In “Sexual Abuse, Physical Abuse, and Posttraumatic Stress Disorder among Women Participating in Outpatient Drug Abuse Treatment” Ms. Gil-Rivas, Mr. Fiorentine, and Mr. Anglin discuss the role played by abuse in the success or failure of treatment of drug abuse. There is indication that sexual and physical abuse results in an increased level of posttraumatic stress disorder (PTSD) symptoms.
Sexual abuse has been defined as being, “Forced or pressured to perform, or being involved in, any sexual act against the individual’s will” (Gil-Rivas, et al). Physical abuse defined as, “being hit or beaten so hard that the individual suffered from cuts or bruises” (Gil-Rivas, et al). These definitions included family members, acquaintances, and strangers and were used for assessment.
Women in outpatient treatment programs for alcohol and substance abuse are more often to be victims of sexual abuse from family, acquaintances, and strangers than are men. Women are more often sexually abused as children as well as during adulthood. Men generally have a decline in the abuse at the onset of puberty. The physical abuse of women often occurs by family members, and acquaintances with less frequent physical abuse taking place by strangers. Men, however, are more often physically abused by family and strangers.
Those women who have entered into drug treatment with symptoms of PTSD also show signs of other mental illness symptoms including depression, anxiety, suicidal ideation, and low self-esteem. These symptoms are signs that could signify a higher rate of relapse. Women with sexual and physical abuse histories have a higher likelihood of entering treatment and if secondary symptomology is treated, then there is a greater success of participation in the treatment process.
There is research to support that those who have had trauma often do not develop skills to manage events of trauma, psychological stress, or life experiences. One of the methods used by abuse survivors is frequently substance abuse. This abuse of drugs often leads to increased psychological stress and increased symptomology of other mental illnesses. There is an important influence on the treatment process brought by sexual and physical abuse. The nature of the trauma could result in the women being labeled as difficult to treat because these women have difficulty following treatment plans and may drop out of the recovery. Additionally, victimization results in PTSD symptomology and may radically increase the chance of relapse.
To increase the chance of success of treatment, assessing for and creating delivery systems to manage PTSD, physical abuse, and sexual abuse may need to become routine practices in substance abuse treatment programs. Additionally, training and implementations of clinical programs to mitigate these complications could increase treatment success. Drug treatment programs are beginning to receive pressure from clinicians to increase the alternative treatment modalities to women with abuse histories and PTSD symptomology in order to meet the needs of these women.
I find this article to be informative but not new information. I believe that there is much information here that has been seen in other research and is practiced in many parts of the country today. I agree with the information presented here. I think that there is a great deal of evidence that drug use is often a result of “self-medication” to reduce psychological pain associated with victimization.
I am discouraged that the clients interviewed here were paid for their participation. I feel that one of the main jobs of intake workers is to get sufficient histories that this information would be readily available. There should be standard questions associated with abuse and victimization in the intake process. A lack of this indicates to me that the workers are not adequately trained.
I have a history of sexual, physical, and psychological abuse and I have used both drugs and alcohol to ease my pain. My cessation of substance abuse resulted in my awareness of my own mental illness. It is for this reason that I feel that if a treatment program is designed to provide complete recovery care, the issue of victimization would be addressed early in the intake process. The entire procedure involved in entering treatment is traumatic and without properly trained clinicians, individuals could be further victimized.
Overall, I believe that this article presents the facts in a manner that will be beneficial to those in the field that are unaware of the relation between abuse and substance use. I hope that this will act to encourage further training and alteration of programs to improve the treatment of addicts who have abuse histories.