You're a guy at a bar. You've had a fight with your wife. Your boss is on your ass. You're two months behind on your mortgage. You need to unwind at a place where you can be accepted and not judged. You want to have a few beers and watch the game. Then in comes a woman. Alone. She sits down and orders a stiff drink. And you think—what? She's looking to get picked up? She's a prostitute? An alcoholic? Why can't she also just be having a bad day? And therein lies the problem.
Personally, I didn't feel the stigma of being a woman alcoholic and addict until I got clean. Then, despite my miraculous rehabilitation from a disease that kills more people than car crashes and guns combined, I was still considered tainted, unstable, and certainly not good wife or mother material. I wasn't seen as a survivor but more as a ticking time bomb who could relapse at any moment; a woman with a frightening, unsavory past which haunted me like a lengthy criminal record.
You might think it's odd that I didn't encounter this social stigma until I got clean, but understand: most of my using and drinking was done alone. Shooting up is a loner activity. You can't just pull out a set of rigs at a nice bar or house party. I was aware of the "junkie" stigma for sure, but that seemed across the sexes. And honestly, when I was loaded, I didn't care what anybody thought. It was just me and the cat, getting fucked up. I learned to avoid drinking in public early on in my addiction career because I blacked out, got naked, sometimes even violent. So party of one it was!
When I got sober, I still didn't really feel this social disrepute until I got out of the recovery bubble—rehab, 12-step meetings. I was writing regularly for TheFix.com, an addiction magazine, under my real name, so I was "out" with my sobriety. I wasn't anonymous and didn't want to be. In the rooms of 12-step meetings (at least AA and NA), there can be a weird one-upmanship, a pride even, among who had the lowest bottom, women included. "You shot heroin in your eyeball? Wow, you're a badass!"
However, when I started dating outside of "the rooms," when I started dating what we call "normies" (our nickname for people who don't have addiction tendencies), it was a whole new, unfriendly world. I noticed immediately that I was considered an oddity at best, but mostly I was seen as dirty, broken, and dangerous. For "normies," there was nothing cool about my past. My prior IV drug use really scared the shit out of men, despite my reassurance that I had been tested and was disease-free.
As I wrote in my memoir, My Fair Junkie: "Let's be honest: nobody really wants the reformed bad girl. They want the party girl or the sweet wholesome girl. Nobody wants the girl who 'doesn't do that anymore,' the girl who used to have threesomes and do coke off strippers' asses but now meditates and drinks decaf." So there's the stigma of being an addict/alcoholic and then there's also the stigma of being a recovered one. I couldn't win.
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During my last relationship, which was with a "normie," despite his own mother being an alcoholic, I was encouraged to keep my "colorful history" to myself or at least to downplay it. My six rehabs and four psych wards became an amorphous "some problems." And I get it. Who wants their son to marry the ex-junkie and alkie? Nobody.
Think about it. Books by female junkies? Not many come immediately to mind. (Obviously there are more by female alcoholics, but that's mostly been in the last decade with Caroline Knapp, Kirsten Johnston, Sarah Hepola, and Koren Zalickas leading the charge.) But books by male junkies or alcoholics? Charles Bukowski, Hunter S. Thompson, William Burroughs, Jerry Stahl, Bill Clegg, James Frey, Patrick O'Neil, John O' Brien. The list goes on and on.
The stigma is even in rock n' roll and entertainment: Sid Vicious was "cool." Courtney Love is a "hot mess." Keith Richards is some weird, respected anomaly. Kathleen Turner is an old alcoholic. If a guy is shit-faced and punches another guy in a bar, he's macho. If a girl does it, she's a psycho. A guy in his "disease" who fucks a string of women is a stud. A woman who does that? Well, despite all the "slut walks" and sex-positive campaigns, she's still considered a whore.
Whether this stigma stems from biology or society or both is anybody's guess. But it's an indisputable fact that alcohol harms women more than men. Bob Weathers, an Orange County, California-based clinical psychologist, recovery coach, and addiction expert, confirms that "women are significantly more vulnerable than men to the toxic effects of alcohol." Why? "For starters, this has been attributed to women's relatively smaller bodies and higher percentage of fatty cells; muscle tissue absorbs alcohol faster than fat tissue," he says. But there is, he adds, something even more crucial at play. "Women have significantly less of the stomach enzyme ADH—alcohol dehydrogenases—which breaks down alcohol before it reaches the bloodstream."
Nearly 10 years ago, Weathers informs me, the Substance Abuse and Mental Health Services Administration (SAMHSA) said that "compared with men, women become more cognitively impaired by alcohol and are more susceptible to alcohol-related organ damage. Women develop damage with less intake and over a shorter period of time than men."
Regarding the social stigma, Heather Beylik, a licensed family therapist in California who specializes in women's issues, addiction, and trauma says, "All of my female clients express strong, deep-rooted feelings of shame in early recovery from alcoholism and addiction. These women use violent language to describe themselves, having internalized harsh judgments about their identity, sense of self, competence, and more specifically their worth as a woman. Many feel that they have failed to live up to societal expectations of what it means to embody womanhood." She adds that, "This stigma is not just about the belief that a woman engaged in behavior that was destructive…it is a belief that these behaviors equate to her failure to embody the ideal woman, and this is devastating."
This continuing bias is what keeps many women from being diagnosed with substance use disorder or even seeking treatment. In my book, I write about a fellow client in rehab who eventually became my roommate in sober living. She was a certified nurse with three children and would only admit to have anxiety and depression. She was so ashamed that this could happen to her as a medical professional—and moreover as a mother, rightfully afraid that her children would be taken from her—that it took her years to admit she was an alcoholic who abused pills.
The bottom line is that our current view is burying the fact that women are getting decimated by what the Journal of the American Medical Association considers a "public health crisis." "Over the past 10 years," Weathers says, "women's high-risk drinking rose dramatically—a 60 percent increase—and alcohol use disorder exploded by 84 percent." Just like cancer, addiction is an equal-opportunity disease and we need to drop our outdated and fatal prejudice against women, mothers, and "ladies," and treat alcoholism and addiction as the lethal threat against all people that it is.
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