Drug and alcohol abuse is a problem for both males and females, but men and women tend to abuse different drugs.

There are many variables to take into consideration when designing treatment approaches for either sex.

Differences Between the Sexes

Why are there differences? Changes during puberty could explain it.

On March 2013, the Journal of Addiction published a study on drug use in adolescents. The study found some changes in the brain that are different for females and males which could explain the differences in how substance abuse manifests according to gender.

A few differences between male and female brain development include:

Grey Matter

All teens show an increase in grey matter and decrease in white matter, but this difference is stronger in the male brain.

Physical and Sexual Abuse

Abuse increases the likelihood of drug misuse, but boys are more likely to be abused physically, while girls are more likely to experience sexual abuse.

Emotional Abuse

This type of abuse may increase the likelihood of substance abuse in girls and women.

Research also shows that men and women are likely to misuse certain drugs at disparate rates.

Men and women also vary in how they respond to certain drugs.

Differences in Drug Abuse Between Males and Females

A January 2017 study from the Journal of Neuroscience Research shows that both women and men experience environmental, sociocultural, and biological factors that influence whether or not they misuse substances and how.

The study breaks down drug addiction into a series of steps and looks at differences in how women and men behave at every stage.

Step 1: Acquiring the Drug

  • Women are more likely to feel pleasure when taking certain drugs, such as amphetamine or cocaine. They tend to self-medicate more than men as well.
  • Men are more likely than women to try a drug or other risky activity to fit in.

Step 2: Escalation

  • Women are more likely to increase their drug use at this stage than men.
  • Men increase their use of drugs more slowly.

Step 3: Maintaining or Cementing Drug Use

  • Women establish their drug use at higher doses than men, and they experience more side effects.
  • Men’s drug use patterns become stable at lower doses than with women.

Step 4: Withdrawal

  • Female smokers report a stronger stress response when they try to quit smoking.
  • Men experience alcohol withdrawal at higher rates than women.

Step 5: Relapse

  • Relapse is more common in women and it can also happen at scattered periods.
  • In recovery, men tend to abstain from drugs longer than women.

Different Drugs of Abuse

An April 2013 report from the Substance Abuse and Mental Health Services Administration (SAMHSA) outlines a few statistics on the differences between female and male substance abuse treatment admissions.

In 2011, 33.1 percent of admissions to treatment facilities were for women, and 66.9 percent were for men.

The SAMHSA report highlights that alcohol is the most frequently abused drug by both women and men.

Among those admitted to treatment, the following shows the breakdown of the drug of choice between the sexes:


This is the second most commonly abused drug. Among those admitted for treatment, men and women were likely to abuse it at similar rates of 15 percent and 15.3 percent.


As the third most popular drug, men were more likely than women to report it as their primary substance of abuse. Their respective rates of abuse were 19.9 percent and 14.6 percent.

Prescription Painkillers

Women are more likely than men to misuse these substances. Admissions to treatment with prescription painkillers as the primary substance of abuse were 13.8 percent for women and 7.8 percent for men.


Women also entered substance abuse treatment for cocaine at higher rates than men — 9.3 percent and 7 percent, respectively.


Women were almost twice as likely to abuse this substance. Treatment admissions were 8.6 percent for women and 4.7 percent for men.

According to the National Institute on Drug Abuse (NIDA), men are still more likely to take illegal substances than women.

Men also are more likely to die of an overdose, but women tend to relapse more and develop cravings more quickly.

Special Needs for Women in Treatment

On January 2010, Harvard Medical School reported that research on specific needs for women is still new and did not truly begin flourishing until the 1990s.

New data eventually showed that men become addicted to higher numbers than women. Women face more obstacles to recovery, despite the fact that men face higher risks. Historically, treatment facilities were designed for the needs of men, and this is beginning to change only now.

It is true that women are less likely to misuse substances, but they become addicted and experience negative side effects faster than men. Though men might be more likely to become addicted, women experience the onset more quickly when it does occur.

New research is just beginning to reveal several factors that affect women and men differently. In June 2018, the BBC stated a few reasons why women respond to alcohol differently than men:

  • Women tend to be smaller than men overall.
  • Women’s bodies produce less of an enzyme called alcohol dehydrogenase (ADH). This enzyme metabolizes alcohol.
  • In addition to less ADH, women have more fat cells in their body than men. They also have lower water levels in the body, which makes it easier to experience alcohol’s adverse effects.
  • Women take less time to develop health issues related to alcohol, such as liver disease and nerve or heart damage.

Obstacles in Understanding Drug Misuse in Women

As Harvard Medical School mentioned, treatment centers have been operating under conditions that are favorable to men. More studies need to be conducted to show the specific benefits of gender-based rehabilitation facilities.

However, we can extrapolate some knowledge about the benefits of female-only treatment from guidelines offered by the United Nations Office on Drugs and Crime(UNODC) in April 2016. These include:

  • Family intervention strategies — These seem to help girls more than boys, as women and girls may benefit more from family bonds than boys.
  • Screenings — Screening girls for depression and anxiety might help, as women with these mental health conditions carry more risks than boys with the same conditions.
  • Prevention strategies — More research is needed on drug abuse prevention strategies, and it needs to include data that is separated by gender.

The guidelines also found that women are more likely to try drugs when they are with an intimate partner, while men are more likely to try drugs while with other male peers.

Women-Only Treatment

UNODC explains that women can do better in treatment that focuses on their needs. Even in coed institutions, this means the treatment center’s staff needs to put the needs of women and girls at the forefront of all treatments, particularly since women’s needs have been traditionally neglected in rehab.

That being said, rehab in a mixed facility can be beneficial to both women and men. Some women, however, may do better in a women-only facility, particularly if they have a history of abuse at the hands of men.

UNODC Also Established Guidelines to Improve Substance Abuse Treatment for Women, Which Include:

  • Adjusting treatment for developmental age — This is just as important as for chronological age.
  • Motivation — Young girls, in particular, require more motivation to pursue education, develop as individuals, and form their own moral compass.
  • Gender separation — Mixing women and men, or girls and boys, might be detrimental to the treatment of women. Being in a coed environment may result in increased harassment of women and make them feel less emotionally and physically safe.
  • Specialized support — Treatment centers should offer support for challenges that women and girls face, such as a propensity for depression and a need for stable family life.

Women also tend to face stigma when it comes to drug abuse. UNODC suggests rigorous training to create a nonjudgmental environment in which women can receive treatment.

In addition to these suggestions and findings, Psychology Today found that female friendships are an important component of women’s lives, so these should be fostered in recovery.

Women can be a great source of support for each other and can listen to each other while also improving each other’s self-esteem. Being in a female-only environment can help women in forming these kinds of bonds.

Rehab for Men

There are many options for men who might prefer receiving rehabilitation services at a male-only facility.

Though more studies need to be conducted on their specific benefits, a 2016 news report from CNN mentions that male friendships are also beneficial to their mental health. Male friendships can help men open up and learn to communicate with others. They can also assist in building trust.

The CNN report also mentions that some men feel they will lose women’s respect if they cherish friendships with other men. These fears may be less likely to manifest in a men-only rehab center. And these male relationships can form the basis of a strong social support network in recovery.

As such, men who feel these vulnerabilities may also benefit from a gender-based approach where they can be safe to open up about feelings and learn how to communicate best.

This can also have an impact on their recovery in the long run.

A Tailored Approach to Recovery

Any type of rehab should be tailored to the unique needs of the individual in treatment, and sex factors into this.

The differences between men and women can greatly shape their treatment plans and therapies. Ultimately, make sure the rehab you choose provides an individualized approach to recovery. A one-size-fits-all approach that applies to all genders just doesn’t work.

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