Salem Press | 2011 | Salem Health: Addictions & Substance Abuse
Essay title: Gender and Addiction Category: Social Issues
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 suggest that men and women often become addicted for different reasons. Diagnosing and treating addiction successfully are also gender-sensitive.
Biological Differences Women are generally smaller than men and cannot absorb as high a volume of alcohol and drugs as men before becoming intoxicated. Yet despite this common understanding, women, especially young women, often keep up with their male peers and consequently sustain a higher level of intoxication. With alcohol addiction, 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 explains how the genders process substances differently, but does gender play a role in becoming substance dependent? In a 2010 article in the American Journal of Public Health, researchers studied gender differences as they related to medical conditions and psychiatric and substance-abuse disorders among inhabitants in U.S. jails. They 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 Dr. 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 has been simply more data on addiction among men. Male substance abuse is more visible, and through institutions like prisons and Veteran Affairs, more data are 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, mental health, and stresses in life. To the extent that gender plays a role in understanding substance abuse, the significance is in how addicts are diagnosed and rehabilitated. 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 rate of feeling their effects, the onset of substance abuse may have much less to do with gender and more to do with temperament and life experience. Yet, when reporting on drivers to ingest substances, females most often attributed an internal emotional stress factor, while men linked an external cue. Also, less women are likely to enter a substance abuse treatment program than men, instead seeking out counseling from a mental health or primary care provider.
Environmental Differences In a 2006 article in Canadian Psychology, researchers reviewed 15 studies to analyze whether any variation in how males and females cope with post-traumatic stress disorder (PTSD) accounts for different rates of substance abuse between the genders. They found that males and females experiencing PTSD were equally at risk for substance-abuse disorders and that, regardless of gender, specialists must be cognisant of the risk for any individual suffering from PTSD in engaging in behavior that can lead to addiction.
According to a 2007 study at the University of Minnesota, women are more inclined to "internalize drinking problems than men." Women tend to hide alcoholism, while men act out alcoholism. The study concluded that intervention reaches men more readily than 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 report, "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. They found that gender-sensitive social cues trigger a desire to drink. As far as gender differences, they 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 gender-centric educational initiatives to reduce alcoholism and analyzed the results. The project began with awareness-raising events such as small group meetings to discuss norms associated with gender and how alcohol may be used to enhance or reduce those norms, discussions to build cross-gender empathy and understanding of how alcoholism harms individuals of the opposite gender, and 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 individuals understand the gender-based norms they are measuring themselves and others against, they can process how alcohol consumption plays into those expectations and resist falling into a gender trap of alcoholism.
Back, Sudie E. "Substance Abuse in Women: Does Gender Matter?" Psychiatric Times (Jan. 1, 2007): 48.
Binswanger, Ingrid A. Joseph O. Merrill, and Patrick M. Krueger. "Gender Differences in Chronic Medical, Psychiatric, and Substance-Dependence Disorders Among Jail Inmates." American Journal of Public Health (March 2010): 476-82.
Cook, Gretchen. "New Research Confirms Alcohol Is Gender-Sensitive." Women's E-News (July 11, 2003).
Condor, Bob. "Gender Differences about Alcohol Are Sobering." Seattle Post-Intelligencer (April 30, 2007): D1.
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 (July 2009): 583.
Stewart, Sherryh, et al. "Are Gender Differences in Post-Traumatic Stress Disorder Rates Attenuated in Substance Use Disorder Patients?" Canadian Psychology (May 2006): 110-24.
"Using Gender-Based Initiatives to Reduce Campus Drinking." Women in Higher Education (May 2007): 22.
Web Sites of Interest American Council for Drug Education http://www.acde.org
Center for Substance Abuse Treatment (CSAT) http://csat.samhsa.gov