reviewed by Diana Temple
Edited by Dorothy Broom. Allen & Unwin, 1994. Paperback, 235 pages, $24.95
Dorothy Broom, a Fellow of the National Centre for Epidemiology and Population Health at the Australian National University and former convener of the Women's Studies Program at ANU, has studied women's health for the past twenty years. She has edited these articles about women affected by drugs, particularly alcohol, from nineteen contributors who are health professionals or social scientists who have studied this topic.
Gender differences in the use and impact of alcohol and other drugs were almost entirely neglected until the 1980s. Most medical research and epidemiology used men as subjects, with the apparent assumption that results were applicable to both sexes.
Comparatively recently it has become clear that it is essential to study data derived from women as well as from men, since the physiological responses to some drugs differ between men and women and the social and psychological effects of drugs of abuse are different between the sexes. The double bind of the title suggests that women needing assistance to deal with the effects of drugs of abuse are disadvantaged because the treatment services have usually been designed for men, who are the vast majority of clients of treatment agencies.
The book is described by its editor as a first step in filling the need for a generally dsitributed book on the subject. Readers seeking such information will find supplementary material in the newly published Women's Health from the Australian Bureau of Statistics.
The book comprises 15 chapters arranged in four parts. Part 1 is about measuring the size of the problem and differentiating between effects on women (who for example are the main users of benzodiazepine tranquillisers) and men. Part 2 discusses the social context of women affected by alcohol and other drugs. Part 3 deals with programs and services available to such women, and Part 4 summarises the findings.
Significant aspects discussed include tobacco smoking which, while it has declined across the population, now affects more women than in past generations and is described as 'the single most preventable cause of drug-related disease and death'. The other notorious legal drug, alcohol, is consumed in greater quantity and by greater numbers of men than women, but it is more likely to be consumed at harmful levels by women. It is well established that physiological differences make the safe daily level to be two drinks for women in contrast to three or four for men.
It is speculated that, because of Australian women's independence
relative to women of many other cultures, Australian women may
outdrink all other women in the world. The risk of foetal
alcohol syndrome is discussed. There is a chapter on Aboriginal
women and their sufferings from alcohol-induced violence from
their male partners. Physical and psychological abuse by drug-
and alcohol-dependent husbands or partners may occur for women
from all cultures. This is discussed in a later chapter, as is
the position of children from such family backgrounds.
The once hidden dependence of women on tranquillisers such as valium, commonly prescribed before the ability of these drugs to cause severe dependence was understood, is discussed. Australian women historically over-used freely available analgesic tablets, a habit responsible for the former high incidence of kidney disease among women. Opiates were abused more commonly by women in the last century, when laudanum was frequently used in medicinal substances, than today. People who see Australia's drug problem in terms of heroin, cocaine or marijuana need to be reminded that alcohol and tobacco are much more common health risks.
The cost to Australia of the abuse of alcohol and other drugs is estimated at more than $14 billion annually. To help counteract this, services exist in each state and city for people suffering from effects of these drugs. This book sheds light on the factors related to drug abuse and the need for treatment services to be aware of the specific needs of women.