Women and men are not exactly the same when it comes to substance use. Yet, as medical science has historically focused more on male subjects, there are gaps of knowledge around women and substance use, which modern science is only now beginning to fill.
Let’s take a look at what we know about the differences between women and men when it comes to substance use. Do women’s hormonal cycles affect drug and alcohol use, and if so, how? What unique barriers to addiction treatment do women face, and how can we remove such barriers to help more women achieve long-term recovery?
The latest science
In April 2020, the National Institute on Drug Abuse (part of the National Institutes of Health [NIH], the largest biomedical research agency in the world) published its Substance Use in Women Research Report. The report found that, while men are more likely than women to use drugs and alcohol, and men have a higher rate of dependency on these substances, women might be more prone than men to cravings and relapse, which play a key role in the addiction cycle.
As a result, substance use disorders can develop faster for women than for men. While women often have a shorter history of using drugs and alcohol, they may enter treatment with more severe medical and behavioral symptoms than men. This may be due to women’s faster progression from first-use to dependence on various substances.
The research also found that fewer women than men seek treatment for drug and alcohol addiction. Barriers to treatment that many women face include a lack of childcare, fear that authorities will take their children away, and the combined burdens of work, home keeping, family care, and other responsibilities typically shouldered more heavily by women.
Female sex hormones & addiction
Women’s hormonal cycles are more complex and variable than men’s (both over the course of a month and over a lifetime), which is one reason why women have been historically excluded as subjects in certain medical research, including addiction research.
Yet the effects of sex hormones such as estrogen, progesterone, and testosterone are not well understood when it comes to substance use. Some animal studies (which have not been replicated in humans) have found that estrogen enhances drug-seeking behavior, possibly by making female animals more sensitive to the “reward” effects of drugs. One study found that female rats were more likely to self-administer cocaine while in the estrus (high fertility) stage, while another showed that female mice were more likely to “binge drink” when their estrogen levels were high.
While animal studies have limitations, some researchers believe that women follow a different process than men when becoming addicted to drugs and alcohol. The need for more research is clear, as is the need for more addiction treatments tailored to—and tested on—women.
Reducing barriers to treatment for women
With far fewer women than men enrolled in substance use disorder (SUD) treatment programs, our culture needs to do better at increasing women’s access to addiction care.
Step one is to address the childcare and family responsibilities that so many women face, and that prevent many from seeking and following through with treatment. Increased support for women can take the form of on-site childcare at treatment centers, as well as more family-friendly treatment options.
Even better, a virtual option such as Aware Recovery Care’s In-Home Addiction Treatment™ (IHAT™) program eliminates the need to leave home to receive evidence-based, compassionate treatment. Women can stay with their families while receiving care, because all care is delivered to the home. The program includes a Family Education Facilitator who and helps heal the family and home, as well as the individual.
It’s also imperative to reduce the stigma and shame surrounding addiction, which may be more pronounced for women. Education and awareness campaigns can help shift public perceptions and encourage more women to seek treatment without fear of judgment.
Gender-specific treatment programs, such as women’s recovery groups and support groups, can create a sense of mutual support so women don’t feel alone in the recovery journey. And increasing access to affordable treatment is critical, as many women lack the financial resources needed for treatment (explore Aware’s insurance coverage and finance options).
Finally, we need more treatments tailored to women to improve recovery outcomes. Hopefully, with more science focusing on women’s addiction experience, that is something we can look forward to soon.
