Gender and Management of AUD in Women

People with AUD may be the carers of young children, and this is especially likely for women.  As noted above, screening for domestic violence should be undertaken to assess child protection needs. Outside of the possibility of violence, a child protection assessment should be considered for anyone living with children under 16 years of age and being treated for AUD. It is critical to ask, rather than assume, whether an individual is caring for or living with children. Childcare responsibilities should be considered throughout treatment planning.  

There are few alcohol-specific parenting programs, but a range of parenting programs and support programs for vulnerable families are available. Referrals should be made to community programs or social work where necessary. Men are much less likely to be the primary carer of children, but parenting responsibilities should also be reviewed. Improving parenting and parenting engagement may be a protective factor for men with substance use disorders. 

Contraception will be an important consideration for women of child-bearing age who regularly consume alcohol, irrespective of their level of consumption or whether they have an AUD. An individual’s level of sexual activity with males can fluctuate over time and therefore the potential need for contraception should be periodically reviewed with the woman. 

Evidence supports the long acting reversible contraceptives (LARC), such as intra-uterine devices and hormonal implants, as these are not user dependent and should be recommended. Integrating contraceptive care into drug and alcohol treatment services has received some attention but has tended to focus on women experiencing other substance use disorders and the evidence currently is weak.