White Women: Addicted, Incarcerated and Overlooked

As the country battles drug epidemics, mass incarceration and nationwide addiction, the people being increasingly affected by these issues are being left behind in the discussion. They are white women.

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Across the country, middle-aged white women are dying at higher rates, particularly from drug overdoses, suicides and excessive drinking. Alcohol-related deaths for white women have increased 130 percent in the last two decades, far surpassing alcohol-related deaths for Hispanic women, which climbed 27 percent, or for black women, which decreased 12 percent, according to the Centers for Disease Control and Prevention.

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Further, white women are increasingly binge drinking, suffering from addiction, being incarcerated and committing suicide. A number of combining factors make this population unique when addressing these issues, especially their status, stereotypes and cultural expectations.

When looking at who is being affected by the ongoing opioid epidemic, it’s disproportionately white women. One factor is their access to medications. They are more likely than women of other races to be prescribed opiate medications, according to the Washington Post’s analysis of middle-aged participants in a National Health and Nutrition Examination Survey.

“Look at the population that has the access to the health care that got the drugs into the houses and who was that population and that was probably the white population at large,” Lowe said. “Who are you more suspicious of as a provider? Is it a housewife or a black man? Racism leads to thinking that white women are safe. It’s seen as they don’t have problems.”

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Prison and parenthood

Physiologically, women will develop addictions much faster than men, said Katina Varzos, a psychiatric nurse practitioner at Turnbridge who is dually certified in women’s health adult psychiatric-mental health. Moreover, women are more apt to be introduced to a substance from an intimate partner than men and rapidly escalate the severity of their use.

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Misdiagnosed or undiagnosed substance abuse has led to white women having the highest rates of binge drinking, being disproportionately affected by the opioid epidemic, becoming the fastest growing prison population and committing suicide.

Since 1980, the female prison population has increased 700 percent, according to the Sentencing Project. While black and Hispanic women are still imprisoned at a higher rates than white women, the trend is reversing.

The rate of imprisonment for black women has declined 47 percent between 2000 and 2014, while the rate of imprisonment for Hispanic women rose 7 percent and imprisonment for white women rose 56 percent and continues its climb.

The crimes for which women are sentenced most are property and drug crimes; combined, they make up 42 percent of sentences for women. In 1986, 12 percent of women in state prisons were incarcerated for a drug offense, but by 2014, it was at 24 percent. Often, property crimes are connected with drug use and committed to sustain an addiction, Lucibello said.

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Diagnosis and treatment

Women tend to be under-diagnosed with substance abuse disorders because they don’t typically present symptoms as their primary issues during doctor visits, Varzos said. More often than not they’re presenting with psycho-social and mental health issues and the substance abuse is never discovered. Even when women do show signs of drug or alcohol abuse, parents and doctors often focus on other mental health issues instead.

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In contrast, men more often disclose a substance use disorder or more readily admit to one because the impact on their lives tends to be much less, Varzos said. It could explain why one-third of people suffering from addiction are women but only make up one in five people in treatment, she said.

“Addiction treatment wasn’t designed for (women) in the first place,” Lowe said. “We haven’t been thinking about them as a special population needing special care or a unique style of treatment in terms of their substance abuse until the last decade, so (women) are going to be overlooked and not seen as having problems.”

The disparity may be because women often need to overcome social barriers and stigma just to get into treatment for addiction. The identity of a woman and her role in society is the first one.

“The societal cost of being a female addict is great,” Varzos said, adding, women who are suffering from addiction have a lot more to lose socially than men.

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Stereotypes and stigma

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Drugs are not the only substance abuse women deal with, though. A vast number of white women drink excessively, to a point that is considered alcoholism. But culture doesn’t call it that.

Excessive drinking, or “binge” drinking, for women is defined as having four or more drinks in two hours. One-third of white women reported binge drinking, according to the National Health Interview Survey. The rate has gone up 40 percent in the last 20 years while it has remained flat for other demographics.

Binge drinking is a form of addiction that’s not taken seriously as a harmful behavior, Santangelo said. Culture even promotes it.

Images of women drinking to excess have been normalized and the cultural climate is one in which it’s funny when women drink heavily. {snip}

Social media memes use women drinking as a punch line for humor, marketing wine a cure-all for women, stress relief and lifeline.

Binge drinking in college, especially, is not only normalized, but expected of young women, so the issue doesn’t get noticed until years later during middle age, Lowe said.

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Women are affected differently physiologically by alcohol as it takes fewer drinks for women to get intoxicated than it does for men. Their blood-alcohol levels climb faster and stay elevated longer. But some women try to “keep up” with men drinking because they want to be seen as cool or because it’s funny when a woman gets drunk, Santangelo said.

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