Early substance abuse research focused on male subjects, but in the 1990s, research studies intentionally recruited women. The medical understanding of how women react to drugs and alcohol is changing. Although more men are still diagnosed with addiction, and women are more often diagnosed with mental health disorder the understanding of how women’s health is impacted by substance abuse and addiction is improving.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), about 15.8 million adult women in the United States abuse illicit drugs per year. This is close to 13 percent of women, ages 18 and older, in the nation.
Women Struggle with Unique Substance Abuse Problems
- Women use smaller amounts of substances, but they develop an addiction to these drugs faster than men and enter treatment faster for substance abuse.
- Women respond to drugs and alcohol differently. For example, they struggle with more cravings.
- Women are more likely to relapse after treatment, potentially due to mood changes associated with menstrual cycles.
- Different levels of estrogen and progesterone in women, compared to androgen and testosterone in men, make women’s bodies respond differently to intoxicating substances
- Differences in body mass and composition also make women’s bodies respond differently than men’s bodies.
- Brain chemistry changes are different in women compared to men.
- Women are more likely to receive a diagnosis for a mood disorder like anxiety or depression compared to men, which may influence their risk of misusing prescription drugs or abusing alcohol or illicit drugs.
- Life stress like child custody struggles, divorce, or loss or death of a long-term partner can trigger a mental health condition, grief, or high levels of stress, leading to substance abuse.
- SAMHSA reports that 4.6 million women, or about 3.8 percent, have misused prescription drugs in the past year. On average, a woman goes to the emergency room every three minutes due to prescription painkiller abuse. The National Council on Alcoholism and Drug Dependence (NCADD) reports that women are the fastest-growing demographic suffering from drug and alcohol abuse in the US. About 4.5 million women over the age of 12 struggle with any substance; about 3.5 million abuse prescription drugs; and about 3.1 million women abuse illicit substances. Every year, 200,000 women die as a result of drug or alcohol abuse.
- Women abuse smaller amounts, per dose, of drugs like alcohol, marijuana, opioids, and cocaine than men do; however, women are more likely to seek treatment for compulsive behaviors around drugs and alcohol. When they enter treatment, women are more likely to have a co-occurring mental, behavioral, social, or medical problem. Research shows that women typically develop symptoms of addiction faster than men once they begin abusing a drug.
Problems Unique to Women That May Trigger Addiction
Although environmental stress, genetic risk, and family history contribute to substance abuse risks in both women and men, women have unique risks that increase their risk of abusing drugs or alcohol.
- Child custody concerns: Women with children, especially young children, are more likely to drop out of treatment, and they are less likely to seek treatment in the first place. This is because they fear that Child Protective Services (CPS) will remove their children from their care or that addiction struggles could lead their partner to seek sole custody.In many instances, women are more likely to have sole or primary custody of children. The stress of caring for children on top of maintaining a job, going through a divorce, and finding safe childcare can trigger addiction or substance abuse.
- Pregnancy and breastfeeding: Women who abuse drugs or alcohol while pregnant put their children at risk of birth defects. However, the hormonal changes during pregnancy and just after childbirth mean women may feel depressed or anxious more often, leading to a higher risk of self-medicating. Some detox medications, like buprenorphine, can also affect fetal development or breastfeeding infants, so new mothers require special approaches to detox and rehabilitation.
- Sexual assault: Anyone of any gender can be a victim of sexual assault, but women are more likely to be victims of rape, assault, and sexual harassment than men. Due to increased life stress, women are also more likely to develop post-traumatic stress disorder (PTSD) after becoming the victim of sexual assault. Abusing drugs changes brain chemistry, and both put women at greater risk of becoming the victim of an assault and experiencing mental health disorders like PTSD after an assault.
- Eating disorders: Like any mental or behavioral health challenge, eating disorders can affect both men and women; however, women are two to three times more likely to develop eating disorders due to societal pressures and environmental stress. About 40 percent of women with eating disorders struggle with a substance abuse disorder, too.
- Menstrual cycles and hormonal changes: A woman’s hormonal cycles associated with menstruation can change how she experiences stress and mood. Some studies show that ovarian steroid hormones, especially progesterone and estrogen, can change the impact of specific drugs. For example, when progesterone is lowest, women will be more responsive to stimulants like cocaine.
- Intimate partner violence: Although men and women can both be victims of intimate partner violence (IPV), commonly called domestic violence, women are more likely to be the victims of IPV from their male partners compared to any other partnership combination.
Substance abuse has been reported to co-occur with IPV in 40-60 percent of cases. Abusing drugs and alcohol makes perpetrators more likely to abuse victims, and the mental changes associated with being intoxicated put victims at greater risk of suffering harm from perpetrators. Both perpetrators and victims are also more likely to abuse substances to self-medicate the stress associated with their role in intimate partner violence.
Women Need Specific Treatment Approaches
Women are more likely to seek help for mental or behavioral conditions compared to men while men are more likely to enter addiction treatment than women. However, both men and women who suffer from one condition are at greater risk of experiencing the other. Women who seek help from a therapist, physician, or even complementary medical specialist may suffer from substance abuse problems on top of mental health struggles. It is important for therapists and doctors to screen their female clients for potential substance abuse if they seek treatment for mental illness.
Rehabilitation programs should offer forms of assistance focused on women’s specific needs. For example, mothers may need childcare to complete an outpatient rehabilitation program, and women are more likely to need treatment for both a mood disorder and substance abuse. Inpatient treatment programs that help women get job training, professional development, and connections for work can help to keep more women in treatment. In addition, women often benefit from group therapy or support groups are gender-specific.