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Sex and Gender Differences in Substance Use

Women face unique issues when it comes to substance use, in part influenced by:

  • sex—differences based on biology

  • gender—differences based on culturally defined roles for men and women

Scientists who study substance use have discovered that women who use drugs can have issues related to hormones, menstrual cycle, fertility, pregnancy, breastfeeding, and menopause. Also, women themselves describe unique reasons for using drugs, including controlling weight, fighting exhaustion, coping with pain, and attempts to self-treat mental health problems.


Science has also found that 19.5 million females (or 15.4 percent) ages 18 or older have used illicit* drugs in the past year. *The term "illicit" refers to the use of illegal drugs, including marijuana according to federal law, and misuse of prescription medications.

  • Women often use substances differently from men, using smaller amounts of certain drugs for less time before becoming addicted.

  • Women can respond to substances differently. For example, they may have more drug cravings and may be more likely to relapse after treatment.

  • Sex hormones can make women more sensitive than men to the effects of some drugs.

  • Women who use drugs may also experience more physical effects on their hearts and blood vessels.

  • Brain changes in women who use drugs can be different from those in men.

  • Women may be more likely to go to the emergency room or die from an overdose or other effects of certain substances.

  • Women who are victims of domestic violence are at increased risk of substance use.

  • Divorce, loss of child custody, or a partner or child's death can trigger women's substance use or other mental health disorders.

  • Women who use certain substances may be more likely to have panic attacks, anxiety, or depression.

Sex and Gender Differences in Substance Use Disorder Treatment

If a pregnant woman attempts to stop using drugs and alcohol without medical help suddenly, she can put her fetus at risk.


It is important to note that treatment for women's substance use disorders may progress differently than for men. Women report using some substances for a shorter period when they enter treatment. However, women's substance use tends to move more quickly from first use to addiction. Withdrawal may also be more intense for women. In some cases, women respond differently than men to specific treatments. For instance, nicotine replacement (patch or gum) does not work as well for women as for men.


It can be challenging for any person with a substance use disorder to quit. In particular, women may be afraid to get help during or after pregnancy due to possible legal or social fears and lack of childcare while in treatment. Women in treatment often need support for handling the burdens of work, home care, childcare, and other family responsibilities.


Specific programs can help pregnant women safely stop drug use and also provide prenatal care. Certain treatment types have shown positive results, especially if they provide childcare, parenting classes, and job training. Medications such as methadone and buprenorphine, combined with the treatments described above, can improve outcomes. Some babies will still need treatment for withdrawal symptoms. However, results are better for the baby if the mother takes treatment medicine during pregnancy than if she continues to use opioids.


For more information about sex and gender issues for women related to substance use, read the Substance Use in Women Research Report.


The Importance of Including Women in Research

In the past, women were not included in most research because researchers believed that women are more biologically complicated than men and that women were too busy caring for their children to participate in studies. However, excluding specific subgroups from research produces knowledge that only helps a portion of the public. Federal agencies, including the National Institutes of Health (NIH), have been instrumental in pushing for women to be included in clinical research. These efforts have ensured that broader public health issues related to sex and gender are studied.


Points to Remember

Women face unique issues when it comes to substance use. These differences are influenced by sex (differences based on biology) and gender (differences based on culturally defined roles).


Research has found many differences in how women and men use substances and react to substances. For example, women use drugs in smaller amounts than men, but they can experience the effects more strongly.


Using substances while pregnant can harm the health of a pregnant woman and her fetus. More women are using marijuana during pregnancy than in past years, resulting in smaller babies, and goes against the top medical group's advice representing obstetricians.

The use or misuse of some drugs while pregnant, especially opioids, can cause a newborn infant to experience withdrawal symptoms, a condition known as Neonatal Abstinence Syndrome (NAS).


Substance use in women tends to develop into addiction more quickly than in men.

It can be difficult for women to get help for a substance use problem during or after pregnancy because of social or legal fears. They may also lack childcare while in treatment.


Treatment programs should consider these issues and offer childcare, job training, and parenting classes.


In the past, women were not included in clinical research. Federal agencies have made significant efforts to ensure that all subgroups of people are included and that issues related to sex and gender are being studied.


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For more information about substance use in women, visit:



Source Reference: https://bit.ly/3q5ZVLi

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