By the NIDA Press Office

Drug abuse among women is a serious, continuing illness. However, women can recover from this disorder when treatment adequately meets their special needs, according to experts.

To further explore this issue, NIH's National Institute on Drug Abuse (NIDA) recently hosted a conference on "Drug Addiction Research and the Health of Women" to focus attention on the unique impact of drug use, abuse, and addiction on women's health.

Speaking at the conference, NIDA Director Dr. Alan Leshner said, "Drug addiction is a chronic, relapsing problem which may progress differently in women of all ages, not just those of childbearing age."

Evidence of health risks from drug abuse throughout a woman's lifespan were cited. Women who use drugs are often underweight or malnourished, depressed, have been physically abused by their partner, and are at risk for sexually transmitted diseases and HIV/AIDS.

Pregnant drug abusers are also at increased risk for ectopic (tubal) pregnancy, stillbirth, low weight gain during pregnancy, miscarriage, hypertension, anemia and other medical problems. Their newborns may have lower birth weight and smaller head size than babies born to healthy mothers.

A major factor in keeping women drug abusers from seeking or accepting treatment is their role as caretakers of children, elderly parents, or other relatives. Women also may not seek treatment out of fear of prosecution by the legal system, and fear they will lose their children, concerns that are well-founded, according to the conference presenters.

Even when women do seek treatment, they face long waiting lists and find that many programs will not accept pregnant women. Further, poor women often have no health insurance and no way of paying for treatment.

When drug-abusing women can find and do accept treatment, they benefit most from programs that address not only their chemical dependency, but provide services that meet their basic needs, such as food, clothing, shelter, child care, and medical care. An individually-tailored, pharmacological/behavioral approach, linking health care and HIV services as well as drug treament, stands the best chance of success, said conference experts.

According to Dr. Loretta Finnegan, Director of NIH's Women's Health Initiative, "Almost half of all women who have ever used illicit drugs are in the childbearing age of 15 to 44. Therefore, it is important to understand the epidemiological issues of these women, including their drug use during pregnancy."

Consequently, as part of the conference, NIDA released findings from its "National Pregnancy and Health Survey," the first comprehensive analysis of drug use among pregnant women. Key findings include:
- In 1992, 221,000 women who gave birth (5.5 percent) used an illicit drug during pregnancy;
- The two most frequently used drugs were marijuana, 119,000 women (2.9 percent) and cocaine, 45,000 women (1.1 percent); - About 757,000 (18.8 percent) of the women drank alcohol and 820,000 (20.4 percent) smoked cigarettes at some time during pregnancy. These results demonstrate a strong link between the use of illicit drugs and alcohol and tobacco use.

Survey results also pointed to issues of prevalence differences among ethnic minorities. The estimated number of white women using drugs during pregnancy was much higher than the number of African American or Hispanic women. Rates of cocaine use (in particular, crack--cocaine pellets that are smoked) however, were considerably higher among African American women than for white or Hispanic women.

The survey also found that despite a generally decreasing trend in drug use from 3 months before and throughout the pregnancy, there was no total discontinuation of drug use. "This is an indicator of how gripping an illness drug addiction can be, even in the face of what may seem to be the ultimate incentive to stay drug-free," noted Leshner.

"Drug addiction has a strong effect on a user, both biologically and behaviorally, but it is a disease that can be treated and managed," Leshner concluded. Findings from other NIDA research indicate that once successfully detoxified and enrolled in a treatment program, the focus of the lives of drug-abusing women changes dramatically from their drug use to their children.

A summary of conference presentations will be available in late 1995 from the National Clearinghouse on Alcohol and Drug Information (NCADI), 1-800-729-6686. NIDA's National Pregnancy and Health Survey will be available from NCADI later this summer.

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