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Why We Need to Get Intersectional When We Talk About Women and Addiction

[TRIGGER WARNING: Substance Addiction, Abuse]

If our feminism is truly intersectional, then it should make room for the millions of women in the throes of substance addiction. Too often we push these women by the wayside; too often, women don’t feel comfortable seeking out treatment because they are judged more harshly for being addicted to drugs or alcohol. The social stigma many women struggling with addictions encounter can hugely impact their quality of life. In fact, to a greater degree, stigma has the potential to kill women who are entrenched in their addictions.

Rehabilitation programs have generally been male-centric, and there can be specific factors surrounding a woman’s addiction that could make gender-specific rehabilitation a more effective way of treating women who feel  unrecognized in the realm of addiction. But evidence doesn’t seem to point to gender-specific treatment as the be-all, end-all—“women-only treatment programs are generally no more effective than mixed-gender programs for alcohol dependence.” states the Harvard Mental Health Letter, “However, some subgroups of women — such as those with a history of trauma or abuse, or who have other psychiatric disorders — are more likely to recover in gender-specific treatment programs that address these factors.” We think about ‘mother’s little helpers,’ popping pills from the medicine cabinet. We think of women who pour themselves a glass of wine at 4 PM, just to deal with the stress of the day. It calls back to a dissatisfaction as described in The Feminist Mystique—a deep yearning, a clawing to do something more, be something more. But women hide this.

There’s no denying that a need for privacy keeps women using secretly, especially since society traditionally considers women to be primary caregivers. This designation places them on a pedestal of unconditional love and support, a pedestal that requires sobriety. This position also immobilizes them, since people view the women as idealized figures, not real people with real problems. In one survey, 87 percent of women stated their alcohol intake happened at home. Perhaps they are pregnant; perhaps they have children. They might be the breadwinner, they might be a single parent. Either way, traditional roles can keep women addicted when the response to typical stress in the home is substance abuse. Other legal problems or social problems, whether to do with using while pregnant or using while taking care of children, often keep women hiding in shame, when what they really need is communal support. While women-specific treatment might not be the exact key to providing efficient treatment for women, there’s no denying that “A key concept is that if we are to develop effective treatment, we must include the experience and impact of living as a woman in a male-based society—in other words, gender—as part of the clinical perspective.” States Treatment for Women: Theory and Practice.

This impact is illustrated by some female-specific facts about substance abuse:

  • Women have unique needs associated with addiction, and move more quickly from abuse to addiction.
  • Women have a stronger response to substances and experience more anxiety, depression, and panic attacks. And of course, a mental illness always predisposes a higher risk for substance abuse.
  • Women have a different biological makeup: water retention, menstrual cycles, and other factors create a lower tolerance in women—so if they drink as much as a cis-man, they undergo heightened effects due to alcohol consumption. For this reason, the 2 drink a day standard for men is too much for women—just 1 drink is recommended in maintaining moderation.

In addition to women, different populations have different rates of substance abuse. According to SAMSHA, people of color have different rates of drug and alcohol abuse, compared to the rest of the population:

  • In 2014, drug abuse for the African American community was 12.4 percent , in comparison to the national average of 10.2 percent.
  • Binge drinking (consuming five or more drinks in one occasion) in the same community was 21.6 percent, in comparison to the 23 percent national average.

For the LGBTQIAP+ community, there is also an increased rate of substance abuse, as exemplified in a study from 2015:

  • 10.8 percent in the sexual minority had an alcohol abuse disorder in 2015 with 6.1 percent in the sexual majority.
  • 7.8 percent in the sexual minority had a drug abuse problem, with 2.6 percent in the sexual majority

There are more disabled women than men living with addictions:

  • 56 percent of disabled women reported domestic, physical, or other forms of abuse—a serious risk factor for developing a substance abuse disorder in the future.
  • Some studies indicate that substance abuse is higher among those disabled, others do not. However, these risks should not be taken lightly, as they can seriously  impact an individual’s quality of life.

There’s no surprise that the social impact and marginalization of these individuals seem to contribute to higher rates of addiction. A marginalized group is more likely to become addicted when they don’t have support, which is why group therapy is such a crucial element of addiction. Where do you turn when society doesn’t include you in its ableist concept of ‘normalcy’? In any case, it can feel logical to turn to substances. What do you do when your other coping mechanisms don’t work? For some, numbing through substance abuse seems to do the trick, for at least a little while.

When women come out with their addictions, we listen in fascination. Poor Whitney Houston, we think. She didn’t stand a chance. Cat Marnell is another example of a woman whose blunt discussion of her addiction foments fascination—not with herself as a person, as a writer, but as an addict with an insatiable need to write her story as loudly as she can. She admits, “you call it oversharing, I call it a life instinct.”  But patriarchal structures set up women for judgment in the public eye—they’re a lost cause. This is likely because female addiction is too often kept under wraps, and when we see these stories in public, it illuminates a private experience that we don’t hear about—that takes us by surprise. But it shouldn’t.

Why do we follow these women? Just as much as someone like Cat Marnell wants to divulge everything, let’s face it—we want to know everything, too—and yet, asks journalist Eva Wiseman, “Why does her self-destruction elicit such glee and anger from readers and the press, commenters quick to point to her privilege, to insult her and her ‘enabling’ editors?”

It makes one think about urges and reality, about the Freudian distinction between the conscious and unconscious mind. When you keep something bottled up, it’s only natural to spill over eventually. This spilling-over, then, is a way of garnering agency, and moving forward—claiming an experience, one that is otherwise shrouded in misconception.

There’s a different representation in the media of drinking—a woman who uses is asking for something bad to happen to her; a male who uses is undergoing a serious medical problem. When women become addicted, we’re morbidly fascinated. Lindsay Lohan and Britney Spears are great examples of the way female addicts are viewed as less-than in the media—they were photographed constantly in various states of distress and intoxication; there was no empathy, only a thirst for entertaining stories of their trips to rehab centers in California. Celebrities like Zach Galifianakis and Bradley Cooper have stories of addiction and recovery, but we aren’t waiting for their next slip-up—we’re following their recovery and imagining what their future sobriety looks like. Ben Affleck revealed his struggles with alcohol addiction on Facebook in 2017 and was met with unwavering support.

Didn’t we hang onto Amy Winehouse’s unraveling until the day she died? Whitney Houston’s drug-fueled existence made the cover of tabloids constantly, whether the stories were truthful or not. We unconsciously make the excuse, but Whitney and Amy were just really bad and deeply addicted, perhaps more than anyone else. But what kind of distinction is that? How are we to say that the representation of women undermines their need for a distinct form of recovery—but does that necessarily mean they are worse? Is addiction really a part of a man’s moral character, or is it merely a hoop to jump through? What about Britney Spears? She was hounded by the press so much and so often that eventually she just snapped—and it makes sense that she’d chase after them with an umbrella, fed up to the point of psychosis. Do we hound male celebrities in the same way?

Take a cursory Google search for “Whitney Houston,” for example. On the first few page results, we see articles about her “long, sad road,” whereas Robert Downey Jr., with an intense recovery from addiction of his own (how do we judge who has had a worse experience with addiction, anyway?) had an “epic saga.” If Robert Downey Jr. were to pass away, which would we hear about? His sad road or epic saga? And there’s plenty of other famous men with harrowing, complex, layered representations of their tales: “Charles Bukowski wrote from within addiction, as did Hunter S. Thompson. Men are allowed to have a thousand takes on drugs, but women, only one. And it’s not: ‘Here’s a life lesson for you, kids – it’s much easier to go through something upsetting when you’re on drugs.’”

Is addiction just something that happens to men? Is it really part of their identity? Do they feel they must claim their substance abuse? Or is it merely part of a more broad experience? Do we treat women as a life lesson, and men as resilient, more capable of recovery? Why, in order to move forward, must women own up and claim their experience in order to gain some control over their recovery?

This kind of tolerance for male addiction and the perception of women’s addiction as a moral defect, both need to stop. A huge part of recovery involves opening up about addiction and making amends. When women are kept in the dark, they stay addicted.


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[Images via x & x]

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Written by Leslie Sullivan

Leslie is a digital marketer, writer, linguaphile, feminist, and collage artist. You can see her art over on Instagram via @laszlosuil, and writings on her website:

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