Gender and addiction

DEFINITION: Though it is unclear whether men or women are more susceptible to alcohol or drug addiction based on gender-specific biological and environmental factors, data suggests that men and women often become addicted for different reasons. Diagnosis and successful addiction treatment are also gender sensitive.

Biological Differences

Women are generally smaller than men in physical stature and cannot absorb as high a volume of alcohol and drugs as men before becoming intoxicated. Despite this common understanding, women, especially young women, often keep up with their male peers in drinking and consequently sustain a higher level of intoxication.

Scientists learned in a 1999 study that women metabolize alcohol differently than men, leaving them with higher concentrations of alcohol lingering in their blood and a higher susceptibility to cirrhosis of the liver and brain damage. This finding explains how men and women process substances differently, but it does not answer the question of whether gender plays a role in becoming substance dependent.

In a 2010 article in the American Journal of Public Health, researchers discussed their study of gender differences in medical conditions and psychiatric and substance-abuse disorders among inhabitants in jails in the United States. The researchers reported that, although gender differences play into the presence of chronic medical and psychiatric conditions, gender differences do not seem to account for the prevalence of substance abuse.

In a 2007 article in Psychiatric Times, neuroscience professor Sudie E. Back refuted assertions that rates of substance abuse among men and women were linked to gender differences. She said that for decades there simply has been more data on addiction among men. Male substance abuse is more visible, and through institutions like prisons and the US Department of Veterans Affairs, more data is available. Less research has been done on women but, according to the little that has been done, the prevalence of substance abuse disorders has less to do with gender and more to do with experiences in childhood and adolescence, with mental health, and with stresses in life. To the extent that gender plays a role in understanding substance abuse, the significance is in how people experiencing addiction are diagnosed and rehabilitated.

Previously, in 1991, the US Department of Health and Human Services (HHS) founded the Office on Women’s Health to correct a trend in prior research where women were often excluded from research studies. Additionally, since its inception in the latter part of the twentieth century, the National Institute on Drug Abuse (NIDA), under the HHS, launched a number of women’s health initiatives, research studies, and programs to correct this bias.

Though chemical differences in males and females, such as the presence of testosterone, progesterone, and estrogen, can account for urges to ingest substances and the intensity of their effects, the onset of substance abuse may have much less to do with gender and more to do with temperament and life experience. When reporting on drivers to ingest substances, females most often attributed an internal emotional stress factor, while males linked an external cue. Also, fewer women than men are likely to enter a substance-abuse treatment program; women seek counseling from a mental health or primary care provider.

Environmental Differences

In a 2006 article in Canadian Psychology, researchers presented the results of their review of fifteen studies that analyzed whether any variation in how males and females cope with post-traumatic stress disorder (PTSD) accounts for different rates of substance abuse between men and women. The researchers found that males and females experiencing PTSD were equally at risk for substance-abuse disorders and that, regardless of gender, specialists must be cognizant of the risk for any person with PTSD in engaging in behaviors that can lead to addiction.

According to a 2007 study at the University of Minnesota, women are more inclined to “internalize drinking problems than [are] men.” Women tend to hide alcoholism, while men tend to act it out. The study concluded that intervention reaches men more readily than it does women, and suggested that women develop alcoholism later in life than men and spiral into alcohol addiction more rapidly. Data pointed to a stigma related to alcoholism for women that is much less apparent for men. Gretchen Cook reported in a 2003 Women’s E-News article that,

Recovery experts often note that while drinking has traditionally almost been a rite of passage for men, it has been considered “unladylike,” and that female alcoholics suffered harsher judgments from themselves and society. It’s only in the past decade that the institute has added women to their subject pools.

Perhaps entry into alcohol and drug dependence could be reduced simply through raising awareness in how gender-sensitive norms can facilitate behavior leading to addiction. In a 2009 article in the Journal of Studies on Alcohol and Drugs, researchers investigated whether social contexts of consuming alcohol influenced college males and females differently in the automatic alcohol associations made in the brain. The researchers found that gender-sensitive social cues trigger a desire to drink. As far as gender differences, researchers found a high general social approval of male heavy drinking and much lower approval for females engaging in heavy drinking. Given the social cognition linked to drinking, the study concluded, this higher social tolerance of males drinking in college creates a higher risk for males developing a lifestyle of heavy drinking.

Gender-Specific Treatment

In 2007, researchers at the University of North Carolina at Wilmington implemented and then analyzed the results of gender-centric educational initiatives to reduce alcoholism. The project began with awareness-raising events such as small-group meetings to discuss norms associated with gender and to examine how alcohol may be used to enhance or reduce those norms. The project also featured discussions to build cross-gender empathy and understanding of how alcoholism harms individuals regardless of gender, and it featured studies into gender-based advertising for alcohol products and bars. Both professional- and peer-intervention measures were integrated into the project.

The researchers discovered that, though professional intervention was most effective in reducing gender-based expectations with drinking, peer intervention was much more effective in directly reducing drinking behavior. This suggests that once a person understands the gender-based norms he or she is measuring themselves and others against, that person can process how alcohol consumption plays into those expectations and resist falling into a gender trap of alcoholism.

Bibliography

Back, Sudie E. “Substance Abuse in Women: Does Gender Matter?” Psychiatric Times, 1 Jan. 2007, 48. Print.

Binswanger, Ingrid A., et al. “Gender Differences in Chronic Medical, Psychiatric, and Substance-Dependence Disorders among Jail Inmates.” American Journal of Public Health 100.3 (2010): 476–82. Print.

Condor, Bob. “Gender Differences about Alcohol Are Sobering.” Seattle Post-Intelligencer, 30 Apr. 2007, D1. Print.

Farrington, Elizabeth Leigh. “Using Gender-Based Initiatives to Reduce Campus Drinking.” Women in Higher Education 16.5 (2007): 22. Print.

Lindgren, Kristen P., et al. “Automatic Alcohol Associations: Gender Differences and the Malleability of Alcohol Associations Following Exposure to a Dating Scenario.” Journal of Studies on Alcohol and Drugs 70 (2009): 583. Print.

Stewart, Sherry, et al. “Are Gender Differences in Post-Traumatic Stress Disorder Rates Attenuated in Substance Use Disorder Patients?” Canadian Psychology 47.2 (2006): 110–24. Print.

"Substance Use in Women Research Report: Sex and Gender Differences in Substance Use." National Institute on Drug Abuse, 4 May 2022, nida.nih.gov/publications/research-reports/substance-use-in-women/sex-gender-differences-in-substance-use. Accessed 1 Dec. 2022.

"Substance Use in Women Research Report: The Importance of Including Women in Research." National Institute on Drug Abuse, 1 Apr, 2020, nida.nih.gov/publications/research-reports/substance-use-in-women/importance-including-women-in-research. Accessed 19 July 2024.