TIP 51 Substance Abuse Treatment Addressing the Specific ...

Substance Abuse Treatment:

Addressing the Speci?c

Needs of Women

A Treatment

Improvement

Protocol

TIP

51

Substance Abuse Treatment:

Addressing the

Specific Needs of Women

A Treatment

Improvement

Protocol

TIP

51

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Public Health Service

Substance Abuse and Mental Health Services Administration

1 Choke Cherry Road

Rockville, MD 20857

Acknowledgments

This publication was prepared under contract

numbers 270-99-7072 and 270-04-7049 by the

Knowledge Application Program (KAP), a Joint

Venture of The CDM Group, Inc., and JBS

International, Inc., for the Substance Abuse

and Mental Health Services Administration

(SAMHSA), U.S. Department of Health and Hu?

man Services (HHS). Andrea Kopstein, Ph.D.,

M.P.H., Karl D. White, Ed.D., and Christina

Currier served as the Contracting Officer¡¯s Rep?

resentatives.

Disclaimer

The views, opinions, and content of this publi?

cation are those of the author and do not neces?

sarily reflect the views, opinions, or policies of

SAMHSA or HHS.

Public Domain Notice

All material appearing in this report is in the

public domain and may be reproduced or copied

without permission from SAMHSA. Citation of

the source is appreciated. However, this publica?

tion may not be reproduced or distributed for a

fee without the specific, written authorization of

the Office of Communications, SAMHSA, HHS.

Electronic Access and Copies of

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Or, please call SAMHSA at 1-877-SAMHSA-7

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ii

Recommended Citation

Substance Abuse and Mental Health Services

Administration. Substance Abuse Treatment:

Addressing the Specific Needs of Women. Treat?

ment Improvement Protocol (TIP) Series, No.

51. HHS Publication No. (SMA) 13-4426. Rock?

ville, MD: Substance Abuse and Mental Health

Services Administration, 2009.

Originating Office

Quality Improvement and Workforce Develop?

ment Branch, Division of Services Improve?

ment, Center for Substance Abuse Treatment,

Substance Abuse and Mental Health Services

Administration, 1 Choke Cherry Road, Rock?

ville, MD 20857.

HHS Publication No. (SMA) 13-4426

First Printed 2009

Revised 2010, 2012, and 2013

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Contents

What Is a TIP? ....................................................................................................... vii

Consensus Panel ......................................................................................................ix

Editorial Board........................................................................................................xi

KAP Expert Panel and Federal Government Participants .............................................. xiii

Foreword............................................................................................................... xv

Executive Summary............................................................................................... xvii

Chapter 1¡ªCreating the Context ................................................................................ 1

Overview..................................................................................................................1

Creating the Context ...................................................................................................1

Gender Responsive Treatment Principles .........................................................................4

Women¡¯s Biopsychosocial Uniqueness..............................................................................6

Organization of This TIP ........................................................................................... 15

Chapter 2¡ªPatterns of Use: From Initiation to Treatment ..............................................17

Overview................................................................................................................ 17

Initiation of Use Among Women ................................................................................... 18

Risk Factors Associated with Initiation of Substance Use and the Development of Substance

Use Disorders Among Women................................................................................... 18

Patterns and Prevalence of Substance Use Among Women.................................................. 26

Prevalence of Substance Abuse and Dependence Among Women .......................................... 30

Chapter 3¡ªPhysiological Effects of Alcohol, Drugs, and Tobacco on Women.....................37

Overview................................................................................................................ 37

Physiological Effects and Consequences of Substance Abuse In Women ................................. 38

Physiological Effects: Factors of Influence...................................................................... 38

Physiological Effects of Alcohol ................................................................................... 40

Physiological Effects of Licit and Illicit Drugs.................................................................. 46

Physiological Effects of Tobacco Use ............................................................................. 48

Effects of Alcohol, Drugs, and Tobacco Use on Pregnancy and Birth Outcomes ....................... 48

Effects of Alcohol and Illicit Drugs on HIV/AIDS Status..................................................... 52

Chapter 4¡ªScreening and Assessment ........................................................................57

Overview................................................................................................................ 57

The Difference Between Screening and Assessment ........................................................... 58

Screening and Assessment: Factors of Influence ............................................................... 58

Contents

iii

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