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Publications
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Gender does matter: Coalescing on women and substance use
CrossCurrents
By Nancy Poole
The past decade has witnessed increased interest in and research on how gender affects all aspects of substance use, addiction
and women’s health and women’s needs and access to resources and treatment. Health Canada has supported the development of
three best practice documents with a focus on women’s substance use. The Canadian Institutes for Health Research have funded
impart, a research training program on gender, women and addictions. The Canadian Centre on Substance Abuse (CCSA), the Alberta
Alcohol and Drug Abuse Commission and the Centre for Addiction and Mental Health in Toronto have published on women and substance
use. And much has been learned about the interconnection of substance use with other issues experienced by girls and women,
such as trauma and mothering.
But a gap remains between what we know and what we do. Program providers and decision makers are often unaware of new evidence
or are not provided with meaningful opportunities to engage with new knowledge in a practice-oriented environment.
New technologies have the potential to engage a wide range of participants in collaborative knowledge exchange. For example,
videoconferencing, list-servs and other virtual methods have been used by the British Columbia Centre of Excellence for Women’s
Health (BCCEWH) to bring together service providers, policy makers, researchers and community-based activists on women’s substance
use issues to discuss the application of research to their practice.
In a new Health Canada–funded project, Coalescing on Women’s Substance Use Issues: Linking Research, Practice and Policy,
researchers at BCCEWH are using web-based technology to support national communities of practice on key women’s substance
use issues, where the resistance to integrating what is known has been particularly strong. The project is co-sponsored by
the CCSA and the Canadian Women’s Health Network. Participants come together in web meetings, discussions and workspaces to
review current literature, share wisdom and prepare syntheses of what we know and how to apply this knowledge in policy, practice
and further research.
Six virtual communities are being created around key issues in girls’ and women’s substance use, where there is a pressing
(and often longstanding) need to bring knowledge to practice and policy:
- Substance use support by anti-violence organizations. The goal is to help violence and sexual assault centres and related
mental health services integrate knowledge on substance use into their settings. Many women identify substance use as a way
to cope with gender-based abuse and trauma. Alcohol problems have been found to be up to 15 times higher among women survivors
of partner violence than in the general population. Yet service providers and policy makers have not always acted on these
connections; as a result, women have not received the support they need. Services with a primary mandate for domestic violence
and sexual assault have often not served women with substance use problems, adding to women’s vulnerability.
- Women-centred approaches to fetal alcohol spectrum disorder (FASD) prevention. Substance-using women who are pregnant or mothering
experience multiple barriers to accessing supports to improve their health and reduce the risk of FASD in their children.
These barriers are linked to broad determinants of health and require collaborative action that includes women, service providers,
policy makers and researchers. Too often we have placed the burden of prevention solely on the shoulders of pregnant women;
yet research and women’s stories indicate the importance of a multi-level, multi-sectoral response. This community presented
initial findings on key barriers and supports for women who use alcohol pre-, during and post-pregnancy to policy makers aligned
with the Canadian Northwest FASD Partnership at the recent 2nd International FASD conference.
- Mothering and substance use. The goal is to help child welfare agencies and substance use treatment services work collaboratively
to link and harmonize support to mothers and their children. This is a key dilemma preventing the advancement of an informed,
respectful and effective approach to treating women and supporting mothers who use substances and face other health, financial
and social challenges. This community is examining a range of pragmatic and innovative options for support of the mother-child
unit developed in various jurisdictions in Canada and internationally.
- Women-centred harm reduction. Harm reduction services need to attend to the specific needs of women and integrate gender-based
analysis into drug policy and harm reduction frameworks. Canada is a leader in adopting harm reduction policy frameworks and
service approaches, yet a gender lens is often lacking. How might we apply what we know about the differing patterns, health
impacts, pathways to problematic substance use and related experiences of mothering and violence that affect women to the
design of harm reduction service provision and policy?
- Violence/trauma in addiction treatment settings. The goal is to help addiction services integrate work on trauma, provide
information on the connections with addiction recovery and offer individual and group programming. Women who have sought help
for trauma and mental health issues report misdiagnosis, medication overprescription and retraumatization through encounters
with health care providers who are not sensitive to their needs. In Canada and in the Women, Co-Occurring Disorders and Violence
Study funded by the U.S. Substance Abuse and Mental Health Services Administration, models for the delivery of integrated
support for women on substance use, mental health and trauma-related issues will be discussed.
- Tobacco treatment for women. This community will examine integrating treatment of tobacco addiction into treatment of other
addictions, or the use of stimulants such as ecstasy and methamphetamine.
Nancy Poole is a research associate with the BCCEWH. She is co-editor of the newly released book Highs and Lows: Canadian Perspectives on Women and Substance Use, published this spring by the Centre for Addiction and Mental Health in Toronto.
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