History of Treatment of Addiction

Treatment Group Part – 1
History
More than 150 years have passed since the earliest U.S. reports on women and addiction (Kandall, 2010). Much of the early history is riddled with misunderstandings and inaccuracies regarding women and addiction (Kandall, 2010). While it has always been challenging to determine the real epidemiological of women and addiction, the range of female addicts spans much beyond those mothers who create sensational headlines by mistreating their children. Throughout history, most cases of female addiction were caused by inappropriate overmedication practices carried out by doctors and pharmacists, deception by the mainstream press, or the person’s own efforts to deal with social or professional barriers that prevented equality and self-fulfillment (Chesler, 2018). Since the middle of the nineteenth century, inhumane tolerance, social exclusion, stigmatization, harassment, and criminal action have gradually, but not entirely, given way to more compassionate treatment within the context of more educated comprehensive care (Kandall, 2010).
Women frequently use substances differently than males, including utilizing lesser quantities of certain drugs for a shorter period before becoming dependent (Chesler, 2018). Women may react differently to chemicals. For instance, they may experience more significant drug cravings and be more prone to relapse following treatment. Sexual hormones may make women more vulnerable to the effects of certain medicines than males (Chesler, 2018). In fact, women who utilize some medications may also have increased cardiovascular and vascular impacts (Chesler, 2018). Research shows that changes in the brains of women who take drugs may differ from those of males (Brennan & Houde, 2017). Women may be more prone to visit the emergency department or pass away due to overdose or other adverse consequences of specific drugs. It is also important to note that women victims of domestic violence are more likely to engage in drug abuse (Chesler, 2018). Various sources of significant stress, such as divorce, the loss of child custody, or the death of a loved one, may precipitate drug abuse and other psychiatric problems in women. Specific drugs may increase the likelihood of panic attacks, stress, and major depressive disorder in women (Chesler, 2018).
Current Situation
Women have particular problems when it comes to substance usage (Chesler, 2018). These variations are affected by sex and gender. Researchers have shown that women and men use and react to chemicals differently (Chesler, 2018). For instance, women consume fewer drugs than males but experience the consequences more intensely. The use of drugs during pregnancy can be detrimental to the health of pregnant women and their unborn child (Brennan & Houde, 2017). Increasingly, women are consuming marijuana while pregnant compared to prior years. This is contrary to the advice of leading medical organizations. This might result in smaller infants. The use or misuse of some medications during pregnancy, particularly opioids, can produce withdrawal symptoms in a baby, a disease known as NAS (Chesler, 2018).
Substance abuse among women is more likely to result in addiction than among males.
Fears of social or legal repercussions might make it difficult for pregnant or postpartum women to seek treatment for drug abuse. In addition, they may lack childcare throughout therapy.
Treatment programs should consider these difficulties and should also provide childcare, career training, and parenting seminars. Historically, women were excluded from clinical research. Significant attempts have been made by federal agencies to guarantee that all subgroups of individuals are involved, and that sex and gender problems are examined.

Rural Implications
Substance abuse has been pervasive in rural regions for a long time, despite the common perception that it is an issue of the inner city (Brennan & Houde, 2017). Cigarette and methamphetamine use is more prevalent among rural individuals, whereas prescription drug abuse and heroin usage have increased in communities of all sizes (Gesler, Rabiner, & Defriese, 2019). Due to inadequate prevention, therapy, and recovery options, substance abuse can be challenging to tackle in rural communities (Gesler, Rabiner, & Defriese, 2019). Substance use disorders can lead to increased criminal behaviors and negative social and physical health outcomes, such as low academic performance, a deteriorating health condition, brain changes, and an increased chance of death from overdose or suicide (Muñoz & Bain, 2020).
In rural locations, behavioral health detox programs are not as readily available, and their scope of services may be restricted (Brennan & Houde, 2017). Patients requiring treatment for drug use disorder may be required to travel considerable distances for treatments (Gesler, Rabiner, & Defriese, 2019). First responders and ER staff in remote areas may have little expertise in treating patients exhibiting the physical symptoms of a drug overdose. Law enforcement and crime prevention programs may be thinly scattered throughout vast rural regions (Muñoz & Bain, 2020). Patients seeking treatment for drug use disorder may be hesitant to do so due to privacy concerns connected with smaller communities. In rural areas, drug misuse can be reduced with the support of prevention programs, particularly those that target teenagers (Gesler, Rabiner, & Defriese, 2019). Programs utilizing evidence-based tactics and including parents in schools and churches may deter youth drug abuse. Opioid abuse refers to prescription painkillers, such as codeine and morphine, or synthetic painkillers, such as fentanyl (Gesler, Rabiner, & Defriese, 2019). Heroin usage has grown due to the rising abuse of prescription drugs (Brennan & Houde, 2017).
States with disproportionately large rural populations relative to metropolitan ones have more significant mental health provider shortages and fewer treatment facilities (Gesler, Rabiner, & Defriese, 2019). Although family physicians, psychologists, social services, and ministers may be accessible in rural regions to provide essential drug use therapy or social support, the number of facilities offering complete substance use treatment services in rural locations is low (Gesler, Rabiner, & Defriese, 2019). In addition to the typical challenges to healthcare access for rural residents, such as travel time and expense, there was a paucity of treatment programs and a poor impression of drug use disorder treatment among rural doctors. Not only do rural communities lack essential medical services, but they also lack the required supplementary services for favorable outcomes (Gesler, Rabiner, & Defriese, 2019). For instance, detox programs give initial therapy to patients to limit any health or physical harm caused by substance abuse. Most rural inhabitants live in counties lacking detox services (Gesler, Rabiner, & Defriese, 2019). Typically, local police enforcement or emergency services offer initial detoxification treatments.
Moreover, based on the stage of their condition, patients may require more sophisticated treatment options, such as inpatient, intensive or residential care, which are typically unavailable in remote locations (Gesler, Rabiner, & Defriese, 2019). Because of the lack of essential therapeutic options, individuals must travel great distances to obtain the necessary care. Greater distances to drug use disorder treatment are frequently associated with lower program success rates (Gesler, Rabiner, & Defriese, 2019). Accessibility to continuing treatment and support programs, especially for clients whose driver’s licenses have been revoked, is sometimes hampered by the absence of public transportation options in rural locations (Muñoz & Bain, 2020). In certain instances, medical practitioners require specialized training to administer and monitor effective medications for treating addiction (Brennan & Houde, 2017).
Assumptions and Solutions
There is a wide range of potential solutions for women facing substance abuse and substance use disorder specifically (Chesler, 2018). Many of such solutions depend on the social support systems, such as family and friends. However, the focus is on policy changes that may impact substance abuse patterns in women. Such policies may impact funding for substance treatment programs, educational and awareness campaigns, and criminal justice reform. The solutions discussed here can be sorted into three categories: prevention, treatment, and law enforcement. Prevention efforts can include many approaches, including teaching women the dangers of abusing substances (Galanter, Kleber, & Brady, 2015). At the community level, providing immediate support can significantly reduce substance abuse (Muñoz & Bain, 2020). Communities are capable of resolving many of the community issues. In the past decade, community-led projects have been tackling substance misuse and associated criminality. Backed by institutions, individual contributors, and the national govt, community coalitions against drug abuse and other programs have emerged around the country. A community coalition consists of community stakeholders that pool their financial and personal assets to solve a specific issue or collection of concerns within the community (Galanter, Kleber, & Brady, 2015). By rallying the community, coalitions have worked to alter public policy and provided citizens with a feeling of ownership and engagement. Governments and private organizations have contributed tens of millions of dollars to fund the formation of community coalitions to combat drug misuse.
Treatment for substance abuse may be the most cost-effective method for reducing addiction, improving drug abusers’ health, and relieving the rising burden of substance-related health care expenses (Neger & Prinz, 2015). With therapy, addicts can quit narcotics, get employment, and become contributing members of society. Comparable to other chronic diseases, such as diabetes, dependence on alcohol and other substances demands a sustained change in behavior for successful treatment. As with many chronic illnesses, recurrence is possible, and noncompliance with therapy diminishes the likelihood of a successful recovery. While criminal justice efforts are intended to reduce drug abuse patterns, especially for illicit substances, they may often fail to contribute to solutions and even harm such efforts (Galanter, Kleber, & Brady, 2015).
Poor income levels, co-occurring mental disorders, and a dearth of social support are the leading causes of relapse for addiction recovery patients (Galanter, Kleber, & Brady, 2015). Numerous risk factors for recurrence are common among criminal offenders, making long-term sobriety even more challenging (Galanter, Kleber, & Brady, 2015). Nevertheless, despite this demographic, therapy has resulted in sustained sobriety for some and a considerable reduction in drug use for others, leading to a decrease in crime and societal costs. According to the NIDB, the conventional rehabilitation treatment approach has been proven to be highly effective at reducing drug use and recidivism (Galanter, Kleber, & Brady, 2015). Intense, long-term residential rehabilitation programs serve as therapeutic communities. Attendees in the program are separated from the general jail population to ensure that the prison environment and culture do not impede rehabilitation progress. The improvements made during treatment may be lost if offenders are reintroduced to the regular prison community following therapy. In addition, relapse and subsequent recidivism are substantially reduced if the offender maintains therapy after rejoining the community.
Theories
According to genetically based substance abuse theories, those most prone to use and get addicted to substances have inherited genetic components for these issues (Galanter, Kleber, & Brady, 2015). While some biological theories place an almost exclusive emphasis on the role of heredity in explaining substance use and abuse, the majority maintains, more sensibly, that genetics is only one of several variables that may incline people to abuse substances and misuse them after they have done so. Generally, biological theories of drug misuse and addiction claim that hereditary traits influence how individuals metabolize substances and perceive their consequences (Galanter, Kleber, & Brady, 2015). It is thought that a person’s genetic makeup influences the experience of substance use in several ways, such as whether a person feels uncomfortable instead of feeling good after consuming a specific drug (Galanter, Kleber, & Brady, 2015).
According to sensitization, persistent administration of some psychoactive substances causes brain changes that enhance susceptibility to continuing drug use, relapse, and need (Brennan & Houde, 2017). Sensitization theory is a form of neurobiological hypothesis of addiction that is different in that a behavior, chronic substance usage, increases a person’s risk for drug use, relapsing, and yearning through biological processes (Galanter, Kleber, & Brady, 2015). Simply put, the hypothesis proposes that persistent drug use induces permanent alterations in the dopamine-related motivational systems of vulnerable individuals. This phenomenon is known as brain sensitization. The parts of the mind that control incentives are linked to dopamine-based neuronal systems. Addictive medications stimulate reward regions in the brain through rapid dopamine releases (Galanter, Kleber, & Brady, 2015).
In contrast, preferring or the real pleasant effect of reward intake is regulated by more fragile brain networks independent of dopamine. When drug seeking reaches a pathologic level, it is referred to as drug desire, which is an overwhelming desire to rediscover a substance’s impacts despite the absence of physical symptoms of withdrawal. Based on the incentive-sensitization theory, substance addiction is primarily attributable to an over-amplification of psychological wanting, mainly when activated by stimuli. This allegedly renders the mind’s reward system less susceptible to drug and nondrug-related benefits.
The genetic ideas are comparable to disease views on drug use (Galanter, Kleber, & Brady, 2015). Specific illness theories emphasize inherited aspects in the origin of addiction, while others emphasize mental mechanisms and use the word disease figuratively. Importantly, all disease views address drug abuse in clinical terminology and argue that addictions should be handled similarly to orthodox medicine issues (Galanter, Kleber, & Brady, 2015). The illness viewpoint is sometimes called the disease model of substance abuse, especially the form of disease theory supported by AA (Galanter, Kleber, & Brady, 2015). This concept does not see substance use as inherently abnormal, but it claims that substance use will always lead to misuse and addiction for certain individuals. The illness model is ostensibly relevant to all psychoactive drugs, although it has been predominantly used for alcoholism (Brennan & Houde, 2017). According to this paradigm, alcoholism is a deadly, incurable, degenerative illness if left untreated (Brennan & Houde, 2017). Addiction as a sickness is not a novel concept. Intoxication was viewed as a disease of the body and spirit, and attendants were advised to assist persons with madness. During the 19th and early 20th centuries, nonetheless, an ethical model of addiction predominated, while the illness model was generally neglected (Brennan & Houde, 2017). In opposition to the illness model, the ethical model regarded drug abuse and excessive drinking as indications of a lack of moral character and considered the medical model to be only an excuse for poor behavior (Brennan & Houde, 2017).
Psychological viewpoints on substance abuse tend to highlight either reward or punishment (Akers, 2017). In opposition to the ideas outlined previously, sociological perspectives of drug use and abuse emphasize the significance of social structure rather than individual or psychological variables. Nevertheless, sociological theory varies in the degree to which individual elements are stressed (Akers, 2017). Classical differential association theory progressed to social learning theory (Brennan & Houde, 2017). In addition to relying significantly on the ideas of differential association theory, social learning theory emphasizes the significance of social processes such as mimicry and classical conditioning, which makes it more suitable for comprehending substance use and addiction (Akers, 2017).
In contrast to most other kinds of behavior, drug use may be socially and physically rewarded. Therefore the functions that punishment and reinforcement serve in the learning experience are recognized by some as significant in relation to substance abuse (Akers, 2017). Substance usage may be reinforced through social mechanisms, as in the instance of positive feedback from one’s peers for getting high. However, it may also be repeated in an unsociable, physiologic sense due to the effects of the drugs (Brennan & Houde, 2017). This physiological reinforcement might be harmful, as in the case of medicines that create physical withdrawal symptoms, motivating another dosage to ease the discomfort, or positive, as demonstrated by the amount to which the drug’s effects on the body are experienced as enjoyable (Brennan & Houde, 2017). Social learning theory also acknowledges that if the effects of a medication are seen as pleasurable is at least in part reliant on the learning experience.
Tools/Interventions
It is crucial to highlight that the progression of therapy for drug abuse disorders in women may differ from that in men (Neger & Prinz, 2015). Women are entering treatment report consuming certain substances for a shorter amount of time. However, women tend to proceed more rapidly from first substance use to addiction. Women may also have a more acute withdrawal. In certain instances, women respond differently to particular therapies than males. For example, nicotine replacement therapy is less effective for women than males (Galanter, Kleber, & Brady, 2015). Quitting can be difficult for anybody with a drug use issue. However, women may be hesitant to seek therapy during pregnancy owing to potential legal or societal concerns and the unavailability of child care during treatment. Women in treatment frequently require assistance in juggling employment, housework, care for children, and other family duties (Galanter, Kleber, & Brady, 2015).
Particular programs can assist pregnant women in safely quitting drugs and offer them prenatal care (Brennan & Houde, 2017). Specific forms of treatment have been effective, particularly when they include child care, parenting programs, and job training. Medications like methadone can enhance results when used in conjunction with the aforementioned therapies. Some infants require withdrawal symptom therapy (Galanter, Kleber, & Brady, 2015). However, results for the infant are improved if the woman takes treatment medication throughout pregnancy instead of continuing to use opioids. Group therapy is one of the most effective interventions to improve functioning and combat addiction in individuals, including women (Bougard et al., 2016; Liu et al., 2015).

Conclusion
The purpose of the current research paper is to provide research support for developing a therapy group. This therapy group intends to bring together East Texas young women battling drug misuse. The members in this group will utilize a workbook to identify triggers, redefine their perspectives, and engage in open discussion. This group is reserved for ladies battling substance misuse. Each participant will get the Sobriety Workbook for Women as part of this program.
Furthermore, we will participate in group discussions. The research reviewed in the current paper will play a significant role in guiding the therapy group, particularly in developing an understanding of the shared experiences of women with substance abuse issues and the problems they may be facing. Similarly, the current paper’s results provide guidance on applying theory and research into how to approach addiction in this group.

References
Akers, R. L. (2017). Social learning and social structure: A general theory of crime and deviance. Routledge.
Bougard, K. G., Laupola, T. M. T., Parker‐Dias, J., Creekmore, J., & Stangland, S. (2016). Turning the tides: Coping with trauma and addiction through residential adolescent group therapy. Journal of Child and Adolescent Psychiatric Nursing, 29(4), 196-206.
Brennan, J. F., & Houde, K. A. (2017). History and systems of psychology. Cambridge University Press.
Chesler, P. (2018). Women and madness. Chicago Review Press.
Galanter, M., Kleber, H. D., & Brady, K. T. (2015). The American Psychiatric Publishing textbook of substance abuse treatment. American Psychiatric Pub.
Gesler, W. M., Rabiner, D. G., & Defriese, G. H. (2019). Rural health and aging research: Theory, methods, and practical applications. Routledge.
Kandall, S. R. (2010). Women and drug addiction: a historical perspective. Journal of Addictive Diseases, 29(2), 117-126.
Liu, Q. X., Fang, X. Y., Yan, N., Zhou, Z. K., Yuan, X. J., Lan, J., & Liu, C. Y. (2015). Multi- family group therapy for adolescent Internet addiction: Exploring the underlying mechanisms. Addictive Behaviors, 42, 1-8.
Muñoz, S. A., & Bain, S. F. (2020). Mental Health and Wellbeing in Rural Regions: International Perspectives. Routledge.
Neger, E. N., & Prinz, R. J. (2015). Interventions to address parenting and parental substance abuse: Conceptual and methodological considerations. Clinical Psychology Review, 39, 71-82. 
Appendix A: Proposal
Abstract
The purpose of this treatment group is to bring together young women who are struggling with substance abuse misuse in East Texas. The participants in this group will use a workbook to identify triggers and reframe their mindsets along with open dialogue.
Purpose
This group is specifically for women who are struggling with substance abuse misuse. As part of this treatment, the Sobriety Workbook for Women will be distributed to each participant. Additionally, we will be participating in group discussions. This group will be facilitated by Tara Allen, a graduate student at Stephen F. Austin University. As a Child Protective Services employee, Ms. Allen has experience providing services for women with substance abuse histories. The topic of substance abuse and misuse holds great significance to Ms. Allen because she lost her mother to substance abuse.
Agency Sponsorship
This treatment group will be sponsored by the East Texas Council-Alcoholism (ETCADA). The mission statement of ETCADA is to support recovery and reduce substance use through education and intervention. By providing essential services, we also facilitate the transition of young adults into adulthood. Is the name and mission of the agency, its resources, and its geographic and demographic data. ETCADA is located in Longview, TX. Participants will receive snacks and drinks each week from Mobberly Baptist Church.

Membership
In this group, women in East Texas who are battling substance abuse misuse will be able to receive support. These women will be between 21 and 35 years old. In this population, the risk of long-term addiction is higher as young adults tend to experiment more with substance abuse.
Recruitment
The facilitator will create a flyer and post it at the local Child Protective Services office, the ETCADA treatment facility, and at the local celebrate recovery meetings to recruit members. Other professionals will be consulted about potential members by the facilitator.
Composition
The group will consist of 10 women who range from 21 -35. The women can be a member of any racial background and religion. This will be a closed group. Confidentiality will be enforced by the facilitator and participants.
Orientation
We will begin the group’s first session with introductions of the facilitator and participants. Group members will be informed of the treatment program’s structure by the facilitator. The facilitator and participants will establish ground rules as part of the group process. Participants will be asked by the facilitator what they would like to achieve during this treatment program. For maximum membership participation, feedback will be taken by both the facilitator and the participants.

Contract
We will have a twelve-week treatment program. The meetings will be held on Mondays from 5:30 PM to 6:30 PM at ETCADA, located at 708 Glencrest Ln, Longview, TX 75601. The phone number for ETCADA is 903-753-7633.
Environment
We will meet in a room at ETCADA that is big enough for 15 people, allowing us room for social distancing. A $500 budget is needed to purchase the Sobriety Workbook for Women. ETCADA will provide the workbook and writing utensils. Mobberly Baptist Church will provide snacks and drinks weekly.