Download Information about substance use and addiction for women with

Information Sheet 2
Making Connections
Information about substance use and addiction
for women with violence concerns
This information sheet offers 10 actions designed to assist women in reflecting on their substance
use following an experience of violence.
1. Obtain information on the effects
of different substances
There is a good deal of information available
online about women and alcohol, tobacco,
prescription drugs, solvents and illegal drugs.
• For reliable information on the short- and
longer-term use of these drugs, we
recommend women access information sheets
such as the “Effects Series” on the website of
the Alberta Alcohol and Drug Abuse
Commission (AADAC).
http://www.aadac.com/547.asp
• The Women’s Addiction Foundation has
info sheets about alcohol and drug use as it
affects certain groups of women such as older
women and lesbians.
http://www.womenfdn.org/
• The Our Bodies, Ourselves website offers
information on drugs most commonly used by
girls and women—alcohol, tobacco and other
mood-altering drugs such as ecstasy—as well
as good information on other aspects of
women’s health.
http://www.ourbodiesourselves.org/book
When pregnant, it is safest not to drink, smoke
cigarettes, or use other substances. There are
many online resources available on pregnancy
and substance use as well.
• The AADAC Effects Series and a booklet
available from the Centre for Addiction and
Mental Health in Ontario entitled “Is It Safe
for My Baby?” provide excellent information
for women on the risks of substance use in
pregnancy.
http://www.camh.net/About_Addiction_Mental_
Health/Drug_and_Addiction_Information/Safe_
Baby/index.html
2. Recognize connections with
violence
When women experience woman abuse, sexual
assault and other forms of trauma, they are
both particularly vulnerable to increasing their
substance use, and at risk for developing
substance use problems. Some of the
connections between substance use and
experience of violence are as follows:
• Many women identify their substance use
(both legal and illegal) as a way to cope with
their experiences of violence—they use
substances to numb their feelings of pain and
despair.
• Girls and women who use substances can be
more vulnerable to violence.
• Intimate partners who also use substances
can make it difficult for women to reduce or
stop their use, through threats or use of
violence.
See Sheet One in this series for more
information on the connections.
3. Take note of “low-risk” substance
use guidelines
To help you avoid developing substance use
problems, it can be helpful to check your
substance use against the low-risk substance
use guidelines for women.
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Alcohol
For alcohol, the suggested guidelines [4] for
women to reduce risk and avoid problems are
as follows:
• Do not drink every day
• No more than 3 drinks on any day
• No more than one drink an hour
• No more than 9 drinks a week
• No drinking at all in the following situations:
o if you are pregnant or breastfeeding
o before you drive or perform any other
task that poses a risk to the safety of
yourself or others
o if you are taking medication that causes a
negative reaction when mixed with
alcohol
o if you have medical problems that are
likely to get worse if you drink alcohol.
Note: Alcohol may have more of an effect on
older women, women in poor health and/or
women who are taking medications, so it may
be better for them to drink even less.
Note: These guidelines do not apply for women
with recognized addiction problems.
Tobacco
There is no safe level of use of tobacco.
Other substances
There are guidelines for reducing risks when
using substances other than alcohol and
tobacco. See, for example,
http://www.ourbodiesourselves.org/book/excer
pt.asp?id=5
Times of stress and transition are often when
women’s substance use increases—not always
knowingly. This can be a good time to take
stock of your substance use, to assess what it is
currently giving you, and what it is taking away.
5. Be aware of the positive intention
behind use
Charlotte Kasl, who has developed a model of
support for women called The 16 Steps for
Discovery and Empowerment [1], suggests that
it is important to think about what positive
intention was behind the start of substance use.
Identifying the positive intention behind
substance use (such as to relax, to reduce
stress, to have fun) may be helpful as it allows
you to notice if the original intention is still
working for you, and to examine other ways to
meet that positive intention other than using
substances.
6. Be aware of how dependence
develops
There are many explanations for the
development of dependence or addiction. It is
often helpful for women to see dependence as a
cycle that begins with using substances as a
way of coping with difficult experiences and
feelings. While the substance may initially
facilitate coping, over time with increasing use
it takes away individual power, choices and
abilities, as is shown in the diagram below [2].
Difficulty managing
experience, emotions
Skills erode
Use of alcohol or
other drugs
4. Take stock of substance use in
difficult times
It is easy to think that advice about substance
use is not for you and to engage in what is
called “magical thinking”: to think it is only
other women who need to think about their
substance use; that you don’t have any
problems with substance use; that even if you
do recognize a problem, it will go away on its
own.
May start here
Short term effects
Decrease time
using other skills
Increase time
using drug
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7. You don’t have to hit bottom
People can change their use of substances at
any point, not only when they “hit bottom”
(when their use is causing significant problems
in many areas of their life).
It is important to notice when your substance
use starts to increase and, if needed, to get
support as soon as problems begin to develop,
to prevent them from getting more serious.
8. It may not be “all or nothing”
New approaches to helping people with
substance use problems do not see abstinence
from all drugs as the only answer. Even if your
substance use is affecting your health and other
life areas, it may be that reducing use, rather
than stopping altogether, may work for you.
Reducing the stresses and harms connected to
your substance use, not only the substance use
itself, can be helpful.
For example, some women accessing help from
transition houses found that the stay in the
transition house, and the life changes made
following their stay, helped them reduce their
use of alcohol and cocaine to manageable levels
[3].
Even if you do need to take a break from using
substances due to their negative effect on your
health and other life problems, it may not mean
you need to be abstinent for the rest of your
life.
9. Get connected: Asking for and
giving help
Often addiction is seen as a problem of
“disconnection,” where we turn to substances
rather than to each other for connection.
Both professionals and friends can make a
difference when they notice that women are in
trouble with their substance use [5]. Raise the
issue and help women get the help they need.
We can all have the courage to do this for each
other.
Even when friends have substance use
problems themselves, it has been found that
they can still help one another by starting a
conversation about risky substance use [5].
Recovery groups, where women share their
wisdom, hope and experience, also help women
get connected to each other.
Treatment groups also help in this way by
providing a place for women to learn from, and
with, each other.
10. Find the most suitable path
The treatment world is changing to offer new
and shorter forms of treatment groups—such as
support for withdrawal on an outpatient basis
(daytox) and short-term (e.g., two week)
groups—that help women start to discover new
ways of managing their substance use and
other life problems.
Treatment does not necessarily mean you have
to go to a residential program. Treatment is a
process that involves a long-term commitment
to ourselves, and it can be done with less
interruption in our mothering and our overall
lives than it has in the past.
For women healing from violence, substance
use, and related health problems, some
agencies are now offering skill sessions and
groups that provide integrated support.
Charlotte Kasl speaks of “many roads, one
journey” [6] to bring attention to the fact that
change in, or recovery from, substance use is
different for everyone. There is no one way to
change one’s patterns of problem substance
use, or one “treatment” that is appropriate for
everyone.
Women with both violence-related and
substance use problems need to be aware that
lessons learned when making positive changes
in one area of life, such as healing from
violence-related problems, may be helpful when
applied to other life areas, such as reducing
harmful substance use.
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References
1.
2.
3.
4.
5.
6.
Kasl, C.D. (1995). Yes, you can! A guide to empowerment groups. Lolo, MT: Many Roads, One Journey, Inc.
Health Canada. (1994). Report on working together: A national workshop for action on women and
substance abuse. Ottawa, ON: Health Canada.
Poole, N., & Greaves, L. (2004). Women's shelters, substance use and domestic violence. Cross Currents:
The Journal of Addiction and Mental Health, 7(4), 16-17.
Sanchez-Craig, M. (1996). A therapist's manual: Secondary prevention of alcohol problems. Toronto, UN:
Centre for Addiction and Mental Health.
Poole, N., & Isaac, B. (2001). Apprehensions: Barriers to treatment for substance-using mothers.
Vancouver, BC: British Columbia Centre of Excellence for Women's Health.
Kasl, C.D. (1992). Many roads, one journey: Moving beyond the 12 steps. New York, NY: Harper Collins.
This information sheet reflects the discussions of a group of Canadian researchers, policy
advocates and service providers from the anti-violence and substance use fields who “met” in a
virtual community over a four-month period from April, 2006, to July, 2006. Participants in the
online community reflected on the responses to women who use alcohol, tobacco, prescription
drugs and illicit drugs by services whose primary mandate is to serve women who have
experienced woman abuse, sexual assault, and/or other forms of gender-based abuse and trauma.
The virtual community was sponsored by the British Columbia Centre of Excellence for Women’s
Health and co-sponsored by the Canadian Women’s Health Network and the Canadian Centre on
Substance Abuse. Production of this information sheet has been made possible through a financial
contribution from Health Canada. The views herein reflect the discussions of diverse participants in
the virtual community and do not necessarily represent the views of Health Canada or the
sponsoring organizations.
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