From: Marnie Regen Subject: Women and methadone clinics Date: 1996/12/20 newsgroups: alt.drugs.hard Reprinted from the American Sociological Association's Alcohol and Drugs Section Newsletter, Volume 6, Number 1, Fall 1996 Women Face Neglect as Major Obstacle in Methadone Clinics by Jim Fraser, assistant professor, Sociology Department, University of Utah Clients in drug treatment centers have unique experiences based, in part, on one larger organizing principle of our society: gender. I conducted a study at a public drug treatment facility to understand how men and women negotiate their roles as methadone clients, and analyze the ways in which treatment modalities were geared more towards men than women. Specifically, I was interested in studying how the clinic culture affected female methadone clients. While conducting over 100 intake interviews with methadone clients, I found that female clients experienced three interrelated types of neglect at the clinic. The first type of neglect was related to misdiagnosis. The female clients all suffered from opiate withdrawal, however, other factors characterizing some women's drug histories, such as domestic violence and sexual abuse, were virtually ignored. Root (1989) suggests that female drug use can be a post-trauma coping response, and that drug use is sometimes not the primary problem women are experiencing when they seek drug treatment. Female clients indicated that their male partners were often hostile toward their decision to seek treatment unless the male partner was in treatment as well. Second, the clinic culture neglected the tangible realities that many female clients faced everyday. The multiple tasks of childcare, work and treatment were difficult for some women to negotiate. The clinic's methadone dosing hours were geared for a male, with work as his only other responsibility. In fact, researchers have recognized that drug treatment in the United States is still generally based on a "univariate concept of alcoholism developed from a male perspective" (Root, 1989). Our society is reflected in drug treatment facilities that expect women to subscribe to traditional gender-role behavior (like childcare) without recognizing that this creates unique treatment constraints for women that men generally do not face. Finally, female clients face symbolic neglect which cannot be quantified (except, perhaps, in terms of women who leave treatment due to discouragement). Clients engage in the internalization of clinic culture, and if a female client internalizes the message that she is not valued at the clinic, the chances of treatment failure increase. Multiple female clients told me they were leaving the clinic because of pressure from male partners, role conflict involving childcare or work, or because the clinic was not empowering them to manage their lives. If methadone clinics ignore the unique constraints that women face in drug treatment, then they are guilty of gender discrimination. Some of the recommendations that I would make to improve methadone treatment for women are: 1) Develop ties with domestic violence shelters and women's resource centers, 2) Invite experts from other agencies and centers to participate in conducting programs that raise the awareness level of staff and clients at the clinic of women's unique needs and obstacles to treatment and, 3) Honor the accounts of female clients of sexual abuse, domestic violence, or role conflict stemming from the multiple tasks that make up female methadone clients' everyday realities. --- [Jim Fraser is currently an assistant professor in the Sociology Department at the University of Utah. While pursuing his doctoral degree at Georgia State University, he took part in a thirteen month long participant-observation study of a public methadone clinic in Atlanta, Georgia.] ==================================================================== From: ppi@neca.com (Carrie Nation) Subject: Re: Women and methadone clinics Date: 1996/12/26 newsgroups: alt.drugs.hard,alt.mens-rights > Here we go again. If women don't recieve special treatment at > institutions, then those institutions are guilty of gender > discrimination. > > How many men feel "empowered" by the clinics, how many men are made to > feel "welcome" and "important" at these clinics? [snip] > The more you request special treatment for women, and the more you > label instututions which are not specifically geared toward women as > "disicriminatory", the harder you make it for those who have > legitimate discriminatory gripes. Good Luck, but I believe that you > are hurting your own cause. I think you're right; the researcher is hurting the cause of treatment in general, but he is making some valid points. In our area, there is about a 3:1 ratio of males to females in substance abuse treatment/methadone maintenance. According to our formal and informal surveys, this does not mean that fewer women than men need treatment. Women *do* experience "pressure from male partners, role conflict involving childcare or work--" and these factors don't seem to be a reason for men to drop out. (There are plenty of other reasons--valid and insubstantiated--why both sexes drop out). I would agree that treatment programs aren't guilty of "gender discrimination" because of the end result of outside societal factors (fear of losing the kids to DCF, fear of an angry spouse) but that doesn't mean that those factors shouldn't be looked at. If women aren't coming to treatment because they are traditionally the ones who are burdened with childcare (and when it comes to treatment, childcare is indeed a burden) and fear their participation in treatment will cost them their children, then social programs and the state agencies that fund them must figure out ways to address this. Substitute the word "men" for women in the above sentence and the prescription is still the same: for a person whose external pressures outweigh the benefits of drug treatment, there is little hope for him/her AND his/her children. The "legitimate discriminatory gripe" here, and there is one, is that voluntary betterment of oneself often leads to punishment in the form of legal consequences or loss of family. "Empowerment," "importance," and "welcome" are all buzzwords to my mind, and have no businesss being attached to one gender or another. A treatment program or clinic that is doing its job is equipped to handle the treatment-related issues of all clients it accepts. A woman who claims she doesn't feel empowered at a methadone clinic is either alerting us to a poorly-run clinic, or is a very common client: the manipulative one, w hom the professional and competent agency is well equipped to serve.