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SAMHSA’s Award-Winning Newsletter
March/April 2010, Volume 18, Number 2 

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TIP 51: Substance Abuse Treatment for Women

Gender makes a difference when looking at the physical effects of substance use and specific issues related to substance use disorders.

SAMHSA’s new Treatment Improvement Protocol 51 (TIP 51), Substance Abuse Treatment: Addressing the Specific Needs of Women, reviews gender-specific research and best practices. The TIP’s primary goal is to assist substance abuse treatment providers in offering effective, up-to-date treatment to women with substance use disorders.

Cover of Treatment Improvement Protocol (TIP) 51 - click to view publication

This TIP provides clinical and administrative information to assist counselors, clinical supervisors, program administrators, and others on how to best respond to the specific treatment needs of female clients. It also provides researchers and clinicians with a guide to sources of information and topics for further inquiry.

TIP 51 proposes that substance abuse treatment for women be approached from a perspective that encompasses the contexts of women’s lives: a woman’s social and economic environment; her relationships with family, extended family, and support systems; and the impact of gender and culture.

Patterns of Use

Women often report that stress, negative affect, and relationships precipitate initial substance use.

Relationships, relationship status, and the effects of a partner’s substance abuse significantly influence women. In addition, women dependent on substances are more likely to have partners with substance use disorders.

Although substance use is more prevalent among men than women, women are as likely as men to develop substance use disorders after initiation.

Screening and Assessment

For women, general alcohol and drug screening that determines current or at-risk status for substance use during pregnancy is essential. Considering women’s likely involvement with health care providers, screening for substance use and abuse should be standard practice for women of any age.

Treatment and Outcomes

As with the risk for substance abuse and its consequences, optimal processes for treatment and recovery differ by gender, race, ethnicity, sexual orientation, and other factors. Women are as likely as men to stay in treatment once it is initiated. Factors that encourage women to stay in treatment include supportive therapy, a collaborative therapeutic alliance, onsite childcare and children’s services, and other integrated and comprehensive treatment services.

Diagnoses of post-traumatic stress and other anxiety disorders, postpartum depression and other mood disorders, and eating disorders are more prevalent among women with substance use and co-occurring mental disorders than among men in treatment for substance use disorders.

Women have comparable abstinence rates with men and are as likely to complete treatment. Even so, women are more likely to have positive treatment outcomes in terms of less incarceration, higher rates of employment, and more established recovery-oriented social support systems. TIP 51 describes some relapse risks unique to women. Those risks include severe untreated childhood trauma, low self-worth connected to intimate relationships, and greater difficulty in severing ties with other people who use drugs and alcohol.

Gender-responsive treatment involves a safe atmosphere, where staff holds a hopeful and positive attitude toward women and shows investment in learning about women’s experiences, treatment needs, and appropriate interventions.

To Order

To order print copies of TIP 51, call 1-877-SAMHSA-7 (1-877-726-4727). Request publication number SMA09-4426. Download a full-text PDF version (382 pages) at

  Cover Story & Related Articles  
Take Action in Your Community

Take Action in Your Community

Three new campaigns bring powerful prevention messages to communities.

  From the Administrator  
Pamela S. Hyde, J.D.

Considering Language in Our Field

Do you use certain terms to describe our field? See terms.

  More on Underage Drinking  
Sober Truth on Underage Drinking

Sober Truth on Underage Drinking

The STOP program is making a difference. Read about grantees in Ohio, Connecticut, and Wisconsin.

Town Hall Meetings Continue To Expand

Nearly 1,800 communities across the Nation recently met to discuss underage drinking.

State Estimates on Underage Drinking

State by state, the numbers differ on children and alcohol use.

  Women & Substance Abuse  
Treatment Improvement Protocol 51

Treatment Improvement Protocol 51

Gender makes a difference. TIP 51 can help providers offer women effective, up-to-date treatment.

Pregnant Teen Admissions

Pregnant Teen Admissions

Comparing data from 1992 and 2007 on admission rates.

  Treatment Updates  
Uninsured Workers: Recent Data

Uninsured Workers: Data

Who needs treatment for substance abuse?

Free Treatment Available

Some facilities offer substance abuse treatment at no charge or a sliding scale fee.

Opioid Treatment Programs: Two Reports

Opioid Treatment Programs: Two Reports

Methadone maintenance, buprenorphine maintenance. What are the similarities and differences among OTPs?

  Evidence-Based Practices  
Evidence-Based Practices KITs

Evidence-Based Practices KITs

The Knowledge Information Transformation (KIT) series offers new KITs.

Fiscal Year 2011 Budget

Fiscal Year 2011 Budget

The Agency outlines a budget request totaling $3.7 billion.

More on the Budget . . .

Established programs, new initiatives, and SAMHSA’s Budget Authority by Activity and the Agency’s Congressional Justification.

  Grants Updates  
Promoting Mental Health Recovery

Promoting Mental Health

Five behavioral health care provider associations recently received funding.

  Media & Messages  
Art & Children’s Mental Health

Art & Children’s Mental Health

Every day is Children’s Mental Health Day: “My Feelings Are a Work of Art.”

1-800-273-TALK Is the Lifeline

1-800-273-TALK Is the Lifeline

Share the Suicide Prevention Lifeline’s number on Twitter, Facebook, and YouTube.

Minds on the Edge

Minds on the Edge

Facing mental illness is the subject of a PBS program.

  Recovery Month  
Flyers Available

Flyers Available

For 2010 celebrations, the flyers are available in print and online.

Inhalant Use & Respiratory Conditions

Inhalant Use & Respiratory Conditions

Thousands of children age 12 to 17 with pneumonia, bronchitis, and asthma used inhalants.


Substance Abuse & Mental Health Services Administration – 1 Choke Cherry Road – Rockville, MD 20857
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