When a male substance abuser seeks help, there often is a wife to care for the children.  When a woman addict voluntarily places her children in foster care - a foster home or institution - it's frequently because she is a single parent.

Involuntary, court-ordered foster care occurs when a child is born addicted or is neglected or abused.  Very seldom do we take a child if another parent is available   And we don't automatically take a child away from an addict unless it inhibits their ability to be a parent.   Surveys show 80 to 90 percent of wives, whose husbands are substance abusers, stay in the marriage.

For 80 to 90 percent of the women addicts, however, the reverse is true - their husbands seek divorces.  The woman stays because she's the nurturer and cares for him. Perhaps she's never held a job. But the husband leaves because she, as an abuser, has 'failed'.    The longer a female addict is able to function as wife or mother, the longer the problem may be swept under the rug. One husband indignantly cited a burned pot roast as "the last straw.  Another surprising statistic dismisses the stereotype of the tippling housewife as the closet alcoholic.  A Gallup poll for the National Institute of Alcohol Abuse and Alcoholism found that married women with jobs had the highest alcoholism rate among women. The exact opposite holds true among men: Employed, married men have the lowest rate; unemployed, single men the biggest drinking problem.

This emphasizes the stress factor involved in the problems of forgotten women.  In a liberated era, some women push themselves to the limit trying to be all things to all people - the perfect wife, mother and employee.

Other societal factors increase stress on women, writes experts at the New York State Division of Alcoholism and Alcohol Abuse.  She cites women's overall lower self esteem, limited job opportunities and lower pay, the role of the single parent, and sex discrimination in renting and borrowing. She points out that alcoholic women often are involved in marriages or relationships with alcoholic men and often are victims of domestic violence.

They don't benefit from the same therapy techniques, however. The most effective intervention programs now available for alcohol problems, such as drinking-driver programs, public intoxicant services and employee assistance programs, are, with few exceptions, far more effective in reaching the male than the female problem drinker.

For a woman in a stressful profession, the three-martini lunch may be a springboard to alcoholism. A typical case of prescription drug abuse, however involves a patient who began taking prescriptions for pain while recovering from a back operation.

The situational stress of divorce proceedings increased her stress and dependency on the product. Then her drug problem became an issue in the child custody suit. But for women addicted to illegal drugs, careers and divorce may seem the least of their worries in surviving life on the streets, heroin cut with oven cleaner or rat poison, hepatitis and venereal disease.

The woman becomes the victim, either being exploited and abused as a prostitute or robbed and beaten if she turns to drug dealing.  as more people recognize substance abuse problems, more women will choose treatment over silent suffering.

But medical centers and self-help groups should address the differences in therapy needs of males and females, he says, including help in arranging child care.  Women need to meet separately because many are intimidated by men's presence in a therapy group.  They also may be inhibited discussing specific addiction side effects such as loss of sexual urge, orgasm or menstruation.

Women outlive men, take better care of themselves, and once they're in a rehabilitation program, they're more successful than men in overcoming addiction.  But if they don't make that step, they're more likely to die.