He loves football, she settles for a sitcom. He loves beer and steak, she loves chocolates. He claims she can’t read maps, she complains he drives too fast. Popular culture has created these gender stereotypes that both men and women laugh at. But science has shown that men and women are indeed wired differently.

Men and women think and act differently. They even get hooked on addictive substances in different ways. These differences exist in the way men and women react to addictive substances, how the addiction progresses from exposure to the manifestation of the symptoms, the degree of severity, and response to treatment and rehabilitation measures. Men and women also differ in the rate of addiction relapse.

Sex Steroid Hormone: The Culprit?

When we are stressed, we tend to reach out for comfort food. Some people down their stresses in a drink. It seems that reaching out for an addictive substance and end up abusing it is a common reaction to combat the negative moods caused by psychological stress. Scientists cannot agree more.

Because addiction is a maladaptive coping response to emotional stress, scientists were curious to know if the gender differences in addiction had roots in the way men and women react to stress. According to one study, steroidal hormones like estrogen and progesterone influence the way individuals respond to stress, which in turn determines their reaction when they are exposed to drug cues. Quite simply, this means that sex hormones work to make a person nod to or say “no” to a second drink or an extra cigarette. Scientists have also discovered that the amount of these hormones in the body determines the effect of drugs on an individual.

According to the findings of the above-mentioned studies, women with higher levels of progesterone in the body show lower degrees of stress-induced drug use or craving for an addictive substance. These women also tend to exhibit lesser degrees of both anxiety and negative cardiovascular responses (like a spike in the blood pressure level) when faced with a stressful situation.

According to another study, estrogen, the female sex hormone, influences how an individual responds to psychological stress. The study was conducted on women who have been administered estrogen. It was found that women who had increased levels of estrogen exhibited greater instances of negative moods in response to emotional stress than those who were not treated with estrogen shots.

Scientists have shown that estrogen affects the dopamine (DA) system. The DA system is responsible for creating reward pathways in the brain. Addictive substances tend to trigger the brain to produce an abundance of dopamine, the “happy” hormone. This is why people become hooked. Researchers are, however, still not sure how the hormone acts on the neural circuitry of reward or positive and negative reinforcement to give rise to such gender differences in addiction patterns.

Available data indicate that women tend to show an accelerated progress from the time they were exposed to an addictive substance to the stage where they become dependent on it. This pattern was noted for female users of alcohol, cannabis, and opioids. It was proposed that the phenomenon of stress-induced cravings for addictive substances can be considered a reliable indicator of the outcome of addiction treatment and the chances of a relapse.

Scientists believe that the presence of higher levels of estrogen is one of the causes why women tend to move from being casual drug users to hardcore addicts faster than men and also have greater instances of relapse.

One study carried out on cocaine-dependent people of both genders shows that women report more cravings than men after being exposed to the substance just before being presented with the questionnaire. A similar pattern has also been noted in heroin-dependent men and women.

Gender Differences in Co-Occurring Substance Abuse and Psychotic Disorders

Scientists have also noted gender differences in co-occurring substance abuse and psychotic disorders. It was found that female drug addicts are not only more sensitive to stress-induced cravings but also more prone to feeling anxious, depressed, and sad in response to a stressful situation. There have also been several studies that indicate a greater incidence of depression-induced alcoholism in women than in men.

In this context, it is worth noting that women tend to feel more guilty about their addictive disorders than men, and are also subjected to greater stigmatization. These add to their stress, bring down their levels of self-esteem, and make many shun social contact. These aggravate their addictive disorders and make them spiral further into the depths of addiction.

Co-morbid substance abuse and psychotic disorders create a vicious cycle of stress and addiction in women. It is imperative that physicians and counselors collaborate to devise treatment methods that do not just stop at curing the addiction but also go a step beyond and empower women with the necessary coping skills, so they can overcome the psychological challenges.

Implications of the Findings on Gender Differences in Addiction

There are widespread implications of the findings of the above-mentioned studies. Researchers, neuroscientists, physicians, therapists, and counselors should re-evaluate the addiction treatment strategies currently in place. There are not many gender-specific treatment and rehabilitation programs around. Given that women tend to have greater relapse rates than men, it now becomes imperative that they be treated and counseled differently. Scientists should devise gender-specific treatment and relapse-prevention programs that address the unique neurological needs of male and female addicts.

Substance abuse is a widespread but imminently preventable healthcare problem all over the world. Addiction not only affects the individual but also wrecks havoc on families, both financially and emotionally. Children, whose mothers have fallen prey to addiction, are the worst sufferers. There are countless instances of talented employees whose addiction forced them to quit work. A greater understanding of the gender differences in addiction patterns can help these people reclaim their lives and reinstate their positions in mainstream society.

References

Bobzean SA, DeNobrega AK, & Perrotti LI (2014). Sex differences in the neurobiology of drug addiction. Experimental neurology, 259, 64-74 PMID: 24508560

Dumas, J., Albert, K., Naylor, M., Sites, C., Benkelfat, C., & Newhouse, P. (2012). The Effects of Age and Estrogen on Stress Responsivity in Older Women The American Journal of Geriatric Psychiatry, 20 (9), 734-743 DOI: 10.1097/JGP.0b013e31825c0a14

Fox HC, & Sinha R (2009). Sex differences in drug-related stress-system changes: implications for treatment in substance-abusing women. Harvard review of psychiatry, 17 (2), 103-19 PMID: 19373619

Greenfield, S., Back, S., Lawson, K., & Brady, K. (2010). Substance Abuse in Women Psychiatric Clinics of North America, 33 (2), 339-355 DOI: 10.1016/j.psc.2010.01.004

Kennedy, A., Epstein, D., Phillips, K., & Preston, K. (2013). Sex differences in cocaine/heroin users: Drug-use triggers and craving in daily life Drug and Alcohol Dependence, 132 (1-2), 29-37 DOI: 10.1016/j.drugalcdep.2012.12.025

Sinha R, Fox H, Hong KI, Sofuoglu M, Morgan PT, & Bergquist KT (2007). Sex steroid hormones, stress response, and drug craving in cocaine-dependent women: implications for relapse susceptibility. Experimental and clinical psychopharmacology, 15 (5), 445-52 PMID: 17924778

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