Substance Use and Addiction in Men

Understanding sex differences in substance use

There are undeniable differences between men and women that extend beyond physical features. Practically every cell in the human body is marked with a sex chromosome, and there are neurochemical and hormonal differences, as well as differences in the structure of the brain. These translate into psychological differences that affect thoughts, emotions, and behaviors, as well as the risk for certain medical and mental health conditions, including addiction. ^[1]

According to research, men are much more likely to develop addictions to drugs and alcohol. Men are also more likely to begin experimenting with drugs early in life, which further increases their risk for substance use disorders in adulthood. The severity of addiction may also be greater, with higher rates of emergency room visits and fatal overdoses reported in males. Despite this, research shows that men are less likely than women to seek professional treatment for an addiction. ^[3][5]

Men and women can also have slightly different responses and effects when consuming certain substances. For example, it is well known that men metabolize alcohol more efficiently than women, meaning it takes more to get them intoxicated. Research also shows that women develop substance dependence more quickly than men, and may also be more likely to experience negative health and mental health effects. ^[2][3][5]

Some of the differences between substance use patterns and addiction rates in men and women may be related to environmental, social, and cultural factors. For example, men are exposed to certain messages and norms related to masculinity that may encourage risk-taking and dangerous behaviors like drug and alcohol use. At the same time, these messages may discourage men from admitting emotional problems or asking for help. Since trauma, emotional concerns, and mental health conditions can all exacerbate SUD symptoms, this means their addictions may go untreated and become more severe. ^[2][3]

Drug and alcohol use statistics in men

Statistics on drug and alcohol use can be conflicting, depending on the source and method of calculation. Still, statistics can be useful when considered in the broader context of data and trends on addiction.

Here are some statistics on drug and alcohol use in men: ^[2][3][4]

• Men are about twice as likely as women to suffer from a substance use disorder.
• Men account for two-thirds of fatal opioid overdoses in the U.S.
• Men are two to three times more likely to overdose on drugs than women.
• About half of those with substance use disorders also have a mental health condition.
• Men are four times more likely to commit suicide than women.
• 30-40% of all suicide attempts involve alcohol intoxication.
• Men are more than three times more likely to engage in binge drinking than women.
• Men are much less likely to receive treatment for mental illness or addiction than women.
• More than half of young men who enter addiction treatment do so because of legal or court involvement.

Why addiction is more common in men: Risk factors

Many researchers have explored explanations of why addiction is more common in men than women, and have presented different theories. Some cite biological, genetic, neurochemical, and hormonal differences as a primary cause, while others hone in on social and cultural factors. Others present theories that are more psychological in nature, like explaining how men are more likely to suppress emotions, externalize stress, and engage in risky or impulsive behaviors. ^[1][2]

There is no singular theory that explains the higher prevalence of addiction in males. Instead, it is likely that a number of biological, psychological, and environmental factors are involved, as well as individual risk factors like genetics, childhood trauma, and personal life circumstances. Throughout the lifespan, there will be times when a person is more vulnerable to drug and alcohol addiction. ^[2][5]

For example, young men are more likely to abuse drugs and alcohol than older men, and circumstances like divorce, unemployment, health problems, and high stress increase the risk for addiction. ^[2] During times when these factors are not present, a person is less likely to develop a drug or alcohol problem, even if they engage in occasional use. These examples help to illustrate that addiction risk factors are not static and change in response to internal and external factors. Also, most of the risk factors for addiction are common in both men and women, rather than specific to men.

Signs of addiction

The signs and symptoms of a substance use disorder, the diagnostic term for an addiction, are the same in men and women. All substance use disorders are diagnosed using a standard set of criteria found in the DSM-5, which is the reference book used by licensed professionals to diagnose mental health conditions.

Here are the signs and symptoms of a substance use disorder: ^[6]

• Using drugs or alcohol in higher doses or more often than intended.
• Excessive time spent trying to obtain, use, or recover from the effects of drugs or alcohol.
• Unsuccessful attempts to cut back or stop using drugs or alcohol.
• Strong urges or cravings to use drugs or alcohol.
• Neglecting basic responsibilities at work or home because of drugs or alcohol.
• Using drugs or alcohol in situations where it is risky or unsafe.
• Giving up important social or recreational activities to use drugs or alcohol more.
• Negative impacts on important relationships because of drugs or alcohol.
• Negative impacts on physical or mental health because of drugs or alcohol.
• Developing a tolerance, needing to use more drugs or alcohol for the same effects.
• Physical or psychological withdrawal symptoms when stopping or cutting back on use.

According to the DSM-5, a person who displays 2-3 of the symptoms above has a mild substance use disorder. Someone with 4-5 symptoms has a moderate substance use disorder, and 6 or more symptoms indicates a severe substance use disorder. ^[6] Because research shows that men are less likely to seek professional treatment, they may be more likely to present with severe substance use disorders that require more intensive treatment. ^[2]

Effects and consequences of addiction in men

Addiction can have many negative consequences on a person’s physical and mental health, as well as affecting other important areas of life, including work, finances, and personal relationships. Without treatment, addictions often progress and become more severe over time, resulting in more severe and lasting negative consequences. ^[2][6]

Research suggests that men may be more likely to wait to seek treatment until they are experiencing severe consequences. For example, men are much more likely to go to the ER for drug-related overdoses or complications, and also much more likely to die from a fatal drug overdose. ^[2][5] Some research suggests that men with substance use disorders are more likely to suffer from medical problems, which may be caused by or contribute to their substance use. ^[3]

Here are some examples of negative effects and consequences of addiction in men: ^[2][5][6]

• Physical health problems like cardiac issues, cirrhosis, or organ failure.
• Mental health problems like psychosis or severe depression.
• More severe addictions because of reluctance to seek treatment.
• Poor self-care, including unhealthy nutrition, sleep, and exercise habits.
• Relationship conflicts, including separation, divorce, or estrangement from family.
• Financial problems, including debts, poor credit, or inability to afford basic needs.
• Housing instability, risk of eviction or homelessness.
• Legal involvement, including incarceration, felony charges, probation, or parole.
• Loss of employment or inability to maintain steady employment.

Treatment of addiction for men

There are many effective treatment options for people looking to overcome an addiction to drugs or alcohol, including some that are specific to men. Addiction treatment can be provided in a variety of settings, including inpatient, residential, and outpatient facilities.

The specific type of treatment provided will vary, but will usually include individual, group, and/or family therapy. Sometimes, medication will also be used to help treat underlying medical or mental health disorders or to minimize cravings or withdrawal.

Mutual help groups like Alcoholics Anonymous, Narcotics Anonymous, or SMART Recovery are helpful to many people in recovery. These groups are free to attend, and are places where people in recovery from an addiction can come together to provide support to one another.

How to seek help

Many people begin their recovery journey by scheduling an appointment with a licensed addiction professional or another provider at an addiction treatment center. Usually, this first appointment is reserved for a comprehensive evaluation that will help to determine the severity of a substance use disorder and explore options for treatment.