Gender influences how people cope with alcohol use disorder, study finds

A qualitative study by researchers from the School of Arts, Sciences and Humanities (EACH-USP) at the University of São Paulo in Brazil suggests that gender influences how people with alcohol-related disorders alcohol cope with their condition.

The principal investigator was Professor Edemilson de Campos, who was supported by FAPESP and collaborated with Nadia Narchi, also a professor at EACH-USP. The results are reported in an article published in the journal Drug and alcohol review.

Campos obtained permission to participate in meetings strictly for women in an Alcoholics Anonymous (AA) group in São Paulo, interviewed the participants and took notes on the testimonies given during the meetings.

“Women-only AA meetings are common in the United States, but not in Brazil,” he said. “AA recommends against this format on the grounds that alcoholism is a unique phenomenon and affects both men and women equally. But the women I interviewed disagreed and told me they felt intimidated in mixed meetings. Some even said they were harassed and targeted with sexist jokes. at such meetings.

According to Campos, the city has 120 AA groups, but only two hold women-only meetings, one in the north of the city and the other in the downtown district of Santa Cecília. “AA has no hierarchical structure. The groups have considerable autonomy and moderators serve on a rotational basis. I asked to be able to attend the women-only meetings of both groups, but only the northern part group. of São Paulo accepted,” he said.

About fifteen women from this group met every Saturday. Some had joined only two months ago, while others had been attending AA meetings for more than 30 years. Generally, they came from low-income households and had little formal education. Some were married to men who also participated in the A.A. program.

It should be noted, Campos explained, that AA members regard alcoholism as a “chronic incurable disease” due to a physical predisposition combined with a mental obsession with drinking, and believe that the disease cannot be fought by individual will alone. The support network formed by the group is essential for alcoholics to learn how to stay sober while living with the disease. AA defines itself as a “community of men and women,” he noted, and is “not tied to any sect, religion, political movement, organization or institution.” Membership is completely free. However, financial autonomy is ensured by voluntary donations.

We had already studied groups with mixed meetings. In the women-only meetings we attended, we respectfully conducted ethnographic research involving participants’ accounts of their family, work, and other relationships, as well as other aspects of their lives. The phrase ‘wounded soul’ was how the women themselves referred to their condition, as well as the rejection and loneliness they experienced due to social stigma.”

Professor Edemilson de Campos, Principal Investigator

He went on to note that while in the mixed meetings the men focused in their testimonies on working relationships and other impersonal aspects of their daily lives, the participants in the women-only meetings spoke mainly about their inner lives. and their feelings. “Hence the importance of women-only meetings,” he said. “They provide a safe space for self-expression and allow participants to regain a sense of dignity.”

Socially conditioned thinking is generally lenient with fathers who neglect their paternal obligations, but relentless with women considered bad mothers. “The feeling that alcoholism may have prevented them from doing what society expected of them weighed heavily on these women,” Campos said.

The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), published by the American Psychiatric Association but also used in many other countries, defines substance dependence as a condition meeting at least three of the following criteria : spending a lot of time in activities necessary to get the substance, use it, or recover from its effects; taking the substance in larger amounts or for a longer period of time than intended; needing significantly higher amounts to achieve intoxication; wanting but not reducing or controlling their substance use; continuing to use the substance despite realizing that it causes or worsens physical or mental health problems; and giving up or reducing important social, occupational, or recreational activities due to substance use.

In the case of alcohol and other substances that cause chemical dependence, such as tranquilizers (benzodiazepines), stimulants (amphetamines), cocaine and crack, a seventh condition is added: manifesting the withdrawal syndrome characteristic of the substance, in which case subjects are considered dependent if they meet three of the seven criteria.

These criteria apply equally to men and women, but the study conducted by Campos found that beyond this general classification, the experience of alcoholism and its treatment were strongly influenced by gender. “Contrary to the common misconception in AA, we have found that women need a safe space in which to express their pain and heal their ‘wounded soul,'” he said.

A 2017 survey of substance use by the Brazilian population, conducted by the Oswaldo Cruz Foundation (Fiocruz, subordinate to the Ministry of Health), found that around 2.3 million people aged 12 to 65 had experienced substance abuse. alcohol dependence in the past 12 months. The proportion was 3.4 times higher in men (2.4% of the male population) than in women (0.7%), but researchers in the field believe the latter may have been underestimated in because of the strong social stigma attached to female alcoholism. Many women may have hidden their alcohol addiction out of fear of what “others” might think, say or do.


Journal reference:

de Campos, EA & Narchi, NZ, (2022) “The Wounded Soul”: What alcoholism means to participants at a women-only meeting of Alcoholics Anonymous in São Paulo, Brazil. Drug and alcohol review.

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