Today, more than 18.4 million U.S. adults are addicted to a substance. Of those, men outnumber women at a rate of almost 2-1. 10.8% of all men have a substance use disorder vs. 5,8% of all women. That’s important, considering women are also almost twice as likely to seek out help. 33.1% of all people in addiction treatment centers are female. Gender disparities in social structure and treatment, stigma, behavior, and emotional connections can actively prevent men from seeking out drug rehab or alcohol treatment. Those same factors influence how men experience treatment and whether or not they benefit from it.
Men face serious problems when it comes to getting into treatment, getting help, and gender bias in and out of treatment. Behavior, including socially trained gender roles, can be detrimental for seeking help, connecting with others, and building the kinds of relationships and support networks many of us need to actually recover. All of this can result in men experiencing significantly longer and more devastating periods of substance abuse, often without help or medical attention.
Gender Expectations and Substance Abuse
Most men react to substance abuse differently than women. Men are more likely to abuse substances to feel good, to reduce inhibitions, and to “loosen up” to be able to perform and function well. Substance abuse for men is therefore, often, a social thing. Men are expected to partake when around each other and are therefore more susceptible to peer pressure.
Males are also significantly more likely to partake in risk-taking behavior. Risk-taking behavior is defined as behavior in which someone is asked to do something which could result in physical, mental, or social harm. Men are so prone to taking actions fueled by need for status, bravado, and peer pressure that they are more than 3 times as likely to be involved in a car accident before the age of 18 as similarly aged females. This translates to substance abuse, where men are significantly less likely to be able to say no, to use with moderation, or to turn down offered substances without peer pressure. This impacts men when they first become addicted to a substance and continues to impact their sobriety long after recovery.
Addiction’s Impact on the Ego and ID in Gender Roles
Women turn inward when using drugs and alcohol, typically replacing the ego or ID with the substance. Men turn outwards, using outward expression of personality and bravado to make up for what they see as personal failings and stigma. The result is quite often that men don’t see a need to seek out treatment because they are under the illusion they are in control. This self-deception means that while only 10.4% of all individuals who should get substance abuse treatment do, 95% of those who don’t get it don’t feel they need it.
Substance Abuse and Crime
Men are both significantly more likely to abuse illicit substances and significantly more likely to engage in violent and impulsive acts while under the influence. This results in men being significantly more likely to face litigation as a result of reckless behavior, theft, or other criminal activity. The result is that men outnumber women in drug courts almost 3 to 1. Criminal cases and potential litigation can severely impact how men take and respond to treatment and therapy, especially if they are being made to participate in treatment as an alternative to prison.
While women are highly likely to have children and dependents when moving into rehabilitation, men are significantly more likely to hold full time employment. This can cause difficulties in seeking treatment, especially for those not aware of their rights under the Affordable Care Act (ACA) or Family and Medical Leave Act (FMLA). A significantly higher portion of men than women seek out detox-only treatment, attempting to return to work and “normal” life as quickly as possible.
This can be detrimental to outcomes, because most treatment relies on behavioral therapy and taking individuals out of environments contributing to substance abuse, rather than simply detox. Pressure to continue earning, to maintain social standing, and to continue providing for a family can be significant and may also be a significant motivator for many men to avoid treatment and to avoid opening up to others following treatment.
Gender Bias in Treatment
Therapists also find themselves acting on implicit gender biases. Even well-trained psychologists sometimes find themselves recommending certain treatments to one person and not to another because they are men or women. This leads to significant differences in how men are recommended to emotional therapy, emotional regulation (except anger management), and stress-management courses like MBSRT and yoga. While women are less likely to be recommended into detox at all, men may move into treatment only to find that their therapist does not see them as an emotional being, despite many behavioral problems like substance abuse being primarily emotionally driven.
Gender Roles in Treatment and Therapy
Gender biases impact men at every level of treatment. Men’s social and gender roles make them less likely to ask for help, less likely to open up to behavioral treatment, and more likely to resist emotional therapy. Psychotherapists have techniques designed to engage men in behavioral and emotional therapy, which typically requires working through gender stereotypes and the self-image. Male bravado can also significantly impinge individual’s ability to be honest in group settings, especially when women are present. Many treatment centers work to combat this by shifting to gendered groups, where men are treated together.
Other tactics include developing treatment supporting men’s need for a sense of independence, personal choice, and autonomy.
Men receive behavioral treatment in subtle, non-confrontational manners
Treatment must be reframed by therapists and staff as courageous and a sign of strength, which can be difficult in light of social stigma around getting help
Men must be helped into expressing, labelling, and working through emotions. Many men simply don’t have the emotional literacy or language to express what they are feeling because of how they were raised
Linking visual references and objects to help men explore and discuss problems in therapy rather than relying on discussion
Men use illicit substances are more than twice the rate of women and are therefore, more than twice as likely to be addicted. While men are less likely to suffer from overdose or organ failure, they’re significantly less likely to get treatment, raising risks of long-term damage to physical and mental health and social life. With more pressure to fit in and drink or use, more stress to provide for family and to uphold themselves, and more barriers to building support networks and friends on leaving substance abuse treatment, men are at significant risk of both not seeking treatment and relapsing after doing so.
Combatting these issues means giving men substance abuse treatment that acknowledges and works for their specific needs. Men’s substance abuse treatment must work to provide emotional literacy, to develop relationship skills, and to foster emotional stability, while providing motivation and affirmation that seeking help is the right thing.
If you or a loved one is struggling with substance abuse, getting help and getting clean or sober is an incredibly powerful choice that will help you get your life back. Speak with one of our experienced treatment advisors today at 800-931-9884 for a free assessment.