The National Institute on Alcohol Abuse and Alcoholism (NIAAA) states that, based on 2015 statistics, there are 16 million people in the United States who struggle with alcohol use disorder, a condition which used to be called alcohol addiction or alcoholism. Of the 15.1 million adults in this group, 5.3 million are women, and 9.8 million are men.
Typically, more men abuse alcohol and drugs compared to women. In their 2014 report, the National Survey on Drug Use and Health (NSDUH) found that women were binge drinking more often, and having more drinks per binge, but men were still drinking a lot more alcohol on average.
- 4% of women consumed five or more drinks in one day at least once in the year before the survey
- 2% of women reported binge drinking in the month before the survey
- 6% of men drank five or more drinks in a binge episode at least once in the prior year
- 3% of men reported at least one binge drinking episode in the prior month
Although women experience more problems with alcohol faster than men do, far more men struggle with problem drinking, including alcohol use disorder (AUD). Because men make up a larger percentage of the group struggling with AUD in the United States, they are also more likely to be in rehabilitation programs; however, this does not mean that as many men seek treatment for AUD as necessary (only about 8.9% of people, regardless of gender, ages 12 and older in the US seek treatment for AUD).
Feeling safe is a factor in attending drug or alcohol addiction treatment, and finding solutions to help men feel more secure and understood is important to increasing the number of men who willingly seek help for AUD. Gender differences in the experience of addiction, and personal experiences in other parts of their lives, suggest that some men may benefit from gender-specific treatment; without women, there may be fewer distractions and possibly more potential camaraderie among peers attending rehabilitation.
The Structure of a Treatment Program for Men
The foundational aspects of female- versus male-specific alcoholism treatment programs are not radically different. Medically supervised detox from alcohol is important, and then a combination of group and individual talk therapy sessions in a rehabilitation program helps the person learn coping mechanisms and understand the dangers of alcohol abuse. However, men may respond differently to different treatment approaches, as they are socialized differently than women.
Men are socialized to be independent, stoic, self-sufficient, and invulnerable. This can lead to deep feelings of shame, denial, and combativeness, and cause aggressive lashing out verbally and even physically. During treatment, men may experience difficulty dealing with their emotions or expressing weaknesses, including addiction. They may have trouble examining their own struggles, and they may feel competitive with others during treatment, including the counselor.
Because entering treatment can be seen as admitting weakness, many men are resistant to asking for help or admitting that they have a problem. Many men in rehabilitation programs are incarcerated, and addiction treatment is part of their sentence. Other men may not be incarcerated, but they could be legally required to attend AUD treatment as part of a sentence for driving under the influence of alcohol. Even if a man has entered treatment voluntarily, resentment or shame may cause a backlash against therapists and addiction specialists, so using more direct forms of therapy, like Motivational Enhancement Therapy or Cognitive Behavioral Therapy, can help.
SAMHSA’s Tip 56, “Addressing the Specific Behavioral Needs of Men,” notes that men are socialized to prefer taking action to solving their problems, which involves setting goals. Counselors in a men-only alcohol treatment program may focus on this process, working with each man in the program to create specific goals, checking them off when they are accomplished, and discussing the steps to take at the next therapy session. Reframing treatment as the first successful step, and a sign of courage and strength, can help men stay in treatment.
A 2012 study from Massachusetts General Hospital (MGH) stated that coping mechanisms when dealing with alcoholism are driven as much by socialized gender roles as other internal or external influences. The group examined data from Alcoholics Anonymous (AA) meetings, from 1,700 individuals who self-reported whether they were successful in achieving and maintaining sobriety through the program.
The men surveyed reported that participating in AA increased their confidence to build a network of like minded, supportive friends, and helped them to stay sober in high-risk scenarios like holiday parties. Having a support network independent of AA was found to be twice as important to men as it was for women. In comparison, women benefited from AA’s steps to manage their anger and anxiety. While the support group helped, the social support was not stated as the most important outcome of attending AA.
Although AA is typically coed, specific meetings using the 12-Step model could be set up for men only, to help them find the social network they need to reinforce positive, sober choices. A therapeutic approach called Seeking Safety was examined as a method of treating co-occurring substance abuse and post-traumatic stress disorder (PTSD). Groups were divided by gender, and a third group was for both men and women. The men-only group reported moderately positive outcomes, including:
- Retention in treatment
- Reduction in problem gambling, alcohol, and marijuana use
- Reduction in PTSD symptoms
While these benefits will certainly not apply to all men, for many, seeking a group of similar peers helps them focus on treatment, find a supportive community, and learn to express their emotions in a safe environment.
According to the Centers for Disease Control and Prevention (CDC), men are more likely to be hospitalized due to alcohol abuse than women; they are twice as likely as women to be intoxicated with a blood alcohol concentration (BAC) above 0.08 percent when they are in a fatal car crash; and they are more likely to commit suicide and be drunk when they do. This means that men are less likely to enter treatment voluntarily and instead enter through the criminal justice system or the hospital system. A men-only treatment program can address these issues directly.
There may be some disadvantages for men in men-only alcoholism treatment programs. Since men are more likely to become aggressive and competitive, group dynamics in peer support sessions can be challenging. Men may threaten each other or try to establish dominance by boasting or refusing to participate. When the group can support each other and call each other out on these issues, treatment in a group of men can be very beneficial, but if they do not find ways to support each other, then treatment may cause a great deal of stress.
Additionally, gay or bisexual men may not feel safe, as they can still be a minority in these treatment programs. Depending on how a person identifies – if they identify with their gender or sexuality more strongly – finding a treatment program specific to those identities can bolster the recovery process.
Men-Only Alcoholism Treatment Programs Are Important Options
Finding a program for men alone can be beneficial for those who may not want to appear vulnerable around women, who have a challenging time with women, or who have a history of aggression toward women. It is important for counselors to be aware of how men are socialized and ensure that group dynamics do not bring the negative aspects of these traits out.
Men who struggle with specific physical or psychological issues related to long-term alcohol abuse may benefit from men-only alcoholism treatment programs because they can receive focused care from medical professionals as well as therapists.