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Why the fairer sex seems more vulnerable when it comes to being ensnared in drug use.

by Liss Mariano, M.D.


Marilyn Monroe. Amy Winehouse. Whitney Houston. Lindsay Lohan. If you were asked to say the first thing that comes to mind when you hear the names of these women, it would probably be fame, charisma or talent. But there is another common thread linking them together—a history of drug abuse.

Fatal fate for femmes

Hollywood has been so abuzz with sensational stories about its stars that we’ve grown numb to them. Another death by overdose, what’s new? Hollywood lives seem so completely different from our own that they seem almost alien. We may often think that famous women are more vulnerable to drug abuse because “they live such a fast life,” or “they don’t have anything else to do with their money.” What we sometimes fail to see is that these stars have more in common with us than we think.

Because of common misperceptions, we tend to think that female substance users are only rampant in the higher classes of society. Women with substance addictions, however, are becoming prevalent in society, perhaps more today than in any other era in history. Currently, women make up one-third of people with alcohol problems, and almost half of those with other substance problems—such as marijuana, prescription drugs and methamphetamine. Findings also report that women are more likely than men to abuse prescription drugs and to use multiple substances concomitantly. Because of this rise in prevalence, the science of gender differences in addiction has been the subject of research and debate. An important question that has come up is this: What makes female addiction different from male addiction? Surprisingly, quite a lot.

The female brain on drugs

It may come to a surprise that women are at an increased risk for addiction than men. Jill Becker, Ph.D. a professor of psychology at the University of Michigan, states that while “women begin using drugs at lower doses than men, their drug use escalates more rapidly into addiction, and they face a greater risk of relapse after abstinence.” We attempt to explain why in three ways: biologically, psychologically, and socially.

Biologically speaking, the basic neural systems involved in addiction are similar for men and women. There are differences between the sexes, however, as to how these neural systems are organized. One of these is the effect of hormones on the female brain. According to Becker, evidence from studies show women have an increased likelihood for escalation of drug use when they are in the estrous phase of their menstrual cycle as compared to the follicular or ovulation phase. The increased estrogen at this time of the cycle leads to enhanced dopamine release in the brain, which is the neurochemical basis for addiction. Unfortunately, the estrogen increase also makes it more likely for women to experience negative feelings during this time.

To make it simpler, we could compare it to the pre-menstrual syndrome or PMS phenomenon—in the days preceding menstruation, women are more likely to be depressed, irritable and anxious. These changes are characterized by an increase in estrogen, which in turn increases the drive to escalate drug use—very similar to the way women usually crave for, and feel better, after chocolate binges right before menstruation. It seems, therefore, that even the pattern of substance addiction in women can be blamed at, least partially, on the hormones.

No simple solution

Psychologically speaking, women with addictions also have different characteristics from men. Papers published in 1995 and 2003 in the U.S. cited that women were found to be more likely than men to come from families characterized by drug-dependent members. This type of family environment then causes them, unconsciously, to search for partners who similarly abuse substances, causing a vicious cycle of drug abuse. Indeed, addicted women are more likely to have an ongoing relationship with a substance-abusing partner, which also has negative implications on treatment.

Unfortunately, addicted women were more likely than men to have experienced trauma and abuse as a child. A U.S. Department of Health and Human Services study also cited that women are more likely to abuse drugs after a specific traumatic event; as many as 70 percent of female addicts have experienced abuse. This may be related to the finding that women engage in substance use to reduce stress or alleviate psychological distress. In essence, women tend to use drugs, including alcohol and nicotine, for self-medication of negative states, unlike men, who primarily use drugs for their positive effects—like euphoria, sexual excitement and energy. Two-thirds of female drug dependents also have a mental health problem, such as depression and anxiety. If we follow this line of thinking, then women with substance dependence are more likely to succeed in treatment once their psychological problems are addressed.

Seeking treatment

Socially, the stigma of addiction for women is of prime concern. Addicted women have been found to abuse substances at home, while men are more likely to have more social opportunities to use drugs, such as parties and bars. In a paper published in the journal “Social Work”, the authors claim these behavior patterns may reflect society’s tolerance of male substance use and the social stigma attached to female substance dependents. This is one of the reasons female addiction is considered a hidden problem.

Ironically, unlike other health issues, women are less likely to seek treatment for their substance dependence. Find out about how medical professionals are trying gender-specific approaches to help treat women with addiction problems in the November issue of HealthToday magazine, out now in newsstands and bookstores.

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