Trauma

Trauma – Substance use by females is linked to traumatic events or stressors, including sexual and physical assault or abuse, sudden physical illness, an accident, or disruption in family life (Grella, 1997; IOM, 1990; Kilpatrick, Acierno, Resnick, Saunders, & Best, 1997; Kilpatrick, Resnick, Saunders, & Best, 1998; Martin, Beaumont & Kupper, 2003; Najavits et al., 1997).

Females often use alcohol or other drugs to self-medicate in an effort to cope with these traumatic events (Miranda, Meyerson, Long, Marx, & Simpson, 2002; Teusch, 2001; Young, Boyd, & Hubbell, 2002).

Women with substance use problems have been found to be significantly more likely than men to exhibit recent physical, emotional, or sexual abuse (Gentilello et al., 2000), and female substance abuse treatment clients report more problems related to physical and sexual abuse and domestic violence victimization than males (Green et al., 2002; Wechsberg et al., 1998).

However, some therapeutic approaches, such as confrontational models often used in traditional therapeutic communities, present a special barrier for female substance abusers (Copeland, 1997) because they often “reenact” traumatic experiences and may engender feelings of distress and powerlessness associated with such experiences.