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Women & Relapse: Are Relationships the Problem?

A significant number of women who seek treatment for addiction were initially introduced to drug use by a romantic partner or spouse. Sometimes, it isn’t until they start exploring their patterns in therapy that women realize how their romantic or sexual relationships were triggers for their addiction, and very likely any subsequent relapse. For women who are grappling with dual problems of addiction and intimacy issues, recognizing and breaking a pattern of dysfunctional romantic associations is the key to effective addiction treatment and relapse prevention.

Gender Differences in Addiction & Relapse

Research investigating gender differences around addiction and relapse is relatively recent, with comparative studies in this area beginning in the 1980s and 1990s. One of the early studies found that women, unlike men, often start drinking or using drugs as a direct result of their relationships. Not only can relationships lead women into addiction, they can also significantly increase the risk of relapse. For women, relapse is associated with using in the context of romantic relationships, having a stressful marriage, being depressed and living apart from their children. Studies have revealed that if a woman completes addiction treatment but does not also address any underlying issues with intimacy, she is likely to continue encountering relationship triggers that undermine her recovery. For example, a study at the University of Pennsylvania found that women in treatment for cocaine addiction were more likely than men to report negative emotions and interpersonal problems before they relapsed. Further, women are more likely than men to enter codependent relationships. This means if a woman’s partner is drinking or using, she is more likely to relapse in an attempt to keep the relationship going. A 2004 study showed that women’s drug use following treatment was significantly influenced by their spouse’s continued drug use. Research also indicates that women tend to engage more than men in 12-step programs and other self-help support groups following addiction treatment. While 12-step groups have been shown to support recovery, women in these programs may become involved with others in the program who also have addiction issues, increasing their risk for relapse if a partner relapses.

Stopping Relationships From Leading to Relapse

How can women stop relationships from derailing their recovery? Here are a few tips:

  • Although discussing sex and relationships can be awkward, be honest and open so your treatment team can identify and address underlying intimacy issues during treatment for addiction. For many women, choosing a women-only recovery program can help them open up more easily and discuss intimacy issues, and allow them to focus more on their recovery.
  • If you’re working a 12-step program, don’t wait to address interpersonal issues until the fourth and ninth steps in the recovery process (as is customary for most 12-step programs).
  • Set aside romantic relationships and sex during drug rehab and the first year of recovery so you can focus on healing.
  • Seek ongoing counseling for intimacy issues to guard against relapse. Many addiction treatment centers can customize aftercare programs, including resources to assist those who have problems with intimacy and relationships.

For women in recovery from both addiction and relationship issues, maintaining sobriety depends on gaining insight into addictive behavior patterns around both of these issues. This requires identifying triggers for relapse, including those triggers related to relationships, and where those triggers are linked to drinking or drug use. An effective aftercare program should include healthy coping mechanisms for dealing with both. Taking a dual approach to the recovery process will help women healing from intimacy and addiction problems recognize which people, relationships or situations are best avoided in order to prevent relapse. Over time, the recovering addict can learn to break old patterns and interact with others in healthier ways, and to identify the kinds of people who can provide healthy, emotional support for a sober life. By Christa Nuber Sources McKay, J.R.; Rutherford, M.J.; Cacciola, J.S.; Kabasakalian-McKay, R.; and Alterman, A.I. Gender differences in the relapse experiences of cocaine patients. The Journal of Nervous and Mental Disease 184(10):616-622, 1996. Drug Use and Gender. Tammy L. Anderson, PhD, University of Chicago, Ill. Anderson. T. 1998. “Drug Identity Change Processes, Race, and Gender. II. Microlevel Motivational Concepts.” Substance Use and Misuse. 33(12):2469-+8+; Anderson, T. md L. Bondi 1998. “Exiting the Drug Addict Role: Variations by Race and Gender.” Symbolic lnteraction 21(2):155-74. Arestee Drug Abuse Monitoring Program tADAflq. 7998.7997A; Rosenbam. M. 1980. Women on Heroin. New Brunswick NJ: Rutgers University Press. Gender Similarities and Differences in the Treatment, Relapse, and Recovery Cycle. Christine E. Grella et al, 2011. Factors predicting attendance at self-help groups after substance abuse treatment: preliminary findings. Humphreys K, Mavis B, Stofflemayr B. J Consult Clin Psychol. 1991 Aug; 59(4):591-3. Hser YI, Huang D, Teruya C, Anglin MD. Gender differences in treatment outcomes over a three-year period: A path model analysis. Journal of Drug Issues. 2004;34(2):419–39.

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