Gender Differences in How Intimate Partners Influence Drug Treatment Motivation
Riehman, Kara S., Hser, Yih-Ing, Zeller, Michelle, Journal of Drug Issues
We examine associations between partner-related variables (i.e., partner's economic support, drug use, treatment experience, and recent partner conflict) and treatment motivation (i.e., drug use problem recognition, desire for help, and treatment readiness). Participants were 266 cohabiting or married individuals recruited from STD clinics, emergency rooms, and jails in Los Angeles County between 1992 and 1994, who reported recent drug use. Multivariate analyses show that for men, partner-related variables are not strong predictors of motivation. For women, however, several partner-related variables significantly predict motivation. Having a partner who has been in treatment increases the odds of women's desire for help and treatment readiness, and having a partner who uses drugs decreases the odds of women's treatment readiness. For both men and women, deriving a greater amount of income from self sources than from a partner is associated with increased treatment motivation.
Motivation to enter drug treatment is an important predictor of treatment-- seeking behavior as well as treatment retention and success (DeLeon, Melnick, & Kressel, 1997; Joe, Simpson, & Broome, 1998; Simpson & Joe, 1993). Motivational domains typically measured include drug-related problem recognition, desire for help, and readiness for treatment (Knight, Holcom, & Simpson, 1994; Simpson & Joe). It is recognized that both intrinsic pressures, such as a desire to live a drug-free lifestyle, and external pressures, such as involvement in the criminal justice system or employment problems, can influence an individual's status in these domains. However, less is known about exactly how and for whom these and other environmental and contextual factors contribute to motivational levels, treatment-seeking behavior, and treatment retention and outcomes. This paper focuses on partner's influence on treatment motivation for men and women.
INTERPERSONAL RELATIONSHIPS AND DRUG USE
Researchers have begun to identify the importance of social support and interpersonal relationships as motivating factors for, as well as barriers against, treatment, and there is some evidence that these factors may differ for men and women. Some studies have found that men are more likely to report family pressure and spousal opposition to drug use as reasons for entering treatment (Grella & Joshi, 1999; Thom, 1987), while women tend to receive less support from their partners for entering treatment (Beckman & Amaro, 1986). Women often are introduced to drugs by a male partner (Anglin, Kao, Harlo, & Peters, 1987) and may encounter a substance-using partner's direct or indirect opposition to recovery efforts (Beckman & Amaro, 1984; Higgins, Budney, & Bickel, 1994; McCollum & Trepper, 1995). In some cases, opposition includes elements of intimidation and threat (Amaro & Hardy-Fanta, 1995). At the same time, studies of addiction and career patterns of women and men have found that while men tend to enter treatment after a period of social disintegration, women who enter treatment tend to be more socially integrated with family (John, 1987). In addition, women more often than men cite marital instability and family problems as reasons for problem drinking and treatment entry (Williams & Klerman, 1984).
The influence of interpersonal relationships on motivation and plans to enter treatment may, therefore, differ for men and women. Men tend to be positively influenced by a spouse to seek and continue treatment. However, while women who enter drug treatment are more likely to be involved in relationships (often with drug abusers) and are more likely to cite problems in those areas as reasons for treatment entry, they are less likely to receive encouragement and support from their partners and family to enter treatment.
Qualitative research has found that many women in treatment perceive partner resistance as a major barrier to completing treatment, and male partners' attitudes toward treatment are viewed as critical to treatment outcome (McCollum & Trepper, 1995). …