1. Gender Separate & Gender Specific

2. Gender Differences
Gender differences are biologically and socially based
These differences have implications in a variety of areas including:
Active Addiction
Treatment Phase
Dual Diagnoses
Aftercare Considerations

3. Active Addiction & Brain Differences
Women become more intoxicated faster and experience other symptoms sooner
Women coming into residential treatment have more consequences
Mortality rates are higher for women with SUD (50-100x)

4. Hormonal Differences
Estrogen – Promotes social interest, provides a sense of wellbeing, feel socially relaxed
Spikes during first 2 weeks of cycle
Progesterine – Causes increased irritability, desire to be alone, increased reactivity to relationship stress, curbs sexual desire
Spikes during second 2 weeks of cycle
Testosterone – Triggers sexual desire, Men have Times more than women
Oxytocin – “The Cuddle Hormone,” Reduces Stress

5. Implication
Estrogen (higher in first 2 weeks) Fuels Oxytocin and Dopamine Reward Production
This + chemical reaction mimics being in love – highly rewarding to the brain
Negative chemical reaction happens when there is rejection
Results in decrease in dopamine, estrogen and oxytocin
Huge relapse risk in early recovery
Women are more likely to be taken out of treatment or recovery by a relationship

6. Females VS Males
Connection = Survival Connection requires social skills Conflict alerts that connection may be threatened Tend and Befriend to cope with this Self esteem = Ability to maintain close relationships Treatment goal: Fix your picker & Relationships
Achievement = Survival Achievement requires competition Conflict alerts that elevated status may be available. Fight or Flight more likely Self esteem = Ability to individute from others Treatment goal: Learn to connect

7. Population Differences
Men are more likely to need treatment including:
Anger Management
Self-esteem related to employment
Difficulty sharing feelings in close relationships
Narcisistic and Antisocial Personality Traits
Women more often need:
Teaching assertiveness and carefrontation skills
Trauma informed care
Sexual traumas higher rates
Trauma leads to more trauma
Disordered Eating & Body Image
Borderline and Dependent Personality Traits

8. Pros & Cons of Gender Seperate
Fewer pairing off instances in recovery community
Women share more often in same sex groups
Men can be more vulnerable without women present (?)
Provides safe environment to discuss past trauma
Increased LOS
Cons
More expensive to staff and keep separate facilities
Lose the benefit of the perspective of the opposite sex from peers
Exposure to proper boundaries with the opposite sex (?)
More training of staff

9. Clinical Focus Anger Management vs. Shame Resilience
Conflict Resolution Skills vs. DBT Skills
Keeping Clients in Treatment
Women begin Therapeutic Leave (TL) at 30 days
Men begin TL at 45 days
Women want calls and contact with children
Therapeutic Community
Women gossip/ passive communication
Men more likely to be aggressive

10. Aftercare
Women with children are less likely to go to ¾ sober living due to work and childcare constraints
Women are more open to seeing a therapist
More difficult for any client with childcare responsibilities to attend 12-step meetings
Challenge of fewer women in AA makes recommendations like working steps with a sponsor more challenging

11. References