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Why Specialized Women’s Services are Needed

Why Specialized Women’s Services are Needed. Dr. Emilie Attwell Becker Medical Director Behavioral Health emilie.becker@dshs.state.tx.us. Do you have to go to medical school to know that women are different than men? . Substance Abuse ■ Biology. Compared to men, women

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Why Specialized Women’s Services are Needed

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  1. Why Specialized Women’s Services are Needed Dr. Emilie Attwell Becker Medical Director Behavioral Health emilie.becker@dshs.state.tx.us

  2. Do you have to go to medical school to know that women are different than men?

  3. Substance Abuse ■ Biology • Compared to men, women • Progress to substance dependence more rapidly than men • Negative effects more “telescoped”     • More depression, phobias, panic d/o, eating d/o

  4. Substance Abuse ■ Biology • Compared to men, women • Higher rates “feeling good” after cocaine • Lower plasma levels • Higher rates “feeling good” after nicotine • Lower plasma levels • Higher HR/ BP 

  5. Substance Abuse ■ Biology • Follicular v. luteal phases • D- amphetamine had more positive subjective effects in follicular phase, compared to luteal • Cocaine effects more pronounced in follicular, compared to luteal   • Does progesterone mask positive subjective effects of some drugs?

  6. Substance Abuse ■ Biology Unknown response to antabuse, acamprosate, naltrexone, methadone, buprenorphine during cycle BUT…. • Known disruption of antidepressants, other meds • Opioids suppress gonadotropin secretion, which blocks ovulation • Consider long acting birth control not only for obvious reasons, but mood regulation/ medication metabolism

  7. Substance Abuse ■ Psychology • Compared to men, women more likely to have • Greater psychological distress/ more mental health problems • More interpersonal conflicts • Greater exposure to childhood trauma • More problems with lack employment/ vocational skills

  8. Substance Abuse ■ PsychologyTreatment implications • Compared to men, women more likely to have • Greater psychological distress/ more mental health problems Must have access to MH tx • More interpersonal conflicts • Greater exposure to childhood trauma • More problems with lack employment/ vocational skills Access to supportive employment/ teaching vocation/ social services

  9. Alcohol ■Treatment Predictions Compared to men, women more likely to • Participate in self help groups, which predicts abstinence • Older women fare better than men (and fare better than younger women) • Spend longer time during the initial treatment phase

  10. Substance Abuse ■Women only programs In women only programs, greater problem severity • Alcohol • Other drug • Family • Medical • Psychiatric

  11. Substance Abuse ■Women only programs In women only programs, less drop outs of • Lesbians • Women with h/o childhood sexual assault • Women with dependent children

  12. Maternal Depression ■Effects on Young Children •  childhood depression (x13) •  suicidal thoughts •  antisocial, aggressive, socially withdrawn • Overarousal/ overinvolvement/ guilt •  Language/ cognition • Mothers • Yell/ hit their children >reasoning/ loss of privileges as discipline • (low income) less nurturing, discussed personal problems more frequently

  13. Further info www.erowid.com

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