Just as when she openly discussed her mastectomy in 1974, former First Lady Betty Ford has now focused national attention on another major medical problem: the perilous combination of drugs and liquor. Mrs. Ford, who had been taking painkillers for arthritis and a pinched nerve in her neck, entered the Naval alcohol and drug rehabilitation center at Long Beach, Calif. to combat what she now frankly admits was addiction to both. As son Steve explained, she was waging “a very rough battle against the effects of Valium and alcohol.” Millions of women—more than twice as many as men—face the same problem, according to writer-social researcher Muriel Nellis, 44. Director of a yearlong HEW study on the subject, Nellis recently published Drugs, Alcohol and Women. A native New Yorker, she graduated from Hofstra University in liberal arts and got involved in drug-abuse problems while working for a congressional committee in 1969. She and second husband Joseph Nellis (between them they have four children, aged 20 to 32) now reside in Washington, where he is an attorney and she serves on the Women’s Task Panel of the President’s Commission on Mental Health. She discussed this growing epidemic with Judith Weinraub of PEOPLE.
Were you surprised by Mrs. Ford’s announcement?
No. Since she was no longer on chemotherapy, I was concerned when she narrated The Nutcracker on television last December that she might be over-medicating on Valium, because of her sloe-eyed, sleepy-tongued behavior.
How do you feel about her public disclosure?
I have extreme admiration for her courage, because she could have undergone treatment without drawing attention to it. Instead she said, “I’ve been overmedicating and I’ve got to do something about it. I can defeat it!” This may be the most critical thing in bringing Congress or HEW to the point where they can no longer ignore alcohol and drug abuse.
How serious is the problem?
It has an enormous impact on all of our social institutions. What we are seeing here is a mood-altering technology that serves as a kind of penicillin for fear and anxiety. As much as penicillin was once given as a cure-all, these drugs are being indiscriminantly overused.
Are women more susceptible to becoming either drug abusers or alcoholics?
Yes, I think they are perhaps twice as vulnerable—and increasingly so. There are about 20 million women in the U.S. with a drug and alcohol problem. In 1975 a study showed that 229 million prescriptions were made out for mood-altering drugs—amphetamines, sedatives, tranquilizers. That year 80 percent of all prescriptions for amphetamines went to women. More than two-thirds of all the others also went to women.
Is the disproportion getting worse?
Yes. A recent study in Santa Clara County, Calif. tracked adolescents over an eight-year period and found that young girls were outdoing young boys three to one in the use of both alcohol and cigarettes. And we have also noticed cirrhosis among women increasing rapidly. This used to be almost exclusively a male disease.
Why are women more susceptible?
It is the increasing stress on women’s lives—a husband’s career, the children’s needs, the absence of purpose. Also, the hard sell from the drug industry for quick panaceas is primarily targeted at female recipients. Pills are more of a way of life for women.
Is there a typical female abuser?
No. But there are vulnerable points in women’s lives. Like the teenage years, when there is a need to break away from a family and establish one’s own identity—or to escape a dull school curriculum. There are the stresses of being single, then there is marriage, when contemporary young women are concerned with fulfilling themselves but are frustrated because they must often address themselves to their husbands’ careers and families. Then there is the menopausal “empty nest” syndrome, a very critical time for alcoholism and pills. The elderly can also be terribly vulnerable.
What are some of the most common addictive drugs for women?
Analgesics, which are painkillers, are all addictive if taken over an extended period of time. These include Darvon, the most widely used prescription painkiller, Talwin, Percodan and Demerol. And of course there are tranquilizers like Valium and Librium—in other words, a whole range of drugs that physicians feel comfortable writing prescriptions for.
When does use turn into addiction?
When the daily use of three or four doses doesn’t treat a specific symptom but is more a prophylactic—something that you need to help you get through the day.
What’s the difference between dependency and addiction?
None, as far as I’m concerned. They are nothing more than words that separate the street people from the rest of us. Dependency is not as nasty-sounding as addiction.
Which comes first, alcoholism or pill-popping?
It can be either way—whatever is accessible. At the University of Washington a group of alcoholic women were found, without exception, to be using a minimum of three other drugs.
The FDA has announced it will require a warning on packages of Darvon that the drug should not be taken with alcohol or tranquilizers. What is the physical effect of taking tranquilizers and alcohol at the same time?
This is really a double dose of depressants, which is dangerously more efficient than just the sum of the two separate parts. The nervous system, the brain and the bloodstream are all involved. The interaction heightens the effect enormously, and the result can be fatal.
Is the child of an alcoholic or drug abuser more likely to become one?
Just seeing your parents having a drink before dinner every night or taking a Valium to ease their anxiety sets up an atmosphere that says it’s all right. Therefore a child growing up in this kind of family environment may be more likely to do it when he or she becomes an adult.
Is being married to a man, such as a politician or corporate figure, whose career is paramount, an additional stress?
Yes, an enormous number of those wives are alcoholic—mostly because they have to sublimate any special separate needs and identity for the sake of their husbands’ careers. They are extremely visible and often feel they cannot afford to do anything non-traditional.
Are doctors to blame for some of this drug abuse?
Some doctors have made a great deal of money providing these quick panaceas for their patients. Some simply don’t know that what they are doing is extremely dangerous—but at this juncture, ignorance of the problem should no longer be an excuse.
Why is the physician’s attitude so important in the case of women?
Women see a physician many more times throughout their lives than men do. One reason is that they are usually the ones who take the children to the doctor. It sounds like a dreadful thing to say, but that puts women in much greater jeopardy.
What can a doctor do to help?
Physicians need to be more specific. The patient doesn’t always know the potential for danger. So a doctor should tell his patient that she doesn’t have to use the drug all the time just because it’s been prescribed. If the specific problem has stopped, then stop taking the drug. Also, doctors should reduce the number of pills that are given, so that she has to come back for a refill if she wants to keep taking a drug.
How many of the 20 million women with drug and alcohol problems are undergoing some form of treatment?
There really aren’t any hard data. I don’t think they’ve got even 10 percent of the people who should be in treatment.
What would you tell women who are afraid to seek help?
First of all, they should know that they are not alone. As Mrs. Ford has done, they should step forward and seek assistance and demand some answers.
How long does treatment take, and is it possible outside a hospital?
Detoxification can take a week, with maybe another week for recovery. But it can be as simple as outpatient therapy and counseling once a week until therapist and patient agree the problem is in hand. It depends on the individual’s determination and willingness to assume more responsibility for—and control of—her own life.