What Are the Differences in Addiction Between Men and Women?
For decades, addiction research only examined drug and alcohol’s effect on men. Men were the only participants in years of studies. This initial, exclusionary medical bias reflects some of the particular issues women have faced in addiction. In the 1990s, several U.S. organizations instituted requirements for the inclusion of women as study participants. Since that inclusion, researchers have discovered a number of differences in addiction between men and women.
Typically, men are more likely to abuse illicit drugs and alcohol – 11.5% of males over 12 have a substance use disorder, compared to 6.4% of females. However, women are more likely to go to the emergency room or fatally overdose due to substance abuse.
The distinctions between men and women suffering from addiction stem from biological and sociological differences. Many researchers now explain gender differences between the two as a result of the impact of society (such as childcare responsibilities, addiction stigma, relationship dynamics, and et cetera). There are also biological differences between men and women, revolving primarily around testosterone and estrogen production as well as average body size and composition, that cause substances to diversely affect the body.
As defined by Harvard Medical School, the notable differences in addiction between men and women center around “susceptibility, recovery, and risk of relapse.” The table below illustrates how these differences affect men and women.
|Risk of Relapse|
Girls between the ages of 12 and 17 are more likely to misuse all types of prescription opioids and stimulants than boys of the same age.
Historically, men and women have more or less followed cultural norms when it comes to depressant use. For much of American history, men were more likely to abuse alcohol and women were more likely to be prescribed and abuse pills (namely prescription opioids). Recently however, the gender gap in depressant abuse grows smaller and smaller. More women nowadays are drinking at levels similar to men and, overall, more men misuse prescription opioids than women.
Some research suggests that women are more sensitive to pain and may experience chronic pain more often than men. Women are also more likely to misuse prescription opioids (like oxycodone) and synthetic opioids (like heroin) to self-medicate for pain or anxiety. Furthermore, women develop a dependence on opioids faster than men due to a heightened dopamine response in the brain. Even so, more men misuse opioids and more men fatally overdose as a result of abuse. In 2016, 27 men died per day from prescription opioid overdose, compared to 19 women per day. Conversely, the rate of opioid-related deaths among women climbed 596% between 1999 and 2016 (deaths among men increased 312%).
In the first years of an opioid use disorder (OUD) involving injecting heroin, women are more likely to fatally overdose. This may be due to the continued use of prescriptions while simultaneously abusing heroin. However, after a few years, women are actually more likely to survive heroin abuse than men.
- More likely to abuse smaller doses for a shorter period of time
- Less likely to participate in injection drug use
A majority of women who participate in injection drug use report doing so due to pressure from social circles or sexual partners.
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Alcohol is by far the most common substance of abuse in the U.S. Historically, men had higher rates of alcohol abuse. Approximately 20% of men have an alcohol use disorder (AUD) compared to between 7% and 12% of women. Yet, recent studies show women’s drinking habits are falling more in line with their male counterparts. On the other hand, adolescent females between the ages of 12 and 20 have higher rates of underage drinking and binge drinking than males of the same age.
Women are more likely to develop a dependence at lower drinking levels than men.
Most people are aware of the differences between men and women when consuming alcohol. Because women typically weigh less than men, alcohol tends to have a greater effect on the female body. Accordingly, in terms of health consequences, women are more likely to develop alcohol-related disease and damage – even if they’ve abused alcohol for a shorter period of time. Drinking also carries a higher risk of breast cancer in some women. Among people with an AUD, the rate of death is 50% to 100% higher for women than men (including suicide, alcohol-related accidents, heart and liver disease, and stroke).
Moreover, some of the general well-being and social risks associated with alcohol affect women disproportionately. For instance, alcohol-related crimes (such as sexual assault, rape, and homicide) are perpetrated against women more often than men. Female drinkers are also more likely to engage in unprotected sex which could result in pregnancy or the transmission of an STD.
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Like alcohol and opioids, more men than women abuse marijuana. According to self-reported data, men are almost 3 times as likely as women to smoke marijuana on a daily basis. The effects of cannabis on both sexes are also interestingly different. Spatial memory impairment may be greater in most women, while men seem to exhibit greater marijuana-induced highs.
Men and women show equal rates of marijuana treatment admissions and both groups equally suffer from at least one other mental health issue (such as depression, anxiety, et cetera). Men, however, are more likely to have other, co-occurring substance use disorders as well as antisocial personality disorder. Women who abuse marijuana are more likely to suffer panic attacks and anxiety disorders.
Stimulants: Cocaine and Meth
Both sexes are more or less equally likely to abuse stimulants, though women report first use at a younger age than men. Hormones may explain the biological differences between men and women with stimulant addictions. Women tend to experience more cravings and are more likely to relapse, likely due to changes during the menstrual cycle and hormone production.
Human and animal studies suggest that estrogen plays a role in the dopamine “reward” effects of stimulants like cocaine and methamphetamine. Women may become addicted faster and take larger doses of stimulants than men because of this. Yet, even when women had been abusing stimulants longer, men and women showed similar rates of impairment in learning, concentration, and academic achievement. Additionally, men are more likely to suffer reduced blood flow to the frontal regions of the brain as a result of cocaine use.
Women are more likely to enter and complete meth addiction treatment than men.
Other differences in stimulant addiction between men and women stem from cultural differences. Men are more likely to abuse cocaine and meth to continue having a good time, whereas significantly more women report stimulant abuse for more energy (commonly associated with family or work responsibilities) and weight loss. Men are also more likely to switch drugs if they can’t get meth.
Ecstasy, also known as MDMA, is a stimulant and a strong hallucinogen. Studies show that women may experience greater highs or more intense hallucinations. Yet, men exhibit greater increases in blood pressure while using ecstasy. Following use, women tend to experience depression more often than men.
Ecstasy is also incredibly dehydrating and impairs the body’s ability to purge excess water and reduce blood sodium levels. When a dehydrated individual on ecstasy begins drinking large amounts of water, their brain cells could hold on to that water instead of releasing it. The result can lead to brain swelling and death. Though rare, young females between 15 and 30 have almost exclusively suffered this type of death.
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Recovering from Addiction
Despite the differences in addiction between men and women, seeking recovery can save a person’s life. If the cost of addiction has become unbearable, reach out to a treatment provider today. Detox and rehab are just the first steps to a more fulfilling, healthy life.