The first time Tatiana Green tried an opiate was when she found painkillers in her mother’s medicine cabinet at age 16. The feeling took the edge off; something she needed after being sexually abused by a babysitter as a child. When she had surgery for a rare medical condition at 17, the pills were prescribed to her post-op, making the high that much easier to attain.
Until it wasn’t. The cost of maintaining the prescription rose, along with Green’s tolerance. But later, while in jail for possession and distribution, she kept hearing about another drug. In rehab, people kept talking about something with a similar high—maybe an even better one—for a fraction of the cost. Heroin. She tried it. And she was hooked.
“You feel no pain when you’re on heroin,” Green said. “It’s like your whole body is in an orgasm.”
Green continued to cycle in and out of jail and rehab for five years. She overdosed multiple times. She sold drugs. She sold herself. She couldn’t stop. “When you’re on the dope, you’re pretty much in a coma. You just don’t care,” she recalled.
Five years ago, following another relapse less than a week after getting out of rehab, Green woke up and decided she wanted more out of her life. She researched treatment centers in Florida and her family came up with the money to send her. She got clean and two years later founded ONWARD FOREVER to provide intervention services, mentoring, counseling and community outreach for addicts and their families.
If that story sounds familiar, it’s because it is—especially among women. The nationwide heroin epidemic is impacting females ages 12 and over like never before. A 2015 report by the Center for Disease Control and Prevention showed heroin use spiked 63 percent from 2002 to 2013. That statistic includes a near doubling among women.
Addiction among women, our mothers, affects the well-being of the whole family. In Suffolk County, 171 babies were born to addicted mothers in 2014, an increase of 105 percent since 2009 and the second highest number in New York State. Nassau experienced an increase of 60 percent.
But it’s not just older women who are getting hooked. Natalie Ciappa put a local face to a growing nationwide problem when she died from a heroin overdose in 2008. Ciappa was an honor roll student with a 113 GPA, a cheerleader at Plainedge High School and one of about 300 students selected for All-County Chorus. Her father, Victor Ciappa, remembers a happy, loving, motivated kid who was set to start her freshman year at SUNY Old Westbury on scholarship that August.
“We had parents of younger children who told us they were using [our daughter] as a role model, telling their kids to be like her,” Doreen Ciappa said.
Why Is This Happening?
The National Institute on Drug Abuse estimates 80 percent of women seeking treatment for an addiction have a trauma history. And that’s just the women who make it into treatment.
“When there’s too much stress there’s fear and when there’s too much fear there’s anxiety and when there’s too much anxiety it’s just, ‘give me what you got,’” said Long Island Council on Alcoholism and Drug Dependence (LICADD) executive director Steven Chassman.
Green knows. She tried to smile through the pain of being sexually abused as a child and then while in an abusive relationship as a teenager. It was enough to drive her over the edge.
“I didn’t have self-esteem, a knowledge of what loving and respecting myself meant,” Green said.
The connection between low self-esteem and drug use is impacting even women who have not experienced trauma, and social media compounds the negative feelings. Since Green got clean five years ago, photo and video sharing services like Instagram, Vine and Snapchat have exploded, and Facebook is still a juggernaut. It’s placed an even larger focus on image, something Green has found to be a problem for some women through her work with ONWARD FOREVER.
“For the woman who is scrolling through and constantly comparing herself [to other women], it may make her feel bad about herself. If you are not comfortable or happy with yourself that’s something that eats you alive,” said Green.
This feeds into social pressures, which women are often more susceptible to than men. A 2010 study by the National Institutes of Health revealed 51 percent of women are introduced to heroin injection by a sexual partner compared to fewer than 10 percent of men.
“If using heroin appears to them as a way to elevate their standing among their peers, become more popular or desirable to a partner, they may begin to dabble with its use, not anticipating the quick path to addiction,” said Kristie Golden, the associate director of operations, neurosciences, neurology, neurosurgery & psychiatry at Stony Brook University Hospital.
Women also experience depression at twice the rate of men. According to the National Alliance on Mental Illness, 1 in 8 women will grapple with the illness during their lifetimes. Fluctuating hormones, especially during pregnancy and after childbirth, are contributors as well, but it’s about more than just biology.
“In society, women tend to be under more stress due to the multiple roles they carry,” Golden said. “These factors can lead to depression and anxiety, which in turn can lead to substance abuse.”
What Needs to Change?
Access to affordable treatment can be half the battle. A 2005 study by Thomas M. Brady and Olivia Silber Ashley showed women face economic barriers to treatment more than men, which should come as no surprise considering women currently earn 79 cents for every dollar earned by men, a disparity of 21 percent.
Then factor in family and childcare, which also prevent women from attending treatment (especially if they’re single moms), according to the same study by Brady and Ashley. Though women are making strides in the workplace, in 2013 PEW Research showed only 37 percent of married mothers are the family breadwinner, which potentially leaves them with more childcare duties.
Nationwide, only 14 percent of drug treatment centers offer childcare services for a parent in treatment, according to The National Survey of Substance Abuse Treatment. Golden believes having on-site childcare can better ensure attendance and retention in programs, and noted that many treatment centers, including all Suffolk County programs, will allow pregnant women to enter right away rather than putting them on a wait-list.
The hope is to stop another alarming trend: opiate-addicted babies. From 2000 to 2012, nearly 22,000 children were born with Neonatal Abstinence Syndrome (NAS), that’s about one baby every 25 minutes. Though an addict might feel like s/he is going to die when experiencing heroin withdrawals, a baby actually can, which is why pregnant women in treatment are given methadone. It keeps the unborn baby alive until the opiates can be weaned off professionally. The long-term impacts of NAS on a person are still unknown, as studies have tended to stop after the first few year’s of a child’s life.
But even when a mother is in treatment with her baby or young child, Green notices they will put caring for their child ahead of their own needs.
“I’ve worked in a mother and child program and a lot of times what I’ve seen is the mother will say, ‘I have to take care of my baby,’” Green said. “Well, yes, but if you don’t learn to take care of you first, you’re not going to be able to take care of your child.”
Green thinks that more gender-specific treatment options are necessary to meet the rise of heroin use among women, particularly in cases where sexual assault, rape and trauma have occurred.
“Women are ashamed,” said Green, who went to co-ed treatment facilities and wishes there were more gender-specific options. “They don’t want to be viewed as washed up, as broken, damaged goods. It’s different when you’re in a room full of men because you feel like the men might laugh, talk and judge you and then there you go…your self-esteem is down in the toilet again.”
Building up self-esteem happens block by block. Addicts have to learn to care for and love themselves, something most people are taught at an early age. Chassman has found those blocks are made stronger by actions in addition to words in a group therapy session.
“You can sit there and tell a young woman how great she is, but that’s not self-esteem,” Chassman said. “You build self-esteem by doing estimable acts. That’s acts of empathy, being able to help others, being able to be seen as a person of integrity and responsibilities.”
LICADD offers volunteer, internship and outreach opportunities, which give women a chance to build self worth and purpose. Chassman said the efforts of these volunteers often result in other women accessing LICADD’s services.
Golden agrees that women’s groups and other gender-specific treatments would be beneficial, but she cautions it should be a mix of both co-ed and separated therapies to help patients learn to communicate across gender lines. She worked closely with James Tomarken, the commissioner of the department of health in Suffolk County, and LICADD to launch a 24/7 hotline Suffolk residents can call to get screenings, referrals and follow ups.
Addiction can be triggered by so many factors, and can be so different from person to person, there’s no telling where it will end. But when it comes to treatment, the experts agree that getting there—and getting the right kind—is everything.
“You have to move fast,” Doreen Ciappa said. “If you don’t move fast, look at me…three weeks and she was gone.”
The LICADD 24/7 hotline for Suffolk County is 631-979-1700. Other New York state residents can also call 1-877-846-7369. Suffolk County Communities of Solutions and LICADD have lists of resources addicts and their families can reach out to for help.