Women and Substance Abuse in India-The common stereotype myth of male-focused addiction in India
Myth: Women don’t have a substance abuse problem
In 1997, ‘The Prodigy’, an English electronic punk, electronic dance music band released one of its most controversial music videos titled, ‘Smack my ***** up’. The video shown from the first-person point of view, shows the person indulging in all kinds of antisocial behaviour, from taking drugs, alcohol to attacking people. Nowhere in the video can you see who this drug-fuelled person is. The video ends with the person passing out and the reflection of the person in the mirror shows that the said person was a woman. The music video created uproar all over the world because it showed a woman being deviant. It was hated in England for its violence and drug use, especially because they showed a woman doing it and in the USA it was loved because it showed that even women are capable of abusing substances and having deviant behaviour.
It’s been 24 years since the video and anyone who sees this video for the first time finds themselves shocked to see a woman in the end. The society that we live in, whether western or Indian, has always placed women on a pedestal. She is a mother, daughter, sister, wife and even a goddess. Women are expected to be infallible! However, the truth is that there are women who have substance abuse problems and by denying their existence, we are doing them a huge disservice.
Substance abuse problem was always considered a disease affecting only men. While the number of men with substance abuse problems is much higher, there are women who are also struggling with this problem. Currently, all our understanding and research is based on male consumption patterns. Modern research has shown that the effects of alcohol and drugs differ for men and women. They differ in biology, epidemiology, socio-cultural factors and psychological comorbidity.
Statistics on the consumption of alcohol and substance use by women
The Ministry of Social Justice and Empowerment, Government of India together with the National Drug Dependence Treatment Centre (NDDTC) and All India Institute of Medical Sciences (AIIMS), New Delhi collaborated with 10 medical institutes and 15 NGOs. They conducted the survey on drug usage patterns in all the 28 states and 8 union territories of India. It was an enormous effort with over 1500 employees involved in collecting critical data between the period of December 2017 and October 2018.
They found that substance abuse problems do exist among the female population. When it came to alcohol, 27.3% of men abuse alcohol, while for women it stood at 1.6%. For cannabis, men stood at 5% and women at 0.6%. For opioid use, 4% of men abused opioids, while 0.2% women abused opioids. While 1.34% of men used inhalant the corresponding figure for women was 0.07%.
While the percentage of men with substance abuse issues is definitely higher, we cannot ignore the small percentage of women with substance abuse issues. These numbers can be higher as usually the representation of women in these studies is less due to many societal restrictions.
According to the Delhi-based Anida David, Additional Secretary of the Indian Drug Users Forum Asian network; “Drug usage amongst women has gone really high across socio-economic classes but it remains behind the curtains especially amongst women. Women in India (as in many other parts of the world) are increasingly turning to drugs…it is present everywhere-colleges, workplaces, at discos and parties and it is definitely not a guy thing anymore. Nor is it restricted largely to women from the disadvantaged sections of society who are commonly seen as turning to substance abuse because of the difficulties they face in their day-to-day life. It is present across society and there are many women from the middle class as well as very wealthy families who are into substance abuse.”
Many rehabilitation centres which are predominantly for male patients have now opened rehabilitation centres for females with addiction problems.
How do women get initiated into alcohol and drug use?
It is not rare but it is also not often either that you would find a woman buying alcohol at a liquor shop. According to Dr Pratima Murthy from NIMHANS (National Institute of Mental Health and Neuro Sciences), most women are often introduced to alcohol and drugs by relatives or friends. There are few studies that suggest that a high number of women alcohol dependents first started drinking to give their husbands company.
Teenagers and young women were introduced to alcohol and drugs by their friends as a way to socialize or to ease the tensions in their lives. There is also a rise in the number of women in their twenties and thirties who are turning to alcohol and drugs to cope with being full-time homemakers, office goers and mothers. The pressure of juggling many roles can lead to a lot of stress and for some alcohol and drugs seem a way out. Some reports have suggested that among the women having substance abuse problems, 62.7% had some form of depression and 53.3% had anxiety-related problems.
Women who have alcoholic partners or abusive partners also tend to turn to alcohol and drugs as a means to escape their emotional trauma. Also, women who have gone through physical and emotional abuse as youngsters also tend to turn to alcohol and drugs as a coping mechanism. There are also a small number of women who use alcohol and drugs as a way to suppress appetite and keep their weight under control. Painful life events like divorce, loss of a custody battle, loss of a child, separation from a partner, can also lead to substance abuse problems in women.
How does the impact of substance use differ in women?
As a progressive modern society, it is absolutely right to say that men and women are equal but from a pure biological standpoint, men and women aren’t created the same. Hence, the effects of alcohol and other harmful substances have different effects on women.
Women get intoxicated much faster than men as women attain higher blood alcohol concentrations than men after drinking the same amount of alcohol. This could be because of less body water in comparison to size. Furthermore, lower levels of alcohol dehydrogenase enzymes in the stomach can lead to a higher amount of alcohol in the systemic circulation. Compared to men, women develop alcohol liver disease in a shorter amount of time even with less intense amounts of drinking. More women die from cirrhosis than men. Excessive alcohol consumption can also lead to increased menstrual problems, infertility and even breast cancer.
When it comes to drugs, women can get addicted faster even with small amounts of drugs. They may also experience more physical effects on their heart and blood vessels. Even brain activity and changes in the brain differ from that of a male user and a female user. Women are more likely to suffer or die from an overdose as compared to men. Women are also likely to have more intense cravings and may relapse faster after treatment. Just like alcohol, drugs can wreak havoc on a woman’s hormone system and can affect her menstrual cycle, fertility, pregnancy and menopause.
Stigma towards women receiving treatment and the need of the hour
Women face much more stigma than men when it comes to seeking help for their substance abuse problems. Women are viewed as caretakers of the family and hence when the roles are reversed and she needs care from the family it’s considered a betrayal of her traditional roles. Many women fear that they will be shamed for their addiction problems and often families will not support the woman the same way they would support a man with addiction problems. Even when they do receive the help they need, it is often kept hidden and family members may want to speed the treatment process as the woman is needed at home to take care of the family. Women who have relapsed and may need treatment again may never seek it because of the humiliation they faced the first time.
To help women overcome their substance abuse problems in the long term, she needs the absolute support of her family and friends. If she is a young woman, she needs support from her parents, who with the help of a counsellor can understand the root cause of the addiction. Young women, especially teenagers need to be made aware of the long-term effects of substance abuse on menstrual and fertility problems.
Women who are married need the support of their husbands and in-laws. If the woman undergoing treatment is a mother, then she should be assured that her children are being taken care of. Every effort should be made to allow the woman the time to heal. Even post-treatment, she should not be thrust into the world of chores and responsibilities. In fact, this is the time for the entire family to come together and create a system that works for everyone and no one person is overburdened with things to do.
In the end, women need the same treatment as men like detoxification, assessment of physical and psychiatric disorders and knowledge building and education. However, family and friends need to go a step further and be as supportive, if not more, towards the woman seeking help. She should not be shamed and humiliated for her substance abuse problems, and her efforts to get better shouldn’t be undermined. There needs to be more scientific studies and research on substance problems in women so that there can be better treatments suited to their physiology which will also mean better recovery.
Let’s hope that the next time that we hear about an acquaintance or a friend who is a woman with an addiction problem, we won’t be shocked or disgusted, but we will be supportive and understanding.
Chatterjee, G. (2019, July) Drug abuse and the Indian Woman. It’s an epidemic. Woman’s Era.
Ambekar A, Agrawal A, Rao R, Mishra AK, Khandelwal SK, Chadda RK on behalf of the group of investigators for the National Survey on Extent and Pattern of Substance Use in India (2019). Magnitude of Substance Use in India. New Delhi: Ministry of Social Justice and Empowerment, Government of India
Kumar, R. (2018, November 9) India’s female addicts battle gender bias, social stigma, poverty. Aljazeera.
Murthy, P., & Chand, P. Substance use disorder in Women. NIMHANS
Sex and gender differences in substance use
Cormier, R., & Dell, C., & Poole, N. (2004, August 25)
Women and Substance Abuse Problems