2017 did not comply with ACA requirements for coverage of substance use disorder benefits. If we are committed to treating addiction as a disease alcohol withdrawal timeline then the stigma related to lack of insurance coverage must be removed (Center for Addiction, 2017). A systematic review [8] based on 28 studies from 2000 to 2011 examined how stigma held by health professionals affects healthcare delivery and found that health professionals typically held negative attitudes towards SUD patients. The healthcare professionals perceived manipulation, violence, and poor motivation as obstructing factors.
Stigma based on drug use and incarceration works to increase the needs of women for health and social services and at the same time, restricts their access to these services. These specific forms of stigma may amplify gender and race-based stigma. Punitive drug and social policies related to employment, housing, education, welfare, and mental health and substance abuse treatment make it extremely difficult for women to succeed. The 20 participants used in the analysis for this paper were selected because they were mothers who had children in their care when they were using methamphetamine or they were of childbearing age.