The Role of Gender in Substance Abuse

Addiction is an opportunistic disease that preys on both genders; however, physiological differences between the two sexes affect the way that addiction manifests itself within the brain and body. When these factors and differences are taken into consideration, the dangers of the disease can be reduced and a higher rate of rehabilitation can be achieved by all impacted individuals.

Addiction’s gender adaptation

Traditional gender roles are societal norms that are widely accepted in our culture and promote specific behavioral patterns for men and women to conform to. Addiction is an opportunistic disease that preys on both genders; however, physiological differences between the two sexes affect the way that addiction manifests itself within the brain and body.

Laboratory animals have shown the same kind of gender differences in addiction studies. These results have made it possible to study these phenomena among rats and mice; however, there is now plenty of direct evidence from humans.1

In order to most effectively treat the disease of addiction, researchers and physicians have conducted countless studies on how gender plays an integral role in the way substance abuse affects each of the sexes. When these factors and differences are taken into consideration, the dangers of the disease can be reduced and a higher rate of rehabilitation can be achieved by all impacted individuals.

Accounting for initial contrasts

Men and women have a wide range of components differentiating how they are physically and psychologically affected by addiction. From how an individual is first exposed to drugs to which substances a person is more vulnerable to abuse, males and females have a large spectrum of differences in regards to addiction.2

Until about a decade ago, most addiction research solely focused on men. In the early 1990s, United States agencies began to require federally funded studies to enroll more women. Since then, researchers have begun to draw conclusions correlating the importance of  gender differences with substance abuse.3

Understanding what addiction is lends to helping to prevent more individuals from its widespread grasp and better treating those afflicted by it. Addiction is a long-term, chronic brain disease that causes compulsive drug seeking behavior. An addicted individual will continue to abuse a substance although they are aware of the negative repercussions of doing so.4

Supporting research and evidence

The Journal of Abnormal Psychology published a study comprised of 43,000 men and women. It investigated the prevalence of various mental illnesses by gender. Researchers found that men are more likely to externalize emotions, which is displayed as noncompliant, aggressive behavior. This is a typical trait in male substance abusers. Women are more likely to develop anxiety disorders. This likely leads to internalized emotions, correlated to depression, loneliness and withdrawal, which are also factors lead towards addiction.5

A study conducted by Harvard Health, which is now supported by countless other studies in agreeance, concluded that men are more susceptible to becoming addicts than women.6

The National Household Survey on Drug Abuse (NHSDA) and Monitoring the Future (MTF) also concluded that a consistent pattern continues each year. This being that there is a greater occurrence of addiction and substance abuse found in men rather than women.

Genetic and environmental factors

Men begin using substances at a younger age and at a more frequent rate than women.

The pathways leading to drug abusing lifestyles differ for men and women. The Harvard Health study showed that men begin using substances at a younger age and at a more frequent and rapid rate than their female counterparts. However, interestingly enough, females become addicted to a substance faster than men do. This phenomenon is known as “telescoping.” Telescoping is the accelerated progression of addiction from initial use of a drug to entry into rehabilitation.7 For women, addiction seems to be a particularly expedited process when using cannabis, alcohol and opioids.

The brain chemistry and sex hormones of females are also key components in a woman’s elevated susceptibility. Studies show that female sex hormones, such as estrogen and progesterone, directly impact how a woman copes with stress. One study revolved around women who had continuously been administered estrogen. Researchers found that women who had higher levels of the hormone were more likely to exhibit negative moods as a response to being more emotionally distraught than females who did not receive any shots.8

Estrogen, dubbed the happy hormone, directly affects the dopamine system. Dopamine is correlated with the brain’s “reward” wiring. Many drugs trigger the brain to produce an excessive amount of this. Thus, when individuals take a people can become addicted to drugs and alcohol so easily.9

Different metabolisms can also produce dramatic differences within males and females on how they react to a substance and their tolerance levels. A woman’s metabolism may make her need less of a drug to feel its effects.10

Original introduction to a substance

Every year, it seems that girls and boys are younger and younger when they are first exposed to illegal substances. Different factors may cause one of the specific sexes to continue to abuse such substances. The Office of National Drug Control and Policy (ONDCP), a branch of the White House, conducted research into this disturbing trend. The ONDCP is committed to conducting research to counteract the effects of a major public health threat: drug use.

The White House released a study conducted by the ONDCP that identified and studied the certain risk factors that make women more vulnerable to addiction.11 The White House stated that the study was over a three year period with girls ages 8 to 22 as the main focus group. The study concluded that women become dependent and suffer the consequences of dependency sooner than males. It also revealed that boys and men use substances for different reasons than girls and women. There are various factors that can lead to a person abusing a drug. For girls and women, most of these are emotional or psychological.

Some factors include:

Boys and men are more likely to begin abusing a substance due to reasons that may include:

For many decades, the profile description of a typical male and female addict would include, low education level, young in age, lower income levels and most likely living within an inner city. However, due to the booming problem, drug abuse has spread to every community in the country, even the most suburban and affluent.

The main necessity for sobriety

Treatment is a necessity for all addicted individuals, male or female, in order for them to return to a sober life. Although rehabilitation is a crucial step, there is an uneven distribution in the amount of men and women that actually enter and complete rehabilitation.

Research from the ONDCP suggests that approximately 33 percent of admissions to rehab facilities in 2011 were women, while nearly 67 percent were male. However, The National Institute on Drug Abuse (NIDA) states that men have a higher likelihood of relapse.12 Women are more likely to stay sober longer due to their more frequent participation in group counseling. This more elevated and intensive type of continued aftercare and rehabilitation aids with them remaining sober.

Gender specific rehabilitation programs

Men and women experience practically every phase of addiction differently. From the onset of addiction and scope of withdrawal symptoms to the everyday impacts and response to treatment, males and females have distinct dissimilar reactions.

Researchers have recently begun to realize the many benefits of offering gender specific treatment programs. With the unique distinctions within each gender such as physical aspects, lifestyle, familial roles and behavioral factors and external social pressures, separate rehabilitation has many advantages. Gender differences in rates of substance abuse usage have been consistently observed and recorded by researchers and physicians. Programs that help patients heal with other men or with other women have continued to produce extremely encouraging results during the rehabilitation process.

For the best possible outcome, an accredited rehab facility will understand and implement this gender specific criteria for addiction treatment that is specifically tailored to the specialized distinctions within each gender.

The Substance Abuse and Mental Health Services Administration (SAMHSA) recently released a report entitled Substance Abuse Treatment: Addressing the Specific Needs of Women and is also known as A Treatment Improvement Protocol Tip 51. The report specifically assists treatment providers who specialize in treating women who are struggling with substance abuse and addiction. This information is considered to be a unique, scholarly guideline reviewing proven and evidence based gender specific research. It also details possible environmental and lifestyle factors that can contribute to a woman’s addictive behavior and strategies to combat it. Possible physical side-effects and complications of substance abuse that are distinct to women are also discussed, such as liver disease and a wide range of cardiac conditions.

Separation allows for males and females to address core issues unique to their group. Many times, both women and men are more comfortable in a setting of same sex peers when divulging personal information and stories. Individuals are less likely to feel embarrassment, guilt or shame.

SAMHSA reports that male and female patients that receive exclusive gender specific treatment are considerably more likely to maintain long-term sobriety.

Behind the reasoning

There are a variety of reasons why people decide to enter rehabilitation to better understand their disease and overcome it. As stated earlier, yearly, fewer women enter into recovery facilities than men. There are several factors that hinder a woman from seeking the help that she needs. Many times due to a wide range of obligations and possible stigmatization from society, women are reluctant to enter into treatment. Caretaker responsibilities, such as looking after the children, and household responsibilities including cooking as well as cleaning and earning money for the household can be obstacles as well.

Men may have less household responsibilities. However, if they are the primary provider for their family, they may feel that if they go to rehab the household may crumble and not be as financially stable without their normal salary contributions. Both sexes have a wide range of factors that can make entering into rehabilitation seem challenging.

Harvard Health also explains that gender socialization and stratification are aiding factors in why a person chooses to end their substance abusing career. For women, familial pressures and opinions from family members, such as spouses and parents, and friends can be held in high regards and truly give that final nudge a person needs to enter rehabilitation. Many times for men, familial pressures and career stress are triggers to enter. When addiction begins to spill over into their work, leading to errors or when it causes legal woes as backlash from possible DUIs or any other type of arrest that may have been made while they were under the influence, men are more likely to seek treatment.

Receiving treatment

In prior years, those struggling with substance abuse seemed to have few options for rehabilitation depending upon their financial means. However, President Barack Obama’s Affordable Care Act (ACA) has now generated more convenient and cost effective plans for those with substance abuse and addiction issues.

Within the ACA, President Obama has created the 10 elements of essential health benefits; within that list is now substance abuse. This means that adults purchasing a healthcare plan and are in need of care are eligible for substance use disorder services.13 No longer will access or the cost of receiving treatment be a barrier for entering into a facility. This will allow individuals to get the treatment that they require and help them with recovery and achieving sobriety.

Summary of key male and female addiction and substance abuse tendencies:

Addiction has not only become an epidemic in the United States, it has grown to such proportions across the world as well. In order to effectively treat this disease, it is imperative to understand the genetic, psychological, physical and societal factors that combine and contribute to an individual becoming an addict.


This article was written by addiction care experts at Behavioral Health of the Palm Beaches. We are committed to offering the most comprehensive addiction treatment services in the nation and being thought leaders in the addiction recovery community.


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