One the most compelling reasons for male-focused rehab services is the prevalence of drug abuse among males (the terms males is used instead of men to capture both adolescence and adulthood). The National Survey on Drug Use and Health, sponsored by the Substance Abuse and Mental Health Services Administration, provides the most reliable information on drug use patterns among Americans. According to the 2103 survey, the following findings directly reflect rates of drug abuse among males:
- The current rate of illicit drug use among males in the 12+ age group is higher than females (11.5 percent versus 7.3 percent).
- It is more common for males to be polydrug users than females.
- More males than females use marijuana (9.7 percent versus 5.6 percent), cocaine (0.8 percent compared to 0.4 percent), and hallucinogens (0.7 percent versus 0.3 percent).
- Among Americans aged 12 or older, more males than females are dependent on drugs (10.8 percent versus 5.8 percent).
- There is relative parity between the number of males and females in terms of rates of alcoholism (23 percent of males versus 22.5 percent of females).
- Females abuse prescription medications, including opioids, at higher rates than males.
These rates reflect that being male itself presents a greater risk factor for drug use in general compared to being female. Within the male group, homosexuals and bisexuals face a greater risk of drug use. According to the Centers for Disease Control and Prevention, homosexual males, bisexual males, and transgender males are more likely to:
- Consume alcohol
- Use drugs
- Experience higher rates of drug abuse
- Be less likely to abstain from alcohol and other drugs
- Continue to drink heavily later in life
Males who are seeking recovery services for substance abuse will find that they have different program options. They may enter a standard mixed-sex program, a mixed-sex program with special internal programming for males (i.e., gender-specific programming), or a male-only program (i.e., programming is gender-specific and the clientele is only male). For males who identify as homosexual or bisexual, they have the added option of attending a rehab program that is mixed-sex with LGBT programming or a program that is exclusively designed for the gay and bisexual males.
Male-Only Rehab
According to research from 2011, twice as many males enter treatment as females. In view of how males use drugs at a greater rate than females, this statistic provides good news. However, at present there appears to be a bias in research literature on addiction and treatment to focus on the female experience. There is a dearth of research available in the area of male needs in rehab and treatment outcomes. In fact, many research articles that purport to discuss gender and recovery skew the discussion heavily in favor of the needs of females alone.
Although addiction treatment research on males may be lagging behind that of females, an increasing number of rehab programs are developing male-only programs. In this way, addiction clinicians are a step ahead of addiction researchers.
Males needs differ from female needs in rehab in significant ways, such as:
- Males may have different reasons for initiating into drug use compared to women.
- Males may relapse for different reasons.
- Males may be the victim of sexual abuse but find it difficult to discuss their victimization.
- Males may have experienced domestic violence but do not feel comfortable revealing this information.
- Males may be more likely than females to have anger related issues that directly impact their substance use.
A male seeking recovery services may categorically choose a male-only rehab, and that’s his choice, but it’s not his only one. Another approach is to learn about the services offered in both male-only and mixed-sex programs, and make a decision based on the quality of care. For instance, if a male strongly feels that he would benefit from therapy sessions with a male therapist, it may be helpful for him to inquire with a mixed-sex rehab about the gender composition of their therapist staff members. Therapists have training across many different traumas, but some have niche training in working with male clients. Working with a male therapist who has special training in the male experience of trauma can provide an added level of comfort for a male in recovery. However, that service can potentially be provided in a mixed-sex program as well.
It is important to keep in mind that entering a male-only rehab program is the right choice for some, but it is not guaranteed to be more effective than a mixed-sex program with gender-sensitive programming. It may be especially important to keep this point in mind should there be a waitlist for admission to an all-male program. The rehab may have a mixed-sex program that is open and that may be a good choice so as not to derail one’s treatment goal.
Gender Sensitive Rehab
A gender-sensitive rehab program is one that has a mixed group of clients, in terms of biological sex, but offers internal programs that separately address the needs of males and females. A gender-sensitive rehab program may include any or all of the following features in its curriculum:
- Ensure that group therapy meetings are co-led by male and female therapists.
- In individual sessions, match clients and therapists based on biological sex.
- Create separate male groups and female groups for certain treatment services.
- Incorporate gender-specific content into treatment literature.
- Provide case management services that address the needs of males, such as ensuring access to a men’s health clinic, legal services for paternal rights, and information on male sober living homes.
Depending on the circumstances or locale, a male-only program may not be available; therefore, a gender-sensitive program is a viable alternative. In other cases, a male may find that a mixed-sex program with gender-sensitive programs can adequately meet his needs.
It is important to note that male-only treatment should never simply be about separating the sexes. An effective male-only program should provide services that can adequately meet the needs of the male experience with drugs and life in general. For instance, research shows that males process stress differently than females, which may be a factor in their greater propensity to use drugs. A treatment program that provides services that incorporate research related to males into the curriculum can truly be said to provide services tailored to males.
Research on females in female-only programs has found that treatment outcomes were not significantly better compared to those of females in mixed-sex programs. This finding led researchers to conclude that the quality of services may be a more significant predictor of abstinence maintenance than the gender composition of a rehab program. Although this research did not focus on male-only rehab, its finding may apply with equal force to male-only programs. Even assuming there is little to no difference in treatment outcomes between mixed-sex and same-sex programs, a male-only program can provide some males with a greater incentive to enter rehab, especially if they are hesitant about recovery.
New Relationships in Rehab
Discussions of male-only rehab programs often refer to how the lack of potential for a romantic alliance can be beneficial; however, this assumes that all males in rehab are heterosexual, which is myopic. Homosexual males and bisexuals in all-male rehab programs can as vulnerable to developing a “rehab romance” as heterosexual individuals in a mixed-sex program. In the context of heterosexual males, however, it may be true that a male-only program provides a safeguard against starting a relationship in rehab, which is not advisable as it can compromise the recovery process.
According to The Fix, a “rehab romance” is often a way of trying to replace the former pleasure of drug use. Starting a relationship may seem like a bonding experience and even a way to foster mutual aid; however, both parties are in a vulnerable position, and addiction specialists generally agree that it is not helpful to start a relationship in recovery. For this reason, it is advisable for an individual who enters rehab to make a firm commitment to recovery at the outset, which necessarily excludes starting a new romance. If two people do feel a strong connection, they can always revisit the potential for a relationship after completion of the rehab program.
At present, the wide availability of treatment programs translates into recovering people having numerous options. Although rehab selection is a component of the recovery process, the focus should always be on achieving and maintaining abstinence. To that end, a program that provides a tailored treatment plan and research-based services is typically a good starting point. Ideally, a person who is seeking male-only treatment will be able to engage the services of a reputable rehab center that provides a full continuum of services and male-specific programming.