The first time Laura Castells went to a day hospital to treat her problematic alcohol consumption, she was 20 years old. She came from a family of recognized professionals, “a good middle class”, and had suffered sexual abuse since childhood. I continued to suffer it. “There were no women anywhere, neither among the users nor among the professionals, they were a minority and I felt that it was not my place”, explains Castells, now recovered, three decades later, from her office at the Health and Community Foundation, which works to integrate the gender perspective in the field of addictions.
This attempt failed. It took him seven years, from that first time, to return to therapy that succeeded after isolating himself for four months in a therapeutic community in Catalonia. All the while, he would come home, drink and no one would notice. It was an addiction invisible to others; “a survival strategy” of an apparently functional person. Until he reached the limit of alcohol or life: “I thought I was going to die if I didn’t do something, I had no other choice.”
Women take an average of 18 years to access addiction treatment resources, and they continue to represent a tiny percentage of Proyecto Hombre’s users. More than 80% are men, according to their data. But alcohol is a very specific substance—socially normalized, legal, and accessible—that usually has different rules. Therapists found one piece of information that “impacted” them in the organization’s latest report: a higher percentage of women (46.8%) than men (33.6%) came to Proyecto Hombre in 2023 for heavy drinking.
María had known for years that her relationship with alcohol was getting out of control, “the hardest thing was saying it out loud.” At the institute where he teaches English, he attended lectures on addiction prevention given to his teenage students. “I didn’t take out my flask at work, but for years I couldn’t open a single beer. It was impossible for me, so I went to work as if I had been hit by a caravan and I blamed my children,” says María, whose name is given only for this report.
Addiction makes days and nights lose their outline. María, now 41, used alcohol to ease her daily suffering: her second motherhood had upset her. It was not the first time he had used this substance as an anesthetic – during confinement he drank a lot – but the situation got worse each time. She moved clandestinely and made her husband go out on the street under any pretext. “I felt bad because what was beautiful and wonderful on the outside,” he says, “was horrible for me.”
“Consumption is prior and consequential, that is, there is greater vulnerability due to problematic consumption but it is also a response to face the violence that women suffer and gender discomfort: undistributed care, triple work, precariousness of the labor market. If we work from this global gender approach, we know that the contribution is reduced,” explains Ana Burgos, anthropologist and member of the Malva project of the Health and Community Foundation. She works closely with Laura Castells.
Treatments have traditionally been very masculinized and bring us other burdens and other problems. Without going any further, having children to support and not being able to reconcile that with outpatient therapy that lasts many hours.
Ana Macías, director of the Proyecto Hombre program in Valladolid
María began therapy at the age of 38 and was discharged at 40. Her greatest fear was disappearing from home. Leaving her two children and her job. This is one of the causes that makes it difficult for women to adhere to treatments. “They have always been very masculinized and we face other burdens and other problems. Without going any further, having children to support and not being able to reconcile that with outpatient or residential therapy of long hours,” admits Ana Macías, program director of the Proyecto Hombre de Valladolid. “If we don’t manage to be more flexible, we won’t get there,” he concludes.
In some places, the organization provides support resources for childcare while mothers undergo treatment. In most cases, users arrive alone, while men usually come accompanied by their partners. The “social” sanction of alcoholism in women, in addition to hiding them, isolates them, experts agree. “They arrive without much support, they lose ties and accumulate many fears, for example that of having their custody taken away,” adds Macías.
“That’s why I think it’s not so much that it’s difficult for us to recognize ourselves in this situation of problematic consumption. It’s not a lack of awareness, but a punishment of the kind, that’s why it takes us longer to ask for help,” concludes Castells. This delay makes women arrive “exhausted of resources” and with “worse prognoses”. With much more deterioration. 84.9% of the women received by the Proyecto Hombre last year, with an average age of around 41 years, had serious anxiety problems (compared to 71% of men) and 75% suffered from depressive disorders (55.5% of men), in addition to suffering more chronic health problems (41.7%).
It is not a lack of awareness, but a gender sanction, which is why we take longer to ask for help.
Laura Castells, psychologist and former consumer
“The idea that they are bad and deviant women also weighs on them, which gives the impression that there are fewer possibilities for restoration than for men, whose addiction can be considered an excess of masculinity,” Burgos analyzes. The same consumption is crossed by gender roles: people do not drink as much at home as they go out to do it and it has a social purpose (“even if in the end we generate an addiction for everything”); However, they have a “more silent” consumption, in “private” and to “alleviate negative emotional states,” explains Macías. And he specifies: “This invisibility prevents them from going to treatments because sometimes no one notices it either.” “In all cases, people start drinking alcohol to have a good time and end up consuming it so as not to have a bad time,” contextualizes Burgos.
Maria only had one partner in her group therapy. “In the end, we create strong bonds, but I was a little alone in telling things that affect us more. I like them a lot, but a group of girls would surely have been better if the same or similar thing had happened to us,” explains the teacher, who remembers telling her classmates “that they were the worst because of the sexist jokes. nature” which they did.
The annual report of the Proyecto Hombre recommends “addressing gender disparities when initiating treatment for mental health and drug addiction problems.” “Awareness campaigns should be designed to address both sexes, emphasizing the importance of early help and combating stigma. In addition, specific programs for women are needed, given the later age of onset and barriers such as domestic violence or child custody,” the organization says. “Beyond recommendations, concrete experiences and people interested in the gender approach who do things, much is missing,” says Ana Burgos.
“The politicization of the unrest, the awareness that it had a social, structural origin and linked to the violence received has been the most important thing in my recovery,” defends Castells, who asks to add this comment a day after speaking with elDiario.es . “That feminism saves lives… well yes, it saved me.”
