Men and substance abuse

DEFINITION: Medical professionals have recorded the effects of substance abuse on men since alcohol addiction was defined in the mid-nineteenth century. Since the 1980s, experts have documented and compared the effects of substance abuse in men and women and have found that the risk factors that men face when abusing drugs and alcohol differ from those that women may experience. Also, the treatment men receive for substance abuse also differs when compared with treatment for women.

Statistics

Men are more likely than women to abuse drugs and alcohol. This has been a stable finding throughout many decades of research. Men were more likely than women to use almost all types of illicit drugs, and illicit drug use is more likely to result in emergency department visits or overdose deaths for men than for women. In general, men have higher rates of alcohol use, including binge drinking, and they begin consuming addictive substances at a younger age than their female peers.

A study in the early 2020s found that, compared to women, men are 44 percent more likely to report drinking every day, 39 percent more likely to report drinking five to six times per week, and 27 percent more likely to drink five to six drinks in a typical day. Men were also more likely to binge drink, which for men means drinking four or more drinks in two hours. Men were 64 percent more likely than women to say they binge drink every day. They were 84 percent more likely to report binge drinking five to six days per week and 33 percent more likely to report three to four times per week.

The National Institute on Drug Use asserts that men are more likely than women to use almost all types of illicit drugs. Their drug use is also more likely to result in emergency room visits and overdose deaths. Illicit drugs are classified into five categories—narcotics, stimulants, depressants (sedatives), hallucinogens, and cannabis (according to federal law). These categories include legally and illegally produced drugs which may be prescribed or bought illegally. Men in most age groups have higher rates of use or dependence on illicit drugs and alcohol than women.

Additionally, studies have shown that men of sexual and gender minority groups abuse drugs and alcohol more often than heterosexual men. Also, men who belong to the LGBTQ community are more likely to experiment with drugs and alcohol and are more likely to continue using drugs and alcohol throughout their lives. Research indicates that this is often how individuals respond to or cope with instances of homophobia, discrimination, or violence experienced because of their sexual orientation or gender expression. Individuals who are part of the LGBTQ community are also more likely than their heterosexual peers to seek help for a substance use disorder.

Surveys also have found that men are more likely than women to start using drugs and alcohol earlier in their lives. Men also are more likely to continue using drugs and alcohol throughout their lives, often in larger doses than most women. The duration and frequency of use typically lead to the body’s ability to tolerate small dosages. This means that most men will increase the amount of drugs or alcohol they consume so they can experience a better high. This behavior often leads to substance abuse and addiction. Men are more likely than women to overdose from illicit drug use, but women are more likely to die from an overdose of prescription medications, such as antidepressants.

Risk Factors

People abuse drugs and alcohol for a variety of reasons. Many of these reasons—stress at work, social pressures, and escape from traumatic memories of the past—are shared between genders.

Women who abuse drugs and alcohol have been found to do so if they are in a mentally, physically, or sexually abusive relationship. Women also are more likely to abuse drugs and alcohol to calm anxiety, depression, post-traumatic stress, and eating disorders. Women tend to develop addictions to drugs or alcohol after having sought comfort in their drug of choice; that is, they wish to numb their feelings and avoid the effects of these situations.

Men, however, appear to turn to drugs and alcohol after they have experienced an unfortunate event, typically one that has occurred at their own hands. Men may drink alcohol or use drugs to avoid the consequences of their own aggressive or violent behaviors, for example.

Men who drink frequently and in large amounts are at a higher risk of developing heart disease, various types of cancers, and other health problems, such as human immunodeficiency virus infection. The additional risks of abusing drugs or alcohol include developing depression or anxiety, contemplating or committing suicide, and forming an addiction to the drug of choice. Men with substance abuse problems also are more likely to participate in risky sexual behaviors, such as having unprotected sex with multiple partners. In this case, men may unintentionally impregnate women they do not know, or they may contract a sexually transmitted disease.

Men and women both risk developing problems at work if they form an addiction to drugs or alcohol; their need to use the substance may become so strong that they arrive at work drunk or high or may simply not show up for shifts to become drunk or high instead. This lack of dependability may also affect their relationships with friends and family members, as the substance abuser may forget plans or neglect responsibilities to acquire or take drugs.

Men also risk becoming aggressive and violent when they abuse drugs and alcohol. Though medical professionals have not proven a direct causal relationship between the use of drugs and alcohol and domestic violence, studies have consistently shown that the two factors are directly related. The US Department of Justice (DOJ) has reported that 61 percent of domestic violence offenders have drug and alcohol abuse problems. The DOJ also found that 50 percent of all spousal murders were committed while the offender was intoxicated.

Scientists, criminologists, and medical professionals cannot say, however, whether becoming intoxicated leads men to physically, verbally, or sexually abuse their spouses or children—or if the relationship works the other way. For example, is it possible that most men who abuse drugs and alcohol do so to deal with the guilt they feel after they act violently or abusively toward their family? One thing all medical professionals agree on, though, is that substance abuse is never an excuse for violence. Men who are violent and those who witness such violence should not attempt to blame their behavior on the substance in question.

Treatment

Treating drug and alcohol abuse is difficult, regardless of the patient’s gender. One of the most important tasks to complete while diagnosing a patient with a substance abuse problem or addiction is determining whether the abuse or addiction exists with another disease or disorder.

Many men who abuse drugs and alcohol may also have a conduct disorder or antisocial personality disorder. Attention deficit hyperactivity disorder is common in men who abuse cocaine. Although women have higher rates of anxiety and depressive disorders than men, both men and women are commonly diagnosed with depressive disorders when they also abuse drugs or alcohol.

In addition to diagnosing any personality disorders or mental illnesses that may be underlying causes or results of substance abuse, medical professionals also must determine whether the patient also needs treatment for aggressive behavior, domestic violence, or past cases of sexual, physical, or emotional abuse. When all underlying conditions are documented, medical professionals then decide how to best treat their patients. In an ideal world, one therapist or group would be able to address all the patient’s issues. However, this is often not the case. A man who is addicted to drugs and a domestic violence offender most likely needs to attend one session to talk about his violent behavior with domestic violence counselors and another session to discuss his substance use with drug and alcohol counselors. He may also need to visit another location to be treated for withdrawal symptoms.

Research from the Recovery Village in the early 2020s found that men were 124 percent more likely than women to seek outside help to quit drinking. Men are also 253 percent more likely to experience a relapse in their first two years of sobriety than women. Other studies indicate that men are more likely than women to seek treatment for illicit drug use. Women may be uncomfortable seeking treatment or admitting they have a substance abuse problem. When seeking treatment, they often do not wish to share their most intimate details in a group of both men and women. For this reason, women often seek women-only support groups or female therapists if they wish to receive help for their condition.

Another reason women resist seeking treatment is childcare. Most men do not have this problem, as they are typically not the primary childcare providers in their household. If women cannot find a caretaker, they may have to skip meetings and appointments. Men, in general, do not have the same childcare responsibilities and thus have fewer barriers to attending therapy and doctors’ visits.

Bibliography

Brady, Kathleen T., and Carrie L. Randoll. “Gender Differences in Substance Use Disorders.” Addictive Disorders vol. 22, no. 2, 1999, pp. 241–52.

Center for Substance Abuse Treatment. Substance Abuse Treatment and Domestic Violence. Revised ed., U.S. Department of Health and Human Services, Public Health Service, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, 2012.

McCabe, Sean, et al. “Trends in Prescription Drug Abuse and Dependence, Co-Occurrence with Other Substance Use Disorders, and Treatment Utilization: Results from Two National Surveys.” Addictive Behaviors, vol. 33, 2008, pp. 1297–1305.

National Institute on Alcohol Abuse and Alcoholism. Assessing Alcohol Problems: A Guide for Clinicians and Researchers. 2nd ed. Washington, DC, DHHS, 2003.

"Sex and Gender Differences in Substance Abuse." National Institute on Drug Abuse, Apr. 2020, nida.nih.gov/publications/research-reports/substance-use-in-women/sex-gender-differences-in-substance-use. Accessed 30 Nov. 2022.

Shelton, Michael. Gay Men and Substance Abuse: A Basic Guide for Addicts and Those Who Care for Them. Center City, Hazelden, 2011.

Substance Abuse and Mental Health Services Administration. "2023 Companion infographic report: Results from the 2021, 2022, and 2023 National Surveys on Drug Use and Health (SAMHSA Publication No. PEP24-07-020)." Substance Abuse and Mental Health Services Administration, 2024, www.samhsa.gov/data/report/2021-2022-2023-nsduh-infographic. Accessed 5 Sept. 2024.

"Survey: Men Drink More and More Often but Women Are Less Likely to Seek Help for Alcohol Abuse." The Recovery Village, 22 Jan. 2024, www.therecoveryvillage.com/alcohol-abuse/alcohol-use-men-women. Accessed 5 Sept. 2024.

US Department of Health and Human Services. Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings, 2011, www.samhsa.gov/data/NSDUH/2k10Results/Web/HTML/2k10Results.htm#7.1.