Substance
abuse has increased in the past three decades in the United States, but
author Priscilla Coleman, a researcher and professor of Human Development
and Family Studies at Bowling Green State University, notes that
"awareness of female substance abuse as an emerging public health concern
is of relatively recent origin."
According
to the article, rates of alcohol dependence among women are now comparable
to that of men, and "drug dependence
has increased steadily among girls and women in recent years and for some
drugs, the increases have exceeded the increases among boys and men."
Although
smoking rates among both sexes have decreased, the decline in smoking
rates among women tapered off in the 1990's, while it increased among
adolescent girls during that same period.
Studies of
substance abuse among women show that they are more inclined than men to
begin abusing drugs, alcohol, and tobacco as a way of coping with
traumatic life events, including physical or sexual abuse, illness, and
family problems.
Women who
abuse substances are also less likely than men to seek treatment and more
likely to be involved in an abusive relationship; to suffer
alcohol-related diseases or death; to struggle with feelings of guilt,
self-blame, and low self-esteem over their substance abuse; and to
experience more depression, anxiety, and symptoms of post-traumatic stress
disorder (PTSD).
"It is
clear that women who abuse substances are more likely to have suffered
from multiple past and current challenging life situations and there is
emerging evidence that women use substances as a means of coping more
frequently than men," Coleman wrote.
Coleman
noted that several recent studies have suggested an association between
having an abortion and using or abusing drugs, alcohol and tobacco.
In
a number of studies have shown women who have abortions are two to five
times more likely to be at risk of subsequent substance use compared to
women who have not had abortions.
Other
studies have found that women with a history of abortion are subsequently
at increased risk for depression, generalized anxiety disorder, suicidal
tendencies, poor bonding with and parenting of later children, and
psychiatric hospitalization.
Dr. David
Reardon, a post-abortion expert and director of the Elliot Institute
research organization, said that there are at least 21 published studies
have found a link between induced abortion and substance abuse.
Reardon
served as lead author on several studies on abortion and substance abuse
-- including a 2004 study that was the first to compare substance abuse
rates among women with unintended first pregnancies -- and also
collaborated with Coleman on two studies finding that women who had
undergone an abortion were more likely to engage in substance abuse during
a subsequent pregnancy.
"Many
women who have experienced abortion have unresolved emotional issues
related to their abortion," he said.
"Substance
abuse can provide an easily accessible way to self-medicate their pain and
numb their emotions. Unfortunately, however, substance abuse only leads to
further difficulties -- both in terms of their own well-being and problems
in their families and other relationships -- and can lead to a further
breakdown in mental health."
Coleman
noted that risk factors may be shared both by women who abort and those
who engage in substance abuse and said that researchers need to focus on
identifying which variables are more likely to lead a woman to have an
abortion. She called for more qualitative, interview-based research with
both women and others in their lives who may have been involved in the
abortion decision.
"Due to a
variety of political, social, and ideological factors, the topic of
induced abortion does not seem to have received the focused research
attention it deserves," she wrote.
"In the
interest of the millions of women who annually undergo one of the most
common surgical procedures available in the United States and elsewhere in
the world, more substantive, well-controlled research should be a
priority."
Both
Coleman and Reardon encourage greater awareness of link between abortion
and substance abuse among abortion providers, health care professionals,
substance abuse counselors, and others who work with women. They believe
substance abuse counselors should ask women seeking treatment about their
reproductive history in order to "give women permission" to talk about
unresolved abortion grief.
Coleman
said that while many mental health professionals are open about
encouraging women who have suffered miscarriage to express their emotions
as a way to foster healing, abortion is often not treated the same way.
This failure to address abortion may be due to either fear of probing a
sensitive personal issue or to an assumption that women won't experience
any emotional conflicts over a medical procedure they requested.
"If
treatment for substance abuse or other mental health problems fails to
address underlying factors such as abortion, the treatment may be
ineffective and women are likely to continue to turn to substances such as
drugs or alcohol to cope," Reardon said.
"If mental
health professionals are truly serious about addressing this public health
concern, they need to gain a greater understanding of this issue and
provide women with the resources to resolve their past abortions."
Citation:
PK
Coleman, "Induced Abortion and Increased Risk of Substance Abuse: A Review
of the Evidence," Current Women's Health Reviews, 1:21-34 (2005).
