Academic journal article Journal of Addictions & Offender Counseling

An Examination of Addiction Treatment Completion by Gender and Ethnicity

Academic journal article Journal of Addictions & Offender Counseling

An Examination of Addiction Treatment Completion by Gender and Ethnicity

Article excerpt

The authors examined the discharge status of all clients admitted to an intensive outpatient facility over the course of 1 year, specifically exploring differences based on client gender and ethnicity. The article also argues the need for more culturally sensitive addiction treatment and addresses some alternative approaches.

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There have been increasing arguments made over the past decade that substance abuse treatment facilities fail to take into account the specific concerns of women and members of ethnic minority groups. Many traditional treatment programs in the United States operate from a model that combines a disease approach to addiction with one that focuses on the character of the addict (i.e., addictive personality) and a spiritual approach to recovery (W. R. Miller & Hester, 1995). W. R. Miller and Hester pointed out that such a model is not as common outside of the United States as it is within the country. In developing their programming, many treatment facilities conceptualize addiction as a disease and draw heavily on the 12-step approach of Alcoholics Anonymous (AA) as a mechanism for recovery. AA itself is a program that was developed by Caucasian alcoholic men based on their own experiences of addiction. Thus, treatment programs that adopt this approach, which combines an understanding of addiction as a disease with a 12-step route to recovery, have been characterized as likewise representing a middle-class, Caucasian model (Berenson, 1991; Drabble, 1996; Rowe & Grills, 1993; Sandmaier, 1992; Saulnier, 1996; Smith, Buxton, Bilal, & Seymour, 1993). Although a clear improvement over earlier perspectives that considered addiction a problem of morality (W. R. Miller & Hester, 1995; Rhodes & Johnson, 1997), the blended model that has become popular nonetheless has its own problems.

There have been a number of criticisms raised regarding using such a "one-size-fits-all" approach to treatment, especially with respect to women and members of ethnic minority groups. One concern has been that the model focuses on individual pathology and fails to take into account social and political realities that may affect not only patterns of use but also the experiences of addiction and recovery (Covington & Surrey, 1997; Ramlow, White, Watson, & Leukefeld, 1997; Rhodes & Johnson, 1997; Rowe & Grills, 1993; Saulnier, 1996). Such a focus fails to take into account the distressing effect of sexism and racism on those who experience it (Rhodes & Johnson, 1997; Watson, 1990; Wright, 2001). In addition, it fails to recognize differences in life experiences that influence the patterns and impact of substance use. For instance, there is greater social stigma attached to drinking alcohol, especially problem drinking, for women than for men (e.g., Covington, 2000; Kline, 1996; Ramlow et al., 1997; Sandmaier, 1992; R. W. Wilsnack & Wilsnack, 1997). Research has found that a large number of women who abuse chemicals have histories of victimization, including childhood sexual abuse, rape and sexual assault, and domestic violence (e.g., Drabble, 1996; B. A. Miller, Wilsnack, & Cunradi, 2000; Rhodes & Johnson, 1997; Vogeltanz & Wilsnack, 1997; S. C. Wilsnack, 1996), and that women are likely to be influenced by a partner's use of chemicals (Vogeltanz & Wilsnack, 1997; S. C. Wilsnack, 1996). Although comorbid psychiatric diagnoses are common among substance abusers, women are more likely to experience concurrent depression and/or anxiety, whereas men are more likely to experience coexisting antisocial personality disorders (Vogeltanz & Wilsnack, 1997).

Likewise, racial and ethnic groups tend to vary a great deal with respect to attitudes toward use and abuse of chemicals (Gilbert & Collins, 1997; Straussner, 2001). These attitudes are also framed by historical influences such as the multiple interconnections between alcohol and the slave trade, the practice of slavery, and the abolition movement (Christmon, 1995; Wright, 2001). …

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