The Association of Women And Drugs: What Triggers Them?

Women’s involvement in drug abuse

Most people believe that the misuse of drugs is mostly dominated by males. However, in the twentieth century, women's involvement in drug abuse has been increasing rapidly. The reason why such things occur is due to women is being anxious to consume illegal drugs at least once or use them not as prescribed. This shows that one of the factors that trigger women's involvement in drug abuse is due to easy access. This is because people tend to be an addict as the substance is becoming accessible to them.

Based on the study conducted by the National Institute of Health (NIH), women do not have trouble getting access to drugs as there is an issue of overmedication that has been arising. To add on, it is said that the social or occupational barriers that prevent equality among genders are the reason why women are involved in the substance abuse (National Institute of Health, 2014). The feeling of the stress of being a woman that needs to adjust to a male-dominated environment has driven them toward abuse to obtain self-soothe (Clancy, 2016). According to Clancy, opium has been given to women who complained of moodiness or other sign of mental health since the early 1900s. This is because they will be prescribed syrup that contains opium or other drugs which will help the consumer to calm their nerves. Hence, it will continuously be consumed to overcome the tension that they are facing, and, in the end, it will cause addiction.

The problem of drug abuse will create a greater impact on women compared to men. This is because, as the abuser becomes addicted, it will expose them to many health issues. For example, due to addiction, can cause cancer and dangerous diseases such as Human Immunodeficiency Viruses (HIV) and acquired immunodeficiency syndrome (AIDS). According to Azim et al. (2015), the researchers have found that the tendency for women to suffer from HIV is slightly higher compared to men. This is because, women who are involved in drug abuse whether injected or not will be more vulnerable to HIV disease as it can be transmitted through injection or sexual (Azim et al., 2015). Hence, this proves that women are prone to suffering many health issues if they are involved with drug abuse compared to men.

Other than that, Recovery Research Institute has found that the rate of overdose between women and men are steadily closing. This is because, from the year 1999 to 2010, there are about 48,00 women died due to overdose of pain relievers, however, in 2015, it increased to over 50,000 cases of overdose among women (National Institute on Drug Abuse, 2020). This proves that women have greater access compared to men obtaining the substance they will be prescribed to treat their mental health situation. Hence, as women are being described to have mental health pain due to their life issues such as working in a male-dominated culture, they will be prescribed higher doses of drugs to relieve their pain.

Rehabilitation centre

To recover from being addicted and avoid relapse, the addict needs to be monitored and guided by the authorized agency. This is because many addicts thought that they are able to be fully recovered without assistance from the authorized agency, however, it has proven that without assistance and guidance from the authorized agency, it is hard for the addict to be fully recovered (Espineli et al., 2015). As the addicts undergo treatment in the rehabilitation center, they will be referred to as clients.

Basically, a rehabilitation centre is an institution that provides treatment services to the addict. The institution is also responsible to correct the behaviour of the addict to ensure that they can break the dependency cycle. Furthermore, at the rehabilitation center, it is a process that helps their clients in achieving their highest level of function, independence, and quality of life (Danquah-Amoah & Charan, 2017). Even though the center does not able to undo the damage that has been made by their clients, it can help to restore the health, and well-being of their clients.

At the rehabilitation center, the treatment will be carried out through conducting programs. The programs initiated by the institution will be associated with physical and mental health issues that target their clients. This is because, when the drug has been abused, it will become a chemical that can have an impact on the body and brain. Each drugs have its own effect which can harm an individual’s health mentally and physically. However, the abuse of drugs will affect the brain as high consumption of drugs will change how the brain work and it will interfere with an individual’s capability to think (National Institute on Drug Abuse, 2020). Thus, a rehabilitation center is important to ensure the recovery of the addict and avoid relapse. Additionally, the focus of the rehabilitation center is to create an opportunity for their clients to change their behavior through curb psychological, physical, and emotional issue that has been caused by substance abuse (Sereta et al., 2016).

As for the treatment, medicine, and rehabilitation services in Malaysia, there are several programs that have been established to help the recovery process of addicts. One of the programs initiated is institutional rehabilitation services. In this program, it provides treatment and rehabilitation facilities for addicts. There are two categories of addicts that are required to go through the program which are addicts by Court Order under Section 6(1)(a) of the Act Drug Addicts (Treatment and Rehabilitation) 1983 (National Anti-Drug Agency, 2019). Under this section, it involves individuals (clients) who are ordered by the Magistrate to undergo treatment and rehabilitation within a period of two years, however, after the period ended, the client needs to undergo a supervision period under the supervision of an officer at a designated place within two years (National Anti-Drug Agency, 2021). The second category is voluntary addicts under Section 8(3)(a) of the Drug Addicts (Treatment and Rehabilitation) Act 1983 (National Anti-Drug Agency, 2019). As for this section, it involves an individual (client) who voluntarily undergoes treatment and rehabilitation for a period of two years, and after that, the client needs to undergo a supervision period by an officer within the period of two years (National Anti-Drug Agency, 2021). This institutional rehabilitation program is implemented in PUSPEN/ Cure & Care Rehabilitation Centre (CRCC) and Cure Clinics & AADK Care (C&C).

Relapse is a situation where during the treatment that the client undergoes, it is not able to be fully recover from the drug abuse, and due to several factors, it has triggered an individual to continue consuming drugs. One of the reasons that has caused the addict to relapse is due to peer pressure (Assim et al., 2011; Asghar et al., 2012; Mughal, 2018; Min et al., 2020; Norazleen & Ashwin, 2017). It is important for the addict to have supportive surroundings to encourage the addict so that they can be fully recovered. This is because, if the addict does not have supportive surroundings, the tendency for the addict to relapse is high. For example, if the addict is surrounded by bad peers which made the availability of drugs more accessible hence it will trigger the abuser to relapse. The second factor is a lack of assertiveness (Assim et al., 2011; Asghar et al., 2012; Mughal, 2018; Min et al., 2020; Norazleen & Ashwin, 2017). Basically, in the process of recovering from an addiction, it is important for the addict to be self-assured and confident with the decision of them to stop depending on drugs. This is because, if the addict is lacking assertiveness, it will cause the addict to be unable to say no to drugs. The other factor is social rejection (Assim et al., 2011; Asghar et al., 2012; Fauziah et al., 2011; Mughal, 2018; Norazleen & Ashwin, 2017; Nasir et al., 2020). To help the addict recover, social acceptance is very crucial as it can affect the emotion of the addict. This is because, without social acceptance, the addict will feel left out, and it will cause depressions which will cause them to relapse. By referring to Table 2, it shows that the statistic of relapse cases in Malaysia. From the year 2017-2019, it can be seen that the number of relapse cases keep on increasing. This proves that it is important to monitor and identify the factors that have triggered the client to relapse.

Therefore, to avoid from the addict to relapse, it is important for the rehabilitation centre to ensure the effectiveness of the treatment provided. World Health Organization and United Nation Office on Drugs and Crime have highlighted several principles that should be carried out by the rehabilitation centre. One of the principles is availability, accessibility, affordability, attractiveness, and appropriateness of substance dependence treatment (International Narcotics Control Board, 2019). To ensure the effectiveness of the treatment, it is important to ensure that the addict has access to a wide range of treatments. For example, as the centre is user-friendly and responsive toward the addict, hence it will contribute toward an effective recovery process. The other principle that should be focused on is the treatment, human rights, and dignity of the addict (International Narcotics Control Board, 2019). This principle is considered as crucial as it is important to ensure that the addict is not being discriminated against based on their drug dependency history. For example, the standard and ethical treatment that is being applied to the addict should be equal to other health treatments. The third principle is targeting special subgroups and conditions. There are several subgroups that require more attention as they have their special needs such as adolescents, women, pregnant women, and ethnic minorities. For example, if the centre does not provide the need that the special subgroups needed, it will cause the subgroups to have problems adapting to the environment at the centre.

In Malaysia, there are several Cure & Care Rehabilitation Centre (CCRC) established throughout the country. However, currently there are only two CCRC that provide drug abuse treatment specifically for women which in CCRC Bachok, Kelantan, and CCRC Tampin, Melaka. Compared to men, women are facing underutilized facilities as the number of women involves in drug abuse keeps on increasing. For example, the statistic shows that from the year 2018 to 2019, the number of women involved in drug abuse increased from 5,468 to 6,330. Yet, each of the women CRCC is only able to accommodate not more than 300 trainees. This proves that it is important to have sufficient rehabilitation centre specifically for women in order to ensure the effectiveness and avoid relapse.

Research design

In this study, the researcher has adopted qualitative research design. By adopting the research design, it requires an intensive examination of a real-life setting. Interview session has been conducted to gain information from the informant.

Unit of analysis

Throughout the interview session process, it involves Malay women clients from PUSPEN Bachok who has undergone treatment at the rehabilitation centre.

Instrumentation

The researcher has used a set of interview questions which will be posed to the informants. The interview questions will be in dual language which are English and Bahasa.

Data analysis

The data obtained will be analysed by using Thematic Analysis.

Family background

Family background may become part of the probable factor that may cause an individual to be involved with drugs. This is because a negative family background may lead to a problematic family. Problematic family refers to the unhealthy environment that needs to be faced by an individual that has led them to the usage of drug abuse to feel calm and forget about their problems at home. By referring to a past study by Nasir et al. (2019), the problematic family often occurs due to parents who quarrel or divorce. For example, due to problematic family, it can cause an individual to run away from home and escape from any domestic violence that occurs at home. In this study, family background refers to the internal negative environment at home which has triggered an individual to be involved with drugs due to the issue that they are facing. This is because, it is believed that, if an individual has a problematic family, they will feel alone and neglected thus the tendency for them to be involved in immoral acts is high.

“… at that time, I was having a family problem. The only way that I can forget about the problem is by using drugs. It helps me to at least forget about the problem for a while…” – (Nurin, p. 4)

“... my husband put me under a lot of pressure. He is hot-tempered and has aggressive behavior. I was so stressed out and every day I was surrounded by drug addicts who is his friends. Then I decided to associate with drugs hoping that it could lessen my burden…” – (Tina, p. 4)

Based on the statement above, the informants have shared the reason why they associate with drugs. The informant is not able to handle the chaotic atmosphere at home which has caused them to seek outside happiness. Apart from that, a husband who uses drugs tends to be more aggressive and were not able to control their emotions. Due to that, the wife is prone to being beaten by the husband.

Influence from peer

Peers are the ones whom they can share their problems and emotions with as they felt more secure around their friends. Based on research conducted at Jordan University, it is found that social acceptance is one factor that has triggered the involvement of youngsters in drug abuse (Al-Zboon & Al-Dababneh, 2017). This is because, in order to fit into a new environment at the university, the youngster tend to imitate each other hence that has led to drug abuse. Hence, influence from peers plays a crucial role in determining the factor that influences the involvement of drug abuse. The reason why an individual is vulnerable toward involving in drug abuse is due to the reason that they wanted to maintain a good relationship with their peers (Nasir et al., 2019). This is because, during their hard times, the abuser only has their peers around them hence they wanted to ensure that their relationship is on good terms.

“… that one day I was at my friend house. I saw her use it (drug) and I voluntarily offered myself to try it. At first I try it just for fun, but then I become more energetic. Since then, I keep on wanting for more…” - (Eka, p. 5)

“… I accidentally met an old friend at a town, back then he was someone special to me. He knew about my divorce and try to be friend with me again. He was the one who introduced me to it. He told me to use it whenever I felt uneasy so that it will make me feel better. I just listened to him, because he is a friend…” – (Syakilla, p. 4)

Based on the interview session that has been conducted with the informants, they have shared several reasons that has triggered them to be associating with drug. The informants have shared on how their friends has influenced them to use drugs. Due to the sense of trust toward a friend, the informants voluntarily offered themselves to associate with it.

Working purposes

The usage of drugs for working purposes is also part of the contributing factor. This is because, most of the interviewed clients stated that they only consume drugs while working. The client needs it as they are doing 2-3 jobs in a day. This means that by using drugs, they are able to have more energy to do all the work for them to support their family. One of the interviewed clients also mentioned that they use drugs to gain self-confidence while doing their job. For them, as they consume drugs, it will boost their confidence level and help them to gain people’s trust.

“… I was not being influenced by my friends; I use it only for working purposes. Every 3 to 4 times a week, I’ll be outstation… I need sufficient energy to travel back and forth from one place to another. To balance between my family and work life requires a lot of energy for me to manage it. But mostly, it took it (drug) just to boost my confidence level so that I look more presentable to gain my client’s trust…” – (Lina, pp. 9-10)

“… I stayed at my adopted sister’s house in Kepong after I had a divorce from my husband. I worked day and night just to make more money to support my little family. I was exhausted and I’ll be depending on it every time I felt like I don’t have enough energy…” – (Syidah, p. 6-7)

Based on the statement given by the informant, they have shared that they only consume drugs for working purposes. This is because they need it to boost their energy level and confidence so that they can do well in their job. Moreover, as they need to do 2 to 3 jobs a day to support their family, hence they justified that it is the main reason why they associate with drugs.