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Finally, incarceration and drug use added to the burden of stigma already elicited by the gender and race/ethnicity of the participants in this study, categories with lower levels of power in our society. In addition, gender and race/ethnicity play a major role in shaping the opportunities that women drug users leaving jail face, demonstrating the importance of understanding the intersecting patterns of stigma that block women leaving jail from successful reentry. Women are more likely to seek treatment for misuse of central nervous system depressants,14 which include sedatives sometimes prescribed to treat seizures, sleep disorders, and anxiety, and to help people fall asleep prior to surgery. Women are also more likely than men to die from overdoses involving medications for mental health conditions, like antidepressants.

Additionally, given the sensitive nature and heightened stigma women experience for having a substance use problem, women may have underreported their substance use behaviors and treatment utilization. However, we relied on highly trained interviewers with significant experience working with substance using populations. Our qualitative interviewers were also women, which may have increased sentiments of trust and rapport, creating a more comfortable environment for women participants to share their experiences. Lastly, our findings merit replication with a larger representative sample of women with SUD to confirm findings from this study and determine if findings are generalizable. Notwithstanding these limitations, this study highlights key differences in barriers to treatment by race/ethnicity and underscores the need to targeted interventions that are specifically designed for the needs of Latinas and Black women.

The audio-recorded interviews were semi-structured and open-ended so that participants could also lead the conversation into new areas of interest. They’re very strict and they’re very judgmental […] there are certain things [people] don’t tell their family, they don’t want them to know. I can’t even stand being around [them], that’s why I feel some people keep things to themselves in a big family […] They are religious, not only that, just how they are, they’re just judgmental. So, I feel like I can control it now, but if I felt like I couldn’t then I might have to [go to treatment] […] I don’t think I’m at that point.

So until I can learn how to deal my emotions, they feel it’s better for me not to be in a shelter. So I was diagnosed [with borderline personality disorder] and I’m waiting – I’m on SSI and pending right now. Instead of actions, they’re just referring me and referring and referring me.

Individuals with hidden stigma “may expend much energy to ensure that stigma-related ‘leakages’ do not occur” (Pachankis, 2007, 335). Yet, while they try to fit into “normal” or conventional society, they also struggle with feelings of insecurity, isolation and anxiety (Hetrick & Martin, 1987). The emergency and referral resources listed above are available to individuals located in the United States and are not operated by the National Institute on Drug Abuse (NIDA). NIDA is a biomedical research organization and does not provide personalized medical advice, treatment, counseling, or legal consultation. Information provided by NIDA is not a substitute for professional medical care or legal consultation. I said to myself, “Okay, now I’m going to go back outside and go back and do the same thing… Prop. 36 they put me into a program. It’s transitional. It helped me out a lot. It gave me housing and stability. And I’m happy.

This study is significant in that stigmatization is examined at each stage of drug use with an in-depth focus on gendered social roles. The findings contribute to a better understanding of how stigmatization of women drug users alcohol and anxiety impacts their recovery. The conclusions provide suggestions for social service and treatment providers. Women who use drugs are stigmatized for their drug use behavior, which marginalizes them from mainstream society.

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Religion offered informal social control by providing a social group outside the drug using network, but religious belief was not for all women. The most important source of social control mentioned by the women was not treatment but instead the social environment where they lived and the social networks they had access to before, during and after using drugs. When their social environment provided positive relationships, they had enough help to stop drug use and recover over time. For example, housing policies [40, 41] often made it more difficult for people returning from jail to find stable housing. Lack of options after release, particularly a safe place to live, for most women we spoke to propelled them back into criminal activity, most often including drug use and drug selling as a survival mechanism.

Women who use drugs while pregnant are identified as having a moral ‘failings’ and ascribed a “spoiled identity” (Stengel, 2014; Stone, 2015). Beyond the stigma of being a drug-user, women can feel the burden of multiple stigmas, such as poverty, minority status, unemployment, transgender identification, and older age (Connera & Rosen, 2008; Lyons et adderall al., 2015; Roberts, 1991). People may face unique issues when it comes to substance use, as a result of both sex and gender. Sex differences result from biological factors, such as sex chromosomes and hormones, while gender differences are based on culturally defined roles for men and women, as well as those who do not identify with either category.

1. It’s like freedom, and then you go see this man and this woman or whoever it is, you know, you get caught up in the codependency of drug addiction, and you want to go and have sex or whatever you haven’t done in a mighty long time.
2. The mothers who currently had children in their care (custodial mothers) provided a comparison group for those who were not mothers or who no longer lived with their children.
3. Qualitative interviews were conducted with 28 women of White, Black, and Latino racial/ethnic descent who reported a substance use disorder in the past five years.
4. Research has documented that people in recovery can inspire and motivate others to seek treatment (Best & Lubman, 2012).
5. Targeted sampling involved ethnographic fieldwork in communities where drug use was prevalent and establishing relationships with community members to reach potential participants.

Informal social control works through “strong bonds with family, friends, work, religion, and other aspects of traditional society motivating individuals to engage in responsible behavior or [acceptable] social norms” (Moos, 2007). According to Goffman (1963), stigmatized individuals try to prove themselves by drawing attention to more positive aspects of their identity while attempting to conceal the aspect that is stigmatizing. Stigmatization can make individuals feel insecure, and they often turn to those similar to them (other stigmatized individuals) for social support (McKenna & Bargh, 1998). Goffman (1963) further explains the limitations and boundaries of what actually defines stigmatization as well as the underlying social functions of stigmatization, such as social control. They may have a substance use disorder, so the language becomes person with a subsistence use disorder. Use of the terms abuse, abuser, crazy, addict, dirty or clean describing a toxicology screen or the status of the person, committed suicide, war on drugs, drug habit, “just say no” exemplify a brief preview of how substance use stigma is perpetuated through language.

Implications for Treatment and Social Services

Being a drug user prevents these women from fulfilling an acceptable mother role even though some effectively provided and cared for their children while using drugs. Society says they are not fit to be mothers, but it offers little help to meet the high standards set. Although Audrey was not trying to medicate herself from emotional stress, she was facing social stress in college. She used meth to try to “medicate” in the sense that it allowed her to complete her work for school. This concept of self-medication relates to the situations that the women faced that motivates them turn to drugs as a coping mechanism.

Some are at a loss of what to do next with their lives after the change in social roles. Other women turn to drugs to try to improve or fix their situation and “cure” themselves—to feel normal. The use of drugs can be divided into several stages which do not necessarily correlate to the amount of drugs used throughout the drug-using period. Instead these stages refer to the concept of starting, using, and the aftermath of being exposed as a drug user by being caught or entering treatment. The Before stage in this paper explains the driving forces (initiation) that influence the women to turn to drugs.

A lot of people will want to get off, but still use while they’re going. And will go and slowly be tired of it, because you’re not going to get off drugs until you’re tired of it. And she told me – supporting me in doing the right thing wherever I was at, whether I was on drugs or I was clean and sober. She always encouraged me to do the right thing cause it’s hard when you get out. You don’t have anyone who is really supporting you in doing the right thing because everybody expects you’re going to do the wrong thing anyways, so you just go right back to what you know.

Trauma screening may improve mental health service recommendations for children

Language describing mental health and addiction has evolved through the years, as we realize the power words carry. Fortunately, we have formally evolved from using terms like “insane asylums”, “lunatics”, “idiots”, or “retards” to describe individuals with mental illnesses. Progression is especially necessary in the substance use disorder and addiction realm. The language one uses formulates and contributes to their thoughts, schemas, actions, values, and beliefs; which all combine to create one’s reality.

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Therefore, even though programs exist, it is also important to consider access to them for disadvantaged women (Sered, 2014; Woodall & Boeri, 2013). The negative perception of recovering or “former drug users” is another reason that these women do not go to these programs. In addition, adderall xr amphetamine dextroamphetamine mixed salts potential participants were identified through staff at NCSL and through one of the interviewers for this project who lived in the Western Addition. The two focus groups were held at the offices of the NCSL, and interviews were held at a time and place convenient to the participants.

This typically included social activities or new networks outside drug using environments. This kind of informal social control focuses on the formation of bonds and relationships outside of drug using community that helps recovering individuals maintain a drug-free lifestyle within mainstream society. The findings support other research showing that new relationships in social environments are important factors to consider when trying to help former drug users maintain drug-free lives (Boeri, Gibson & Boshears, 2014; Moos, 2007; Zschau et al. 2015). This study suggests that for recovering drug users, treatment services must focus on the social environment of their clients after leaving treatment. The study findings show that women need resources as well as access to new social networks.