Clinical Audit of Women with Substance Use Disorders: Findings and Implications

Aim: To examine the socio-demographic, clinical and psychosocial profiles of women seeking treatment for substance use disorders (SUDs) in order to understand their treatment needs. Materials and Methods: The psychiatric case records of 40 women with SUDs who sought consultation between the year 2012 and 2013 were analysed. Results: The mean age of the sample was 38 years (standard deviation, S.D = +/- 7.24). Among these, 52.5% were married and 30% were separated or divorced. Mean age of onset of substance dependence was 28.68 years (S.D. = +/- 7.02) with an average of 9.65 years (S.D = +/- 7.69) of dependence. Alcohol dependence was present in 80% of the patients, followed by nicotine dependence in 54% of the patients. Co-morbid Axis I and Axis II disorders were present in 62.5% and 10% of the patients respectively. Childhood adverse experiences such as abuse and neglect were reported by 20% of the patients. The factors contributing to initiation and maintenance of substance use were marital discord and interpersonal conflicts (70%), influence of significant others (66%), death of a family members (10%) and other stressful life events (25%). Major consequences of substance use were substance-induced physical problems (62.5%) and interpersonal conflicts (40%). Data analysis indicated poor follow up and relapse rate of 50%. Conclusions: Adverse life events and interpersonal conflicts are significant contributing factors to substance use among women. The study has implications for planning gender sensitive, multi-dimensional treatment programmes for women seeking treatment for SUDs in India.