Consumi di sostanze e dipendenze nel genere femminile Percorso

A.S.L. TO2
Azienda Sanitaria Locale
Dip. Patologia delle Dipendenze
“C. Olievenstein”
Consumi di sostanze e
dipendenze
nel genere femminile
Percorso conoscitivo e preventivo nella
Regione Piemonte
Newsletter n° 2, Aprile 2015
L’elaborazione e l’invio della seguente newsletter fa parte del piano di disseminazione della ricerca intervento
‘Consumo e comportamenti di dipendenza con e senza uso di sostanze nel genere femminile: progetto per un
percorso conoscitivo nella Regione Piemonte’. La newsletter intende fornire notizie e informazioni su alcune
recenti e significative iniziative (progetti, programmi, studi, ricerche, ecc.) realizzate a livello regionale,
nazionale e internazionale sul tema dei consumi di sostanze psicotrope e delle dipendenze patologiche nelle
donne. Gli invii vengono effettuati sulla base degli indirizzi di istituzioni, organismi e operatori coinvolti nelle
fasi di realizzazione della ricerca e di ulteriori soggetti individuati rispetto al potenziale interesse per
l’argomento. È possibile naturalmente rifiutare l’invio della newsletter o, per chi non è iscritto, essere inserito
tra i destinatari o inviare segnalazioni e commenti. A tal fine è possibile contattare lo staff del Dipartimento di
Patologia delle Dipendenze ‘C. Olievenstein’ dell’ASL TO2 all’indirizzo [email protected]
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Consumi di sostanze e dipendenze nel genere femminile – Newsletter Aprile 2015
IL PROGETTO
“Consumo e comportamenti di dipendenza con e senza uso di sostanze nel genere
femminile: progetto per un percorso conoscitivo nella Regione Piemonte”
Come previsto dal ‘Piano di disseminazione’ del progetto nel primo trimestre 2015 sono stati realizzati quattro
seminari finalizzati alla presentazione dei risultati della ricerca, alla programmazione del lavoro di ulteriore
diffusione territoriale e alla raccolta di indicazioni operative. I seminari sono stati realizzati a::
Cuneo, 19/02/2015 – 15 partecipanti: operatori del SerT.
Biella, 25/02/2015 – 23 presenti: operatori del SerT, del Drop in e degli Enti Accreditati.
Novara, 26/02/2015 – 17 presenti: operatori del SerT, della Neuropsichiatria Infantile, del Comune di Novara,
operatori delle ASL VC e VCO, operatori del Consultorio.
Alessandria, 11/03/2015 – 30 presenti: operatori del SerT, dei Centri antiviolenza, della Caritas, dei Servizi
Sociali, dei Consultori, del DSM e degli Enti Accreditati.
SINTESI dei SEMINARI. Per ciascun seminario è stato prodotto un verbale raccogliendo descrizioni e
indicazioni specifiche per ogni territorio. Di seguito una sintesi preliminare di quanto emerso.
Criticità emerse
Sensibile abbassamento dell’età di accesso che pone gli operatori di fronte alla necessità di ragionare su
possibili strategie alternative di aggancio e trattamento;;
Le adolescenti femmine: come raggiungerle? Cosa offrire? Per ora si interviene solo nelle situazioni già
critiche.
Bisogno di confronto e circolarità sui protocolli e sulle esperienze cliniche;;
Differenze tra la provincia e l’area metropolitana: i servizi sono gli stessi ma sono offerti in modalità
diverse;;
Culturalmente i servizi sono ancora lontani dal pensare a una medicina di genere;;
Un problema della rete è la forte identificazione con il soggetto curato: difficile creare una posizione terza
che tenga in considerazione tutto il sistema con obiettivi e bisogni diversi e a volte contrastanti
Marcata difficoltà di conoscere adeguatamente le risorse già presenti sul territorio;;
Strategie individuate
Formazione per gli operatori dei SerT per riflettere su alcuni spunti di trattamento: l’obiettivo è alzare la
soglia di attenzione sulle specificità femminili;;
Effettuare una mappatura puntuale di risorse e iniziative gender oriented presenti sul territorio;;
Incrementare la sensibilità degli operatori e rendere più efficace e funzionale l’integrazione tra Servizi
specialistici e non specialistici;;
Pensare a specifici progetti di ricerca, che consentano sia di accrescere la conoscenza delle
caratteristiche del fenomeno nelle sue dimensioni locali, sia di favorire l’emersione dell’eventuale
sommerso
Consumi di sostanze e dipendenze nel genere femminile – Newsletter Aprile 2015
Prossime tappe del “piano di diffusione”
Costruzione e sperimentazione di uno strumento di rilevazione delle priorità individuate dagli operatori, delle
criticità maggiori esistenti e delle eventuali proposte e strategie di azione relative agli ambiti della
sensibilizzazione, prevenzione, emersione del fenomeno e gestione delle situazioni specifiche.
Si ricorda che in una specifica sezione del sito della Commissione Regionale per le Pari Opportunità è
disponibile il testo integrale della ricerca e tutti i materiali finora prodotti nell’ambito del progetto:
http://www.regione.piemonte.it/pariopportunita/cms/index.php/commissione-­pari-­opportunita/454-­
ricerca-­qconsumo-­e-­comportamenti-­da-­dipendenza-­con-­e-­senza-­uso-­di-­sostanze-­nel-­genere-­
femminile-­progetto-­per-­un-­percorso-­conoscitivo-­nella-­regione-­piemonte
ALTRI PROGETTI, INIZIATIVE E INCONTRI NAZIONALI
Essere donna nelle dipendenze
Reggio Emilia 18 Marzo 2015
La dipendenza affettiva: quando l’amore fa male”
Fidenza (PR) – 16 Aprile 2015
http://www.ausl.pr.it/comunicazione_stampa/archivio_3/dipendenza-­affettiva-­parla-­convegno-­aprile.aspx
Dipendenze al Femminile
Il numero di Dicembre 2014 di MDD – Medicina delle Dipendenze (Italian Journal of Addictions) è dedicato alle
dipendenze l femminile con una serie di articoli sul tema del genere e del consumo di sostanze:
http://www.medicinadelledipendenze.it/rivista/tutti-­i-­numeri/dipendenze-­al-­femminile.html
PROGETTI, INIZIATIVE E RICERCHE INTERNAZIONALI
Progetto “DAD-­Net” Donne Alcol Droga Network
http://www.dadnet.it/index.php/in-­primo-­piano
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Consumi di sostanze e dipendenze nel genere femminile – Newsletter Aprile 2015
NOTIZIE ON LINE
ITALIA
La dipendenza dal fumo varia fra uomini e donne (13/01/2015)
http://www.chedonna.it/2015/01/13/la-­dipendenza-­dal-­fumo-­varia-­fra-­uomini-­e-­donne/
Uno sviluppo diverso per il cervello di maschi e femmine (04/02/2015)
http://www.lescienze.it/news/2015/02/04/news/sviluppo_fetale_cervello_maschi_femmine_metilazione_
geni-­2470456/
Dipendenza affettiva? Fa male all'amore (12/02/2015)
http://www.tgcom24.mediaset.it/donne/amore/dipendenza-­affettiva-­fa-­male-­all-­amore_2093329-­
201502a.shtml
Dipendenze e comportamenti, le differenze tra uomo e donna (18/02/2015)
http://www.cronacatorino.it/scienze-­salute/53427-­dipendenze-­e-­comportamenti-­le-­differenze-­tra-­uomo-­
e-­donna.html
La storia di Carla, giovane mamma uscita dal tunnel della droga (24/02/2015)
http://www.liberta.it/2015/02/24/la-­storia-­di-­carla-­giovane-­mamma-­uscita-­dal-­tunnel-­della-­droga/
I malati da gioco si moltiplicano, tra loro anche donne (26/02/2015)
http://www.primonumero.it/attualita/primopiano/articolo.php?id=18773
Dipendenze: sempre più donne tra le vittime (26/02/2015)
http://www.ilfriuli.it/articolo/Cronaca/Dipendenze-­points-­
_sempre_pi%C3%B9_donne_tra_le_vittime/2/140534
I rischi della marijuana durante la gravidanza (27/02/2015)
http://www.estense.com/?p=442525
Le donne italiane amano la birra (27/02/2015)
http://www.teatronaturale.it/tracce/cultura/20696-­le-­donne-­italiano-­amano-­la-­birra-­purche-­chiara-­e-­dai-­
sapori-­leggeri-­e-­delicati.htm
Così le donne possono liberarsi dai meccanismi della violenza (01/03/2015)
http://ilpiccolo.gelocal.it/tempo-­libero/2015/03/01/news/cosi-­le-­donne-­possono-­liberarsi-­dai-­
meccanismi-­della-­violenza-­1.10962538
Si inaugura il "Centro per la salute della donna" a Cuneo (04/03/2015)
http://www.targatocn.it/2015/03/04/leggi-­notizia/argomenti/salute-­e-­benessere/articolo/si-­inaugura-­il-­
centro-­per-­la-­salute-­della-­donna-­dellazienda-­ospedaliera-­s-­croce-­e-­carle.html
Il bugiardino rosa, nuova frontiera del diritto alla salute delle donne (05/03/2015)
http://www.redattoresociale.it/Notiziario/Articolo/479578/Il-­bugiardino-­rosa-­nuova-­frontiera-­del-­diritto-­
alla-­salute-­delle-­donne
Consumi di sostanze e dipendenze nel genere femminile – Newsletter Aprile 2015
Donne alcoliste, sempre di più. Il gap che non volevamo colmare (05/03/2015)
http://www.iodonna.it/attualita/primo-­piano/2015/donne-­alcol-­articolo-­12-­50290318404.shtml
8 marzo, da Oms dieci sfide per la salute donne nel mondo (06/03/2015)
http://www.ansa.it/saluteebenessere/notizie/rubriche/salute/2015/03/06/8-­marzo-­oms-­dieci-­sfide-­per-­la-­
salute-­donne-­nel-­mondo_1ce70033-­fd8d-­435b-­838e-­7a4646dd9e6e.html
Salute, donne tre volte più depresse degli uomini (06/03/2015)
http://www.italiachiamaitalia.it/articoli/detalles/26410//Politica/salute-­donne-­tre-­volte-­pi%C3%B9-­
depresse-­degli-­uomini.html
Lorenzin: "Sogno un ospedale della donna, con assistenza e cure di genere" (06/03/2015)
http://www.adnkronos.com/salute/sanita/2015/03/06/marzo-­lorenzin-­sogno-­ospedale-­della-­donna-­con-­
assistenza-­cure-­genere_kRLajhFiqDXGnlGB3hvR0L.html
Le donne restano indietro. Il rapporto dell'UN Women (07/03/2015)
http://www.americaoggi.info/2015/03/07/43743-­le-­donne-­restano-­indietro-­il-­rapporto-­dellun-­women
Salute delle donne: il piano d’azione dell’Oms (07/03/2015)
http://www.corriere.it/salute/15_marzo_07/salute-­donne-­piano-­d-­azione-­dell-­oms-­50d0068e-­c4b8-­11e4-­
ab5e-­6baf131e67e8.shtml
Eurispes: donne, il termometro della crisi (07/03/2015)
http://www.ilvelino.it/it/article/2015/03/07/8-­marzo-­eurispes-­donne-­il-­termometro-­della-­crisi/a7c725aa-­
b87c-­4e6d-­a84b-­1fbb0f64717e/
Salute, in Italia donne più indifese di uomini (07/03/2015)
http://www.repubblica.it/salute/2015/03/07/news/donne_lo_stato_di_salute_in_italia_rapporto_pangea_
all_onu-­108984118/
Donne "analcoliche" la vita si allunga e cala il rischio tumori (07/03/2015)
http://genova.repubblica.it/cronaca/2015/03/08/news/donne_analcoliche_la_vita_si_allunga_e_cala_il_r
ischio_tumori-­109032894/
Una donna su quattro dorme poco o male, specie dopo i 45 anni (07/03/2015)
http://ilpiccolo.gelocal.it/italia-­mondo/2015/03/06/news/una-­donna-­su-­quattro-­dorme-­poco-­o-­male-­
specie-­dopo-­i-­45-­anni-­1.10993100?id=2.2514&fsp=2.2515
Sanità, un blog sulla salute della donna (08/03/2015)
http://www.bussolasanita.it/schede.cfm?id=1377&sanita_un_blog_sulla_salute_della_donna
Le confessioni della porno-­addicted (10/03/2015)
http://www.ilgiornale.it/news/cronache/confessioni-­porno-­addicted-­mi-­masturbavo-­5-­ore-­giorno-­
1103513.html
La salute delle donne e la medicina di genere (11/03/2015)
http://www.pupia.tv/2015/03/caserta-­provincia/salute-­delle-­donne-­medicina-­genere/286158
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Consumi di sostanze e dipendenze nel genere femminile – Newsletter Aprile 2015
Depressione pre e post-­parto: nasce il primo gruppo di mutuo aiuto on-­line (12/03/2015)
http://www.romagnamamma.it/2015/03/depressione-­pre-­e-­post-­parto-­nasce-­il-­primo-­gruppo-­di-­mutuo-­
aiuto-­on-­line/
Oms: «Liberi dal fumo entro il 2040» (13/03/2015)
http://www.corriere.it/salute/cardiologia/15_marzo_11/oms-­liberi-­fumo-­entro-­2040-­9b862814-­c7f8-­11e4-­
a75d-­5ec6ab11448e.shtml
Buoni shopping come incentivo alle donne incinte per smettere di fumare (13/03/2015)
http://www.corriere.it/salute/sportello_cancro/15_marzo_09/buoni-­shopping-­come-­incentivo-­donne-­
incinte-­smettere-­fumare-­8a439544-­c665-­11e4-­80fc-­ae05ebe65fb1.shtml
Le pillole della felicità. dal Miltown al Prozac (13/03/2015)
http://www.stateofmind.it/2015/03/pillole-­della-­felicita-­psicofarmacologia/
Donne alcoliste: pratiche di trattamento (13 marzo 2015)
http://parma.repubblica.it/agenda/day/2015/03/13/0/donne-­alcoliste-­pratiche-­di-­
trattamento/2942509?time=2015-­03-­13T080000
Donne lunatiche e incostanti? È una risorsa (23/03/2015)
http://www.huffingtonpost.it/2015/03/23/donne-­lunatiche-­incostanti_n_6924388.html
ESTERO
Special populations in addiction psychiatry: the elderly and women (05/12/2014)
http://www.psychiatrictimes.com/AAAP2014/special-­populations-­addiction-­psychiatry-­elderly-­and-­
women
Cigarette Addiction Affects Men, Women's Brains Differently;; Brain Scans Reveal Need For Tailored
Treatment (28/12/2014)
http://www.medicaldaily.com/cigarette-­addiction-­affects-­men-­womens-­brains-­differently-­brain-­scans-­
reveal-­need-­315628
Plans underway to open addiction center for women (11/01/2015)
http://www.bdtonline.com/news/plans-­underway-­to-­open-­addiction-­center-­for-­women/article_274f0c88-­
9943-­11e4-­b08c-­9f6fa439fcf4.html
It’s Harder for Women to Quit Smoking than It Is for Men (22/01/2015)
http://blogs.psychcentral.com/science-­addiction/2015/01/its-­harder-­for-­women-­to-­quit-­smoking-­than-­it-­
is-­for-­men/
Brain basis for female addiction (29/01/2015)
http://www.hcplive.com/news/Brain-­Basis-­for-­Female-­Addiction
Drug addiction among women shocking (03/02/2015)
http://www.hindustantimes.com/chandigarh/drug-­addiction-­among-­women-­shocking-­
manpreet/article1-­1313274.aspx
Consumi di sostanze e dipendenze nel genere femminile – Newsletter Aprile 2015
AIDS Council: Female drug users left behind in health, social support (05/03/2015)
http://www.thestar.com.my/News/Nation/2015/03/05/women-­drug-­users-­not-­given-­equal-­focus-­as-­men-­
says-­aids-­council/
Women winning the battle with food addiction (17/02/2015)
http://www.news4jax.com/news/women-­winning-­the-­battle-­with-­food-­addiction/31299058
Jailing criminals is a sign of failure, says Clegg as he aims to cut the number of women and drug
users behind bars (23/02/2015)
http://www.dailymail.co.uk/news/article-­2964578/Jailing-­criminals-­sign-­failure-­says-­Clegg-­aims-­cut-­
number-­women-­drug-­users-­people-­mental-­illness-­bars.html
Why alcohol is killing our women and children (24/02/2015)
http://www.thechronicle.com.au/news/why-­alcohol-­killing-­our-­women-­and-­children/2554049/
7-­country study shows triple-­drug combination superior for preventing infant HIV infection
(25/02/2015)
http://www.aidsmap.com/7-­country-­study-­shows-­triple-­drug-­combination-­superior-­for-­preventing-­
infant-­HIV-­infection/page/2948262/
New campaign warns pregnant women not to drink alcohol (26/02/2015)
http://www.runcornandwidnesworld.co.uk/news/11814564.New_campaign_warns_pregnant_women_n
ot_to_drink_alcohol/
Local program helps mothers recover from addiction (27/02/2015)
http://www.kens5.com/story/news/2015/02/27/local-­program-­helps-­mothers-­recover-­from-­
addiction/24146593/
Ohio prisons host 4,000 women, mostly with charges stemming from drug dependency (27/02/2015)
http://www.newsnet5.com/news/local-­news/cleveland-­metro/ohio-­prisons-­host-­4000-­women-­mostly-­
with-­charges-­stemming-­from-­drug-­dependancy
Sexual addiction is an illness (04/03/2015)
http://www.mmegi.bw/index.php?aid=49640
Women with alcoholic partners may benefit from Internet-­based interactive support program
(04/03/2015)
http://www.news-­medical.net/news/20150304/Women-­with-­alcoholic-­partners-­may-­benefit-­from-­
Internet-­based-­interactive-­support-­program.aspx
Painkiller-­Addicted babies a growing U.S. concern (06/03/2015)
http://www.webmd.com/baby/news/20150306/painkiller-­addicted-­babies-­a-­growing-­us-­concern-­
especially-­in-­fla
Alcohol race taking its toll on females (06/03/2015)
http://www.richmond-­news.com/news/friday-­feature/alcohol-­race-­taking-­its-­toll-­on-­females-­1.1784650
Anti-­Drug Coalition to host “Helping Women Recover” (08/03/2015)
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Consumi di sostanze e dipendenze nel genere femminile – Newsletter Aprile 2015
http://www.jacksonsun.com/story/news/local/2015/03/08/anti-­drug-­coalition-­host-­helping-­women-­
recover/24630719/
CDC Investigates Rise in Opioid-­Addicted Newborns (09/03/2015)
http://www.medscape.com/viewarticle/841081
Research points alcohol as major gender-­based violence cause (09/03/2015)
http://dailynews.co.tz/index.php/local-­news/42340-­research-­points-­alcohol-­as-­major-­gbv-­cause
Differences in addiction patterns between the sexes (10/03/2015)
http://brainblogger.com/2015/03/10/differences-­in-­addiction-­patterns-­between-­the-­sexes/
Dangers Of Alcohol In Pregnancy (10/03/2015)
http://leadership.ng/style/416635/dangers-­of-­alcohol-­in-­pregnancy
Addiction recovery seminar focuses on gender, trauma (12/03/2015)
http://www.jacksonsun.com/story/news/2015/03/12/addiction-­recovery-­seminar-­focuses-­gender-­
trauma/70236842/
Seminar focuses on addiction, abuse recovery for women (12/03/2015)
http://www.wbbjtv.com/news/local/Seminar-­focuses-­on-­addiction-­abuse-­recovery-­for-­women-­
296135951.html
Here's The Real Difference Between How Much Men & Women Drink (12/03/2015)
http://www.refinery29.com/2015/03/83717/when-­we-­drink-­the-­most
Are you addicted to food? Study asks if binge eating is an addiction (13/03/2015)
http://globalnews.ca/news/1882294/are-­you-­addicted-­to-­food-­study-­asks-­if-­binge-­eating-­is-­an-­
addiction/
N.C. Senate bill would criminalize women for using drugs during pregnancy (18/03/2015)
http://www.indyweek.com/news/archives/2015/03/18/nc-­senate-­bill-­would-­criminalize-­women-­for-­using-­
drugs-­during-­pregnancy
A nation of shopaholics! One in four British women are addicted to shopping and admit they lie about
their purchases afterwards (18/03/2015)
http://www.dailymail.co.uk/femail/article-­3000512/A-­nation-­shopaholics-­One-­four-­British-­women-­
addicted-­shopping-­admit-­lie-­purchases-­afterwards.html
Should a bar refuse pregnant women alcohol? (19/03/2015)
http://www.nzherald.co.nz/lifestyle/news/article.cfm?c_id=6&objectid=11419745
Second chances for drug-­addicted moms in Delaware (20/03/2015)
http://www.newsworks.org/index.php/local/delaware/79705-­second-­chances-­for-­drug-­addicted-­moms-­
in-­delaware-­video
More than 1,700 born in Mass. with drug issues in 2014 (20/03/2015)
http://www.bostonglobe.com/metro/2015/03/19/with-­scourge-­opiates-­more-­babies-­mass-­born-­with-­
addiction/bz75a0bf5zmxDogZFuAuQO/story.html#
Consumi di sostanze e dipendenze nel genere femminile – Newsletter Aprile 2015
Should Pregnant Addicts Go to Jail? (21/03/2015)
http://reason.com/archives/2015/03/22/should-­pregnant-­addicts-­go-­to
Alcohol and Women’s Health (23/03/2015)
http://www.divine.ca/en/health/articles/c_11_i_5653/alcohol-­and-­womens-­health-­1.html
‘Pretty Woman’ normalizes something that destroys lives (23/03/2015)
http://www.bostonglobe.com/opinion/2015/03/23/pretty-­woman-­normalizes-­something-­that-­destroys-­
lives/0IOwKGZd89JsgBEnaY0RDP/story.html
Young people cling to gender stereotypes that could lead to domestic violence (24/03/2015)
http://www.canberratimes.com.au/act-­news/young-­people-­cling-­to-­gender-­stereotypes-­that-­could-­lead-­
to-­domestic-­violence-­report-­20150324-­1m6h1i.html
STUDI E RICERCHE
(Aggiornamento della bibliografia N.2: Gennaio-­Marzo 2015)
Missing data in substance abuse research? Researchers' reporting practices of sexual
orientation and gender identity
Flentje A, Bacca CL, Cochran BN
Drug and alcohol dependence. 2015 Feb;; 147: 280-­4
Abstract
Lesbian, gay, bisexual, and transgender individuals are at higher risk for substance use and substance use
disorders than heterosexual individuals and are more likely to seek substance use treatment, yet sexual
orientation and gender identity are frequently not reported in the research literature. The purpose of this study
was to identify if sexual orientation and gender identity are being reported in the recent substance use
literature, and if this has changed over time.
The PsycINFO and PubMed databases were searched for articles released in 2007 and 2012 using the term
"substance abuse" and 200 articles were randomly selected from each time period and database. Articles
were coded for the presence or absence of sexual orientation and gender identity information.
Participants' sexual orientation was reported in 3.0% and 4.9% of the 2007 and 2.3% and 6.5% of the 2012
sample, in PsycINFO and PubMed sample articles, respectively, while non-­binary gender identity was reported
in 0% and 1.0% of the 2007 sample and 2.3% and 1.9% of the 2012 PsycINFO and PubMed sample articles.
There were no differences in rates of reporting over time.
Sexual orientation and gender identity are rarely reported in the substance abuse literature, and there has not
been a change in reporting practices between 2007 and 2012. Recommendations for future investigators in
reporting sexual orientation and gender identity are included.
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Consumi di sostanze e dipendenze nel genere femminile – Newsletter Aprile 2015
Gender Differences in Treatment Retention Among Individuals with Co-­Occurring
Substance Abuse and Mental Health Disorders.
Choi S, Adams SM, Morse SA, MacMaster S
Substance use & misuse, 2015 Jan.
Abstract
Objectives: The purpose of this study is to examine gender differences on treatment retention for individuals
with co-­occurring substance abuse and mental health disorders who participate in private residential
treatment. Methods: The participants were 1,317 individuals (539 women and 778 men) with co-­occurring
substance abuse and mental health disorders receiving treatment at three private residential treatment
centers. Bivariate analyses, life tables, and Cox regression (survival analyses) were utilized to examine gender
effects on treatment retention, and identify factors that predict treatment retention for men and women.
Results: This study found that women with co-­occurring disorders were more likely to stay longer in treatment
when compared to men. The findings indicate the factors influencing length of stay differ for each gender, and
include: type of substance used prior to admission;; Addiction Severity Index Composite scores;; and
Readiness to Change/URICA scores. Age at admission was a factor for men only. Conclusions/Importance:
These findings can be incorporated to develop and initiate program interventions to minimize early attrition and
increase overall retention in private residential treatment for individuals with co-­occurring substance use and
mental health disorders.
Personal network recovery enablers and relapse risks for women with substance
dependence.
Brown S, Tracy EM, Jun M, Park H, Min MO
Qualitative health research. 2015 Mar;; 25(3): 371-­85
Abstract
We examined the experiences of women in treatment for substance dependence and their treatment providers
about personal networks and recovery. We conducted six focus groups at three women's intensive substance
abuse treatment programs. Four coders used thematic analysis to guide the data coding and an iterative
process to identify major themes. Coders identified social network characteristics that enabled and impeded
recovery and a reciprocal relationship between internal states, relationship management, and recovery.
Although women described adding individuals to their networks, they also described managing existing
relationships through distancing from or isolating some members to diminish their negative impact on
recovery. Treatment providers identified similar themes but focused more on contextual barriers than the
women. The focus of interventions with this population should be on both internal barriers to personal network
change such as mistrust and fear, and helping women develop skills for managing enduring network
relationships.
The interacting effect of depressive symptoms, gender, and distress tolerance on
substance use problems among residential treatment-­seeking substance users.
Ali B, Seitz-­Brown CJ, Daughters SB
Drug and alcohol dependence. 2015 Mar;; 148:21-­6
Consumi di sostanze e dipendenze nel genere femminile – Newsletter Aprile 2015
Abstract
Depression is associated with substance use problems;; however, the specific individual characteristics
influencing this association are not well identified. Empirical evidence and theory suggest that gender and
distress tolerance-­defined behaviorally as an individual's ability to persist in goal-­directed behavior while
experiencing negative affective states-­are important underlying factors in this relationship. Hence, the purpose
of the current study was to examine whether gender and distress tolerance moderate the relationship between
depressive symptoms and substance use problems.
Participants included 189 substance users recruited from a residential substance abuse treatment center. The
Short Inventory of Problems-­Alcohol and Drugs scale was used to measure self-­reported substance use
problems. The Beck Depression Inventory was used to assess self-­reported depressive symptoms. Gender
was self-­reported, and distress tolerance was behaviorally indexed by the Computerized Paced Auditory Serial
Addition Task.
Hierarchical linear regression analysis indicated a significant three-­way interaction of depressive symptoms,
gender, and distress tolerance on substance use problems, adjusting for relevant demographic variables,
anxiety symptoms, impulsivity, as well as DSM-­IV psychiatric disorders. Probing of this three-­way interaction
demonstrated a significant positive association between depressive symptoms and substance use problems
among females with low distress tolerance.
Findings indicate that female treatment-­seeking substance users with high levels of depressive symptoms
exhibit greater substance use problems if they also evidence low distress tolerance. Study implications are
discussed, including the development of prevention and intervention programs that target distress tolerance
skills.
A prospective investigation of emotion dysregulation as a moderator of the relation
between posttraumatic stress symptoms and substance use severity.
Tull MT, Bardeen JR, DiLillo D, Messman-­Moore T, Gratz KL
Journal of anxiety disorders. 2015 Jan;; 29:52-­60
Abstract
Despite strong evidence for an association between the experience of posttraumatic stress (PTS) symptoms
and substance use, little is known about the particular individuals most at-­risk for problematic substance use in
response to PTS symptoms. Consequently, the goal of this study was to conduct a prospective investigation of
the moderating role of emotion dysregulation (assessed through self-­report and behavioral measures) in the
relation between PTS symptoms and substance use 8-­months later within a sample of 106 young adult
women. No main effect of PTS symptoms on substance use was found. Instead, PTS symptoms were only
associated with later substance use in the context of heightened emotion dysregulation. Results provide
support for emotion dysregulation as a key factor that may increase risk for substance use among women
experiencing PTS symptoms and highlight a target for future interventions aimed at reducing risk for the
development of maladaptive behaviors stemming from PTS symptoms.
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Reward Responsiveness Varies by Smoking Status in Women with a History of Major
Depressive Disorder.
Janes AC, Pedrelli P, Whitton AE, Pechtel P, Douglas S, Martinson MA, Huz I, Fava M, Pizzagalli DA, Evins
AE
Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. 2015
Feb.
Abstract
Major depressive disorder (MDD) and nicotine dependence are highly comorbid, with studies showing that
~50% of individuals with MDD smoke. The link between these disorders persists even after the clinical
symptoms of depression subside, as indicated by high levels of nicotine dependence among individuals with
remitted depression (rMDD). Recent evidence indicates that individuals with rMDD show blunted responses to
reward as measured by a probabilistic reward task (PRT), which assesses the ability to modify behavior as a
function of reward history. Given nicotine's ability to enhance reward responsiveness, individuals with rMDD
might smoke to address this persistent reward deficit. However, it is unclear whether smokers with rMDD show
enhanced reward responsiveness relative to rMDD individuals who do not smoke. To test this hypothesis, we
evaluated reward responsiveness on the PRT in four groups (N=198): individuals with and without rMDD who
were or were not nicotine dependent. As hypothesized, rMDD nonsmokers had lower reward responsiveness
relative to both control nonsmokers and rMDD smokers;; conversely, smokers with rMDD showed behavioral
patterns comparable to those without a history of depression. Given nicotine's ability to enhance reward
sensitivity, it is possible that nicotine normalizes the otherwise blunted reward responsiveness in individuals
with rMDD. Therapies aimed at enhancing this reward-­based deficit may be beneficial in the treatment of both
nicotine dependence and MDD.Neuropsychopharmacology advance online publication, 11 March 2015;;
doi:10.1038/npp.2015.43.
Clinical correlates of prescription opioid analgesic use in pregnancy.
Smith MV, Costello D, Yonkers KA
Maternal and child health journal. 2015 Mar;; 19(3): 548-­56
Abstract
A 2012 committee opinion from the American College of Obstetricians and Gynecologists highlights the
considerable increase in opioid addiction in recent years, yet little is known about clinical correlates of
prescribed opioids among pregnant women. This study examines clinical and demographic factors associated
with the use of opioid analgesics in pregnancy. Data were derived from a prospective cohort study of pregnant
women. Participants were administered the Composite International Diagnostic Interview to identify depressive
and anxiety disorders and data on medication use were gathered at three assessment points and classified
according to the Anatomical Therapeutic Chemical Code (ATC) classification system ATC group N02A.
Participants included 2,748 English or Spanish speaking pregnant women. Six percent (n = 165) of women
used opioid analgesics at any point in pregnancy. More pregnant women using opioids met diagnostic criteria
for major depressive disorder (16 vs. 8 % for non users), generalized anxiety disorder (18 vs. 9 % for non
users), post-­traumatic stress disorder (11 vs. 4 % for non users) and panic disorder (6 vs. 4 % for non users).
Women who reported opioid use were also significantly more likely than non users to report using illicit drugs
and almost three times as likely to report smoking cigarettes in the second or third trimester of pregnancy (4
and 23 %, respectively) as compared to non-­opioid users (0.5 and 8 %). The use of opioids in pregnancy was
Consumi di sostanze e dipendenze nel genere femminile – Newsletter Aprile 2015
associated with higher levels of psychiatric comorbidity and use of other substances as compared to non-­
opioid users.
Psychosocial outcomes of fetal alcohol syndrome in adulthood.
Rangmar J, Hjern A, Vinnerljung B, Strömland K, Aronson M, Fahlke C
Pediatrics ,2015 Jan;;135(1):e52-­8
Abstract
Primary disabilities in children prenatally exposed to alcohol have a major impact on their daily life. It is
suggested that these issues persist into adulthood, but few studies have addressed the outcome in adults with
prenatal exposure, especially those with fetal alcohol syndrome (FAS). The aim of this follow-­up study was to
investigate outcome variables, such as education, employment, health, and criminal acts, in 79 adults
diagnosed with FAS.
We carried out a national register-­based study of 79 adults with an FAS diagnosis, at a mean age of 32.
Education, social adjustment, and mental health outcomes were analyzed and compared with 3160
comparison individuals matched on age, gender, and place of birth.
The FAS group was much more likely to have received special education (25% vs 2%), be unemployed (51%
vs 15%), and receive a disability pension (31% vs 3%) than the comparisons, but the levels of criminal
offenses were similar. The FAS group had higher hospital admission rates for alcohol abuse (9% vs 2%) and
psychiatric disorders (33% vs 5%) and was more likely to be prescribed psychotropic drugs (57% vs 27%).
Swedish children with FAS have quite diverse psychosocial outcomes in adulthood, considerably worse than
for majority population peers. Potential risk and protective factors within the FAS group deserve study to
enable development of effective interventions.
Implementation of a statewide surveillance system for neonatal abstinence syndrome -­
Tennessee, 2013.
Warren MD, Miller AM, Traylor J, Bauer A, Patrick SW, Patrick SW
MMWR. Morbidity and mortality weekly report, 2015 Feb;;64(5):125-­8
Abstract
Over the last decade, rates of opioid pain reliever prescribing grew substantially in the United States, affecting
many segments of the population, including pregnant women. Nationally, Tennessee ranks second in the rate
of prescriptions written for opioid pain relievers, with 1.4 per person in 2012. The rising prevalence of opioid
pain reliever use and misuse in Tennessee led to an increase in adverse outcomes in the state, including
neonatal abstinence syndrome (NAS). NAS is a withdrawal syndrome experienced by infants shortly after
birth. The syndrome most commonly occurs after antenatal exposure to opioids, although other medications
have also been implicated. From 2000 to 2009, the incidence rate of NAS in Tennessee increased from 0.7 to
5.1 per 1,000 births, exceeding the national average, which increased from 1.2 to 3.4 per 1,000 births. NAS is
associated with numerous morbidities for the infant, including low birth weight, poor feeding, and respiratory
problems. Previous population-­based analyses of NAS relied on hospital discharge data, which typically
become available for analysis only after substantial delay. In Tennessee, the rising incidence of NAS and its
associated public health burden created an urgent need for timelier incidence figures to drive policy and
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Consumi di sostanze e dipendenze nel genere femminile – Newsletter Aprile 2015
prevention efforts. Beginning January 1, 2013, the Tennessee Department of Health (TDH) made NAS
reporting mandatory. A total of 921 cases were reported in 2013 (among 79,954 births), with the most cases
clustered in eastern Tennessee;; 63% of cases occurred to mothers who were reported to be using at least one
substance prescribed by a health care provider (e.g., opioid pain relievers or maintenance medications for
opioid dependency), and 33% of cases occurred among women using illicit or diverted substances (e.g.,
heroin or medications prescribed for someone else). The first year's surveillance results highlight the need for
primary prevention activities focused on reducing dependence/addiction among women of childbearing age
and preventing unintended pregnancy among female opioid users.
Low-­to-­moderate prenatal alcohol consumption and the risk of selected birth outcomes:
a prospective cohort study.
Lundsberg LS, Illuzzi JL, Belanger K, Triche EW, Bracken MB
Annals of epidemiology, 2015 Jan;;25(1):46-­54.e3
Abstract
To estimate whether low-­to-­moderate prenatal alcohol exposure is associated with selected birth outcomes.
Low-­to-­moderate prenatal alcohol drinking and effects on low birthweight, preterm delivery, intrauterine growth
restriction, and selected neonatal outcomes were evaluated among 4496 women and singleton infants. Odds
ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariable logistic regression,
controlling for confounding variables.
Early pregnancy drinking was associated with reduced odds of low birthweight, OR, 0.66 (95% CI, 0.46-­0.96)
and birth length less than 10th percentile, OR, 0.74 (95% CI, 0.56-­0.97). Drinking during the first 3 months
showed lower odds for birth length and head circumference less than 10th percentile, OR, 0.56 (95% CI, 0.36-­
0.87) and OR, 0.69 (95% CI, 0.50-­0.96), respectively. Third trimester drinking was associated with lower odds
for low birthweight, OR, 0.56 (95% CI, 0.34-­0.94) and preterm delivery, OR, 0.60 (95% CI, 0.42-­0.87).
Our results suggest low-­to-­moderate alcohol exposure during early and late gestation is not associated with
increased risk of low birthweight, preterm delivery, intrauterine growth restriction, and most selected perinatal
outcomes.
Prevalence of substance abuse in pregnancy among Danish women.
Rausgaard NL, Ibsen IO, Jørgensen JS, Lamont RF, Ravn P
Actaobstetricia et gynecologica Scandinavica, 2015 Feb;;94(2):215-­9
Abstract
There are few recent data on the prevalence of substance abuse among Danish pregnant women. During
2013, in the Region of Southern Denmark, a cross-­sectional, anonymous, screening-­based study was
conducted among pregnant women attending for routine ultrasound scan at 12 weeks gestation. The women
submitted a urine sample and completed a short questionnaire. Urine samples were tested for opiates,
cannabis, benzodiazepines, cocaine, methadone, amphetamine and methamphetamine. Positive samples
underwent repeat analysis for confirmation. Of 690 pregnant women, 88.1% participated. Overall, 3.6% of
women had a positive urine sample confirmed by repeated analysis. The age distribution in women with
positive samples did not differ from the entire cohort. Our findings indicate a larger prevalence than
Consumi di sostanze e dipendenze nel genere femminile – Newsletter Aprile 2015
anticipated, and that a substantial number of pregnant women with substance abuse are not appropriately
referred to the focused specialist center for such women at risk.
Benzodiazepine use among mothers of small children: a register-­based cohort study.
Raitasalo K, Holmila M, Autti-­Rämö I, Martikainen JE, Sorvala VM, Mäkelä P
Addiction (Abingdon, England). 2015 Apr;; 110(4): 636-­43
Abstract
To compare benzodiazepine (BZD) purchases in different groups of mothers of small children.
Prospective population-­based cohort study based on the Finnish social and health care registers.
Finnish women of child-­bearing age.
All women who gave birth in 2002 in Finland (n=54519).
Latent class analysis (LCA) was used to create a typology of mothers according to their substance abuse
status, psychiatric disorders and socio-­demographic characteristics. The mothers were followed-­up yearly for
purchases of benzodiazepines, starting 4 years before the child's birth and continuing up to the child's 7th
birthday. BZD purchases in different mother groups were compared using negative binomial hurdle models.
The five mother types identified by LCA were mothers with substance abuse (1%), mothers with psychiatric
disorders (1%), mothers with a risk of social marginalization (11%), mothers with minor social problems (18%)
and mothers with no identified problems (69%;; the comparison group). Mothers with substance abuse
problems had the highest odds of purchasing BZDs [odds ratio OR=27.5, 95%CI=22.9-­33.0;; RR=20.2,
95%CI=14.9-­27.3. The change in time was similar in all groups: the probability of purchasing and the number
of purchases were lowest during pregnancy and the year of the child's birth.
In Finland, among mothers of young children, prevalence of benzodiazepine use is reduced during pregnancy
and the child's first year, and then increases as the child grows older. Mothers with substance abuse and
psychiatric disorders are at particularly high risk of benzodiazepine use.
Gender differences in the associations of gambling activities and suicidal behaviors
with problem gambling in a nationally representative French sample.
Husky MM, Michel G, Richard JB, Guignard R, Beck F
Addictive behaviors. 2015 Jan;; 45:45-­50
Abstract
The objectives of the present study are to describe gender differences in factors associated with moderate risk
and problem gambling.
Data were extracted from the 2010 Health Barometer, a large survey on a representative sample of the
general population aged 15-­85years living in France (n=27,653), carried out by the National Institute for Health
Promotion and Health Education. Data were collected between October 2009 and July 2010. A computer-­
assisted telephone interview system was used.
The findings indicate that men are three times more likely to experience problems with gambling. Men and
women have different patterns of gambling activities. Men were more involved with Rapido, internet gambling,
sports and racetrack betting, poker, and casino tables, whereas women gambled more often on scratch
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Consumi di sostanze e dipendenze nel genere femminile – Newsletter Aprile 2015
games. Both men and women engaging in immediate reward games were significantly more likely to
experience difficulties with gambling. This association, however, was stronger in women. Furthermore, suicidal
ideation and behaviors were more likely to be associated with gambling problems in women as compared to
men.
The study underscores the importance of considering gender-­related differences in the study of gambling
behaviors.
Telescoping and gender differences in the time course of disordered gambling:
evidence from a general population sample.
Slutske WS, Piasecki TM, Deutsch AR, Statham DJ, Martin NG
Addiction (Abingdon, England). 2015 Jan;; 110(1): 144-­51
Abstract
The course of disordered gambling in women has been described as 'telescoped' compared with that in men,
with a later age at initiation of gambling but shorter times from initiation to disorder. This study examined the
evidence, for the first time, for such a telescoping effect in a general population rather than a treatment-­
seeking sample.
Participants in a large community-­based Australian twin cohort (2001 men, 2662 women) were assessed by
structured diagnostic telephone interviews in which they reported the ages at which they had attained various
gambling milestones and additional information to be used as covariates (the types of gambling in which they
had participated and history of symptoms of alcohol dependence, major depression, and adult antisocial
behavior). Cox proportional hazards regression models were used to examine differences between men and
women in the time from gambling initiation to the first disordered gambling symptom and a diagnosis of
disordered gambling.
Men had a higher hazards than women for the time to the first disordered gambling symptom [hazard ratio
(HR)=3.13, P<0.0001] and to a diagnosis of disordered gambling (HR=2.53, P<0.0001). These differences
persisted after controlling for covariates. Earlier age of initiation was the most potent predictor of progression
to the first symptom.
When assessed at the general population level, female gamblers do not appear to show a telescoped
disordered gambling trajectory compared with male gamblers.
What keeps female problematic internet users busy online?
Piguet C, Berchtold A, Akre C, Suris JC
European journal of pediatrics. 2015 Mar.
Abstract
While problematic Internet use is recognized to be predominant among male adolescents, a female trend is
gradually becoming apparent. Our study aimed at investigating the characteristics of female Internet users and
distinguishing between the online activities of problematic and regular Internet users' on school days. Data
were retrieved from a cross-­sectional survey of a representative sample of 3067 8th graders in the canton of
Vaud, Switzerland, that completed an online questionnaire in 2012. Only females were included. Based on the
Internet addiction test, the sample was divided into regular (RUs) (IAT<50, n=1339) and problematic users
Consumi di sostanze e dipendenze nel genere femminile – Newsletter Aprile 2015
(PIUs) (IAT 50, n=201). Groups were compared regarding sociodemographic variables, online activities,
devices used to access the Internet, substance use, and physical activity. Significant variables were included
in a backward logistic regression. At the multivariate level, PIUs were more prone to spend time online for
leisure activities (odds ratio [OR] 2.38) and to access the Internet through a smartphone (OR 1.79) or tablet
(OR 1.84). PIUs were less likely to be physically active (OR 0.86) and more likely to present poor emotional
well-­being (OR 2.67) and to smoke (OR 1.88). Conclusion: A sizeable percentage of female adolescents are
problematic Internet users. When performing a comprehensive biopsychosocial assessment, teenagers
owning numerous devices to access the Internet, presenting other health-­compromising behaviors or poor
emotional well-­being should be specifically targeted. What is Known:
• Problematic Internet use has been found to be predominant among males.
• Specific online activities have been identified as being addictive for young men and women differently.
• Problematic Internet use is known to impact in several ways the general health and daily functioning of
teenagers.
What is New:
• A sizeable percentage of female adolescents are problematic Internet users.
• Tobacco use, poor well-­being, as well as compact devices to access the Internet are positively related to
problematic Internet use.
• In addition to their special interest in online social and communicational activities, female problematic Internet
users also reported more online gambling.
Identifying and intervening with substance-­using women exposed to intimate partner
violence: phenomenology, comorbidities, and integrated approaches within primary
care and other agency settings.
Weaver TL, Gilbert L, El-­Bassel N, Resnick HS, Noursi S
Journal of women's health. 2015 Jan;; 24(1): 51-­6
Abstract
Substance use and/or disorders (SUDs) have been identified as a significant correlate of intimate partner
violence (IPV) exposure and present complex issues that intersect with the topography of IPV, attendant
mental health, and physical co-­morbidities and may pose barriers to primary care-­ and other agency-­based
screening and intervention efforts. Despite substantial research indicating significantly higher rates of all types
and severity of IPV victimization among women with SUDs and bidirectional associations between partner or
self-­use of drugs or alcohol and IPV victimization, effective screening, brief interventions, coordinated systems
of care, and treatment approaches to address these co-­occurring problems remain very limited. We integrated
select research examining the intersection of IPV victimization and SUDs and several comorbidities that have
significant public health impact and provided recommendations for scaling up targeted interventions to redress
these co-­occurring problems among women in primary, emergency, and other care settings.
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Baseline social characteristics and barriers to care from a special projects of national
significance women of color with HIV study: a comparison of urban and rural women
and barriers to HIV care.
Eastwood EA, Fletcher J, Quinlivan EB, Verdecias N, Birnbaum JM, Blank AE
AIDS patient care and STDs, 2015 Jan;;29 Suppl 1():S4-­10
Abstract
We describe the baseline sociodemographic characteristics of the Health Resources and Services
Administration's Special Programs of National Significance Women of Color (WOC) Initiative. Between
November 2010 and July 2013, 921 WOC were prospectively enrolled in HIV medical care at nine sites, six
urban (N = 641) and three rural sites (N = 280) across the US. We describe the study sample, drawing
comparisons between urban and rural sites on sociodemographics, barriers to HIV care, HIV care status at
study entry, substance use and sexual risk factors, and the relationship among these variables. Urban sites'
participants differed from rural sites on all sociodemographic variables except age (median = 42.3). Women at
urban sites were more likely to be Hispanic, less educated, single, living alone, unstably housed, unemployed,
and to have reported lower income. More urban women were transferring care to HIV care or had been lost to
care. Urban women reported more barriers to care, many relating to stigma or fatalism about HIV care. Urban
women reported more substance use and sexual risk behaviors. A better understanding of how HIV care is
embedded in communities or fragmented across many sites in urban areas may help understand barriers to
long-­term engagement in HIV care encountered by WOC.
Factors associated with retention and viral suppression among a cohort of HIV+ women
of color.
Blank AE, Fletcher J, Verdecias N, Garcia I, Blackstock O, Cunningham C
AIDS patient care and STDs, 2015 Jan;;29 Suppl 1():S27-­35
Abstract
Access to sustained HIV medical care is critical to achieving viral suppression. However, a variety of factors
may impede or facilitate retention in care or becoming virally suppressed. Though retention and suppression
are often treated separately, this study examined both in a cohort of 921 HIV+ women of color who
participated in eight demonstration programs across the US. For women who met the inclusion criteria, 83% (n
= 587) were retained and 73% (n = 357) were virally suppressed. Average age of women retained was 40.9,
and 41.9 for those virally suppressed. The majority were African American/Black or Hispanic/Latina, single,
and had no children less than 18 years of age, had health insurance, a high school degree or higher, were
stably housed, and unemployed. Some factors associated with retention in care were indecision about seeking
HIV medical care (AOR = 0.42) and having children under the age of 18 (AOR = 0.59). Some factors
associated with being virally suppressed were living with others (AOR = 0.58), current substance abuse (AOR
= 0.38), and fair/poor health (AOR = 0.40). The findings suggest different processes and social mechanisms
may influence retention and viral suppression. Interventions seeking to improve retention in care may require
tailored program components and strategies that focus on improving viral suppression.