For many people suffering from substance abuse, the stigma of addiction creates an additional barrier to treatment and recovery. Sadly, only a small percentage of people with addiction seek and receive treatment. People may face unique issues when it comes to substance use, as a result of both sex and gender. Sex differences result from biological factors, such as sex chromosomes and hormones, while gender differences are based on culturally defined roles for men and women, as well as those who do not identify with either category.

Substance Use in Pregnancy: Identifying Stigma and Improving Care

This could bedue, in part, to the large variability in stigma measures employed across studies.Nearly half (17; 43%) of the included quantitative studies employed one or more of 15different drug use-related stigma measures. Additionally, 15 (37%) studies adapted ameasure of mental health stigma while the remaining studies (8; 20%) either adaptedmeasures of other stigmatized characteristics (i.e., HIV or HCV), selected specificitems from existing drug use stigma measures, or developed their own items to assessdrug use-related stigma. Also, notably, across all quantitative measures, item contentreflects PWUD as a homogeneous archetype, and does not reflect the dimensions bywhich gender might shape how drug use stigma is experienced (e.g., in the context ofparenthood). There was a lack of consensus across 40 quantitative studies regarding theassociation between gender and drug use-related stigma..

Managing Stigma: Women Drug Users and Recovery Services

[29] Link and Phelan developed a conceptualization of stigma that describes stigmatized individuals as those who are labeled and assigned negative attributes, set apart as not fully human, and treated negatively. [30] Stigma results in prejudice and discrimination 9 healthy things that happen to your body when you stop drinking for 30 days or more against the stigmatized group, reinforcing existing social inequalities, particularly those rooted in gender, sexuality and race. According to Link and Phelan, those who are stigmatized can experience direct, structural or internalized discrimination.

1. Additionally, research has documented lower problem recognition, lower perceived need for treatment, and logistical barriers (e.g., childcare concerns) among women, which contribute to gender disparities (Brienza & Stein, 2002; Schober & Annis, 1996; Thom, 1986; Zemore et al., 2014).
2. Pre-release planning can be a challenge when a woman’s length of stay in jail is unknown or may last only a few days, but if reentry planning begins at a person’s point of entry into the criminal justice system it has potential to reduce substance use and improve community health and public safety.
3. Formal social control of behavior, such as laws and bureaucratic rules, are distinguished from informal social controls.

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We were only able to identify one national study that investigated gender disparities by race/ethnicity. Zemore et al. (2014) found pronounced, significant Black-White and Latino-White disparities in the use of specialty alcohol treatment services among women only, although Latino-White disparities were significant among men in multivariate analyses. After controlling for socio-demographic characteristics, dependence severity, and social influences (i.e., pressures from family to abstain from drinking, work-related consequences, and legal consequences) Latino-White disparities persisted, while Black-White disparities did not (Zemore et al., 2014). Findings from this study suggest that social pressures are greater contributors to Black-White disparities, compared to Latina-White disparities.

Structural Stigma

In addition, we refer to both chest and breast-feeding people to include all populations capable of lactation but may not identify as female or as having breasts. To learn more about the unique impact of stigma on pregnant women and mothers, visit NIDAMED’s Your Words Matter – Language Showing Compassion and Care for Women, Infants, Families, and Communities Impacted by Substance Use Disorder. For example, the Americans with Disabilities Act was developed to help protect people with disabilities from discrimination. That being said, not all laws that are in place to end stigma and discrimination based on stigma are adhered to all of the time.

Stigma Related to Substance Use Disorders

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. Many researchers indicate that these interactions are essential for improving education and awareness of risks. One of the most critical needs, however, seems to be the establishment or increase of facilities exclusively for women with addiction problems, as well as medical facilities for pregnant women or women with children, and above all, the adaptation of treatment programs to the specific needs of women [26,27,28,29,30,35,39]. It is also important to introduce appropriate social, health, and care interventions for women suffering from drug addiction before and after drug treatment [5,23], if possible, with the introduction of interventions implemented by women for women [32]. Of course, for these interventions to be implemented, adequate preparation of medical personnel is necessary, especially therapists’ high cultural competence, empathy, unconditional positive regard, and authenticity (Rogers’ triad) [25].

Mothers may frequently receive ridicule for resorting to substance use and may be seen as failures while fathers may be excused for having a few beers after a hard day’s work. To conduct this narrative review, PubMed and Google Scholar databases were searched using the terms AND [ OR OR ] along with , , , or between 1980 and August 2021. Inclusion criteria were articles in English the dangers of drinking after work and those focused on the forms and effects of stigma toward pregnant people who use any substance. Articles that were not available in English or were not focused specifically on pregnant people who use substances were excluded from the review. Overall, 17.1% of the population, or 48.5 million people, met the criteria for a substance use disorder at some point in the past year.

In the 1970s and 1980s, medical practitioners and researchers began to recognize how little was known about providing adequate treatment to women with substance use disorders. Research suggests that women are less likely to develop a substance use disorder compared to men. However, women often develop drug and alcohol addictions faster than men do, and they frequently face more barriers to treatment.

See Table 4 forthe full analysis of the individual perspective qualitative articles. Our thematic synthesis of the qualitative data used methods developed byThomas and Harden (2008) and was guided bythe Stigma and Substance Use Process Model (Earnshaw& Smith, 2017; Smith & Earnshaw,2017). Thematic synthesis is a method in which descriptive and analyticalthemes are developed through the coding of original studies (Guise, Horniak, Melo, McNeil, Werb, 2017; https://soberhome.net/alcohol-use-and-cancer-american-cancer-society/ Thomas & Harden, 2008), where the focus of the codingand analysis is on the constructs identified by study authors (i.e., second orderconstructs). This is done to avoid introducing bias through the reinterpretation ofprimary data given our limited understanding of the context in which the originaldata were collected, and the potential for misinterpreting isolated fragments of data(Guise, Horniak, Melo, McNeil, Werb, 2017;Thomas & Harden, 2008).

At the individual level, stigma is manifested among individuals who are not living with the stigmatized status of focus (referred to herein as perceivers) as well as individuals who are living with the stigmatized status (referred to as targets). Boundaries between structures, perceivers, and targets are porous, interlocking, and reinforcing. Blurring the lines between structures and individuals, individuals populate government systems that pass laws, organizations that construct policies, and neighborhoods that are home to local movements.

These two women considered the treatment services they attended were not very helpful, and they did not attain a drug-free life after they left the treatment services. 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. These women were able to accomplish multiple tasks due to the increased energy, which also linked to avoiding stigma. They felt that by using drugs they were functioning according to the norms of society.