In this episode of ASAM Practice Pearls, Dr. Peter Selby and Dr. Hendree Jones discuss the importance of implementing gender-responsive and trauma-informed care in addiction treatment. They offer insights on recognizing trauma in patients, creating safer treatment environments, addressing gender-specific treatment gaps, and emphasizing the importance of language and empathy in clinical practice. Together, they highlight the positive impact that a compassionate and inclusive approach can have on patient care and treatment outcomes.

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Host

Peter Selby, MBBS, CCFP(AM), FCFP, FASAM 

Dr. Peter Selby is a Senior Scientist and Senior Medical Consultant at the Centre for Addiction and Mental Health (CAMH) and Vice-Chair, Research, and Giblon Professor in Family Medicine at the University of Toronto. His research focuses on innovative methods to understand and treat addictive behaviors and their comorbidities. He utilizes technology to scale and test health interventions, with his cohort of over 400,000 treated smokers in Ontario serving as an example. Dr. Selby has received over $100 million in grant funding from CIHR, NIH, and the Ministry of Health and has published more than 200 peer-reviewed articles. His most recent research program utilizes a Learning Health Systems approach to investigate how technology-equitable, collaborative care can enhance the delivery of evidence-based interventions to the patient while providing a more satisfying care experience for patients and providers across systems.

Expert

Hendree Jones, PhD

Dr. Hendree Jones is a licensed psychologist and an internationally recognized expert in the development and examination of both behavioral and pharmacologic treatments for pregnant women and their children in risky life situations. She was the Division Director of UNC Horizons for a decade and, in May of 2023, stepped into a Senior Advisor role for Horizons to take on several national policy and international policy projects. Expertscape ranks Dr. Jones as a top world expert in neonatal abstinence syndrome and opioid-related disorders. She has received continuous National Institutes of Health funding since 1994 and has written more than 350 publications. Dr. Jones has also authored two books, one on treating patients for substance use disorders and the other on comprehensive care for women who are pregnant and have substance use disorders. She has also written multiple textbook chapters on the topic of pregnancy and addiction, as well as 17 courses for adult learners on topics of substance use disorder treatment (WISE, CHILD, PEERS, ALLIES, etc.). Dr. Jones has co-authored multiple national and international guidelines on the topic of caring for pregnant and post-pregnant patients with substance use disorders and their children, including those published by the WHO, SAMHSA, and ASAM. She also co-authored both the women’s and children’s section of the UN International Standards for the Treatment of Drug Use Disorders and the UN guidelines on prevention and treatment for girls and women. In 2020, Dr. Jones won the ASAM R. Brinkley Smithers and Distinguished Scientist Award. In 2024, she won the MED Brady-Schuster Division 28 American Psychological Association award for lifetime achievement for contribution to addiction science. She consults for the UN and the WHO and is a member of the NIH’s HEAL multidisciplinary working group and the Advisory Committee on Research on Women's Health. Dr. Jones has been involved in over 43 projects around the world focused on improving the lives of children, women, and families.

📖 Show Segments

• 00:05 - Introduction 


• 01:09 - Patient Story: The Impact of Trauma on Women with Addictions


• 03:34 - Principles of Gender Responsive and Trauma-Informed Care


• 05:41  - Language and Communication in Addiction Treatment


• 08:06 - Challenges and Solutions in Implementing Trauma-Informed Care


• 17:17 - Biological and Gender Differences in Addiction


• 17:30 - Addressing Treatment Gaps for Women in Addiction Care


• 23:56 - Practical Steps for Trauma-Informed Care in Clinical Practice


• 27:08  - Conclusion and Additional Learning Opportunities

📋 Key Takeaways

• Implement Trauma-Informed Care: Trauma plays a significant role in women's addiction, requiring a trauma-informed approach to care that considers not just the events but also the lasting effects and individual experiences of trauma.


• Create Safe, Supportive Environment: Fostering a safe, transparent, and non-punitive environment is crucial for effective trauma-informed care. This includes considering physical surroundings, psychological safety, and the overall treatment environment to create a more welcoming and less anxiety-inducing environment.


• Use Respectful, Non-Stigmatizing Language: The language used by providers can significantly impact the comfort and dignity of patients. Avoiding stigmatizing terms and promoting respectful communication are essential to building trust between healthcare providers and patients.


• Implement a Gender-Responsive Approach: There are biological and social differences in how women experience addiction and substance use. Healthcare providers need to address these unique needs, such as offering targeted support and addressing gender-specific triggers.


• Address Systemic Issues and Barriers: Barriers to implementing trauma-informed care can be both systemic and cultural. Securing buy-in from all stakeholders, addressing staff concerns and fears, and ensuring consistent and positive reinforcement of new practices are important steps in overcoming organizational and cultural barriers.


• Foster Collaborative Care: Engaging patients as partners in their own treatment plans through shared decision-making and understanding their individual needs and triggers can enhance engagement and outcomes. This collaborative approach also applies to interactions with team members and creating a supportive work environment.


• Engage with Compassion and Curiosity: Maintaining empathy, validating patients' experiences, being genuinely curious about their needs and stories, and using mindfulness techniques can build stronger, more supportive patient-provider relationships, ultimately improving recovery.

🔗 Resources

• ASAM’s Women and Addiction Education and Resources: Explore HERE
  
  
  
  • Trauma-Responsive Care for Women with Substance Use Disorders – Factsheet
  
  
  • Patient-Centered Care for Women with Substance Use Disorders – Online Course
  
  
  
  


• ASAM’s Clinical Tips Microlearning Video Series: Women and Addiction
  
  
  
  • Engaging Families and Care Providers in Women’s SUD Treatment
  
  
  • Substance Use Among Aging Women
  
  
  • Pregnancy and Substance Use Disorders
  
  
  • Dressing Motivated Behaviors in Women with SUD
  
  
  
  


• NIDA Substance Use in Women Research Report: Provides an overview of how women not only use and respond to substances differently than men but also face unique biological, psychological, and social barriers in developing, experiencing, and treating substance use disorders.


• Your Words Matter – Language Showing Compassion and Care for Women, Infants, Families, and Communities Impacted by Substance Use Disorder: Offers tips on how to use person-first language and which terms to avoid using to reduce stigma and negative bias when discussing addiction or substance use disorder with pregnant women and mothers.


• Opioid-Use Disorders in Pregnancy: Management Guidelines for Improving Outcomes:
  
  
  
  • Intimate Partner Violence, Pregnancy, and Substance Use Disorder:
    
    Soper R, Jones H. Intimate Partner Violence, Pregnancy and Substance Use Disorder. In: Wright (Ed.), Opioid-Use Disorders in Pregnancy: Management Guidelines for Improving Outcomes. Cambridge University Press; 2018:41-48.
  
  
  • Treatment Approaches in Women with Substance Use Disorders Who Become Pregnant: Jones H. Treatment Approaches in Women with Substance Use Disorders Who Become Pregnant. In: Wright T (Ed.), Opioid-Use Disorders in Pregnancy: Management Guidelines for Improving Outcomes. Cambridge University Press; 2018:72-83.
  
  
  
  


• The ASAM Principles of Addiction Medicine (Seventh Edition):
  
  
  
  • Substance Use During Pregnancy: <a href="https://shop.lww.com/The-ASAM-Principles-of-Addiction-Medici