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Although men are more likely than women to experience substance use disorders, the manifestations and causes of addiction in women can differ significantly. Addressing addiction in a gender-specific context can ensure that women are aware of and access the resources and treatment they require to manage substance use issues.
- Addiction in women can result in different experiences compared to men, including the rates and types of substance use, likelihood of seeking treatment, and societal perceptions.
- Substances with which women are most likely to experience issues include alcohol, cannabis, and prescription medications.
- Women with addictions can benefit from gender-specific treatments and resources focused on addressing women-specific barriers to treatment.
Understanding addiction in women
Millions of Americans are affected by substance use and addiction including alcohol, nicotine, prescription drugs, and illicit substance use disorders. Reports show that 48.7 million Americans aged 12 and older have a substance use disorder and around 100,000 people per year die from drug overdose.
Although men are more likely to develop addictions than women, substance use issues and health consequences are also common among women. The Substance Abuse and Mental Health Services Administration’s 2022 National Survey on Drug Use and Health shows that 21.1 million women (14.7%) in the US have a substance use disorder, of which:[1]
- 12.2 million women (8.5%) have alcohol use disorder
- 12.1 million women (8.4%) have a drug use disorder
Additionally, reports show:
- The age group among women who are most likely to experience a substance use disorder is 18-25-year-olds. [1]
- 94% of women with a substance use disorder do not seek treatment due to believing that they don’t need it. [1]
- Drug overdoses among women increased from 9.1 per 100,000 people in 2009 to 13.7 per 100,000 in 2019. [2]
- Over a quarter of women with a substance use disorder experience co-occurring mood or anxiety disorders. [3]
- Many women who are prescribed substances to relieve mental or physical issues develop a substance use disorder. [1][3]
- In 2022, 9.6% of pregnant women used illicit substances in the past month and 8.4% used nicotine products. [4]
How addiction affects women differently
Addiction in women can develop differently than it does in men, with differences in underlying causes, types of substances commonly used, rates of treatment-seeking, and types of stigma and treatment barriers faced.
Societal norms and expectations
Women have historically been considered the mother or caretaker within the home, with many being the sole caretakers of children. This can prevent women from accessing treatment, due to childcare responsibilities, as well as the fear of facing involvement from legal or social services.[5]
Additionally, women who are homemakers or full-time mothers may be isolated from others, potentially reducing social support networks, which can impact the risk of substance use and relapse. [5][6]
Stigma
The expectation of women to be mothers and caretakers also impacts the level of stigma women face when seeking treatment for substance use disorders. Mothers in particular may be perceived or believe they are perceived as failures or causing harm to their family when experiencing substance use issues. This can cause feelings of guilt and shame, which may prevent women from seeking treatment. [7]
Telescoping
Studies have found that women differ in the way they develop dependence and addiction. Typically, women begin using drugs at a later age than men, but they are quicker to progress from their first substance use to dependency, particularly with alcohol, opioids, and cannabis. [3][8]
This progression is known as telescoping. It can mean that, despite experiencing a shorter duration and amount of substance abuse, women may have more severe substance use issues and associated medical, behavioral, and psychological issues when entering treatment. [3]
Relapse risk
Neurological differences between men and women can impact the development of addiction. Hormones relating to the stress and reward systems can increase the vulnerability of women to drug use, cravings, and relapse.[3][6]
Biological effects
Some research suggests that women respond differently to certain substances, which can increase the risk of health complications. For example, alcohol can affect women more adversely than men due to differences in body water percentage and metabolic systems.[8]
Substance abuse effects on pregnancy & childbirth
Substance use can have numerous effects on pregnancy and fertility. For example:
- The use of illicit or prescription drugs can increase the risk of stillbirth by up to three times. [10]
- After birth, babies can experience neonatal abstinence syndrome (NAS), causing them to go through drug withdrawal. This risk is particularly high among babies of pregnant women who use opioids, alcohol, benzodiazepines, and barbiturates. [11] (Also see Fetal Alcohol Syndrome)
- Babies born to mothers who use cocaine may be a smaller weight and length and experience symptoms including irritability, tremors, and excessive crying. [12]
Differences between addiction in men and women
Reports suggest that men are more likely to experience alcohol and drug use disorders than females. Other differences between men and women include:[3][6][7][8]
- Men are more likely to use substances with friends, while women are more likely to use drugs with a partner.
- Women are more likely to experience cravings and relapse while in recovery.
- Women are more likely to seek and receive prescription medications for pain, anxiety, and sleep issues, which may contribute to high rates of prescription drug misuse. [9]
- Women progress more rapidly than men from substance use to dependence (telescoping).
- Women may be more likely than men to experience social, professional, and mental impairments relating to substance use, although men experience more substance-related legal issues.
- Co-occurring mental health issues differ between genders with substance use disorders. Women are more likely to experience anxiety disorders and depressive disorders, and men are more likely to experience conduct or antisocial personality disorders.
Common substances abused by women
Alcohol use is common among females in the US, and 40% of female alcohol users report regular binge drinking. Of all illicit substances, females are most likely to use marijuana. In 2022, 28.4 million (19.8%) women used marijuana. [1]
Other commonly used substances by females in the country include: [1]
- Prescription pain relief: 4.2 million (2.9%). Hydrocodone is the most commonly misused prescription pain relief, and 14.6% of females who use or misuse prescription pain relief have a severe substance use disorder.
- Hallucinogens: 3.3 million (2.3%)
- Prescription tranquilizers or sedatives: 2.8 million (1.9%)
- Prescription stimulants: 1.9 million (1.3%)
- Cocaine: 1.7 million (1.2%)
Risk factors for substance abuse in women
Common risk factors that contribute to substance abuse and the development of addiction in women include: [3][5][9][13]
- Trauma: Physical assault, sexual assault, and the development of post-traumatic stress disorder (PTSD) can increase the risk of substance misuse.
- Mental illness: Mood and anxiety disorders, particularly major depressive episodes and suicidal ideation, are significantly higher in women with substance use disorders, suggesting a causal association.
- Health issues: Women may be more likely to seek professional treatment for mental health issues, such as anxiety or chronic pain conditions. This results in a high number of prescriptions among women for drugs that are commonly misused or abused, such as benzodiazepines and opioids.
- Partner influence: Women are more likely to use drugs or relapse if they have a partner who uses substances.
- Stressors: Life circumstances can increase the risk of substance use in women, including factors such as partner violence, unemployment, financial issues, and social isolation.
- Childhood experiences: Witnessing addiction in childhood, particularly among parents or caretakers, can significantly influence the likelihood of addiction in later life.
Gender-specific treatment and supportive measures for women
The main barriers that women face when needing or seeking treatment include stigma, financial issues, and time constraints due to responsibilities. Gender-specific treatments involve measures to address these barriers and other women-specific needs.
This might include: [3][4][14]
- Childcare: Facilities and clinics that offer childcare can support mothers requiring treatment.
- Comprehensive care programs: Pregnant women with substance use disorders may need integrated prenatal care, counseling, and education about substance-related risks, alongside nutritional support to address deficiencies and promote maternal and fetal health.
- Legal advice: Women with addiction may fear legal repercussions of seeking treatment, such as social service involvement and losing custody of children. Legal advice may also be required to provide support with domestic issues that contribute to substance use such as partner violence.
- Sexual health: Women should be supported with sexual health issues that contribute to substance use, such as sexually transmitted diseases, family planning, and hormonal imbalances.
- Mental health focus: Women with addictions are likely to experience depression, anxiety, low self-esteem, or trauma-related issues, which may require a more empathetic and mental health-focused approach to treatment.
- Same-sex interventions: Same-sex treatment providers or support groups can help provide women with a safe treatment environment.
- Training and support: Women may require support with issues relating to housing, employment, financial independence, parenting skills, and body image.
Conclusion: Breaking the stigma around women and addiction
Although addiction is not an issue exclusive to women, the manifestation of addiction in women can occur in unique ways that may require a specific or gender-focused approach. Societal roles, self and perceived stigma, and harmful home environments can significantly influence the risk of substance use and treatment-seeking in women.[14]
Providing women-focused treatment and encouraging awareness and understanding among others can help women access necessary treatment to address substance use issues. This includes providing a safe environment, social support during and after treatment, and ensuring access to essential resources and services.[4]
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