While men have historically had higher rates of substance use disorders (SUDs), the gap between men and women in SUD prevalence is narrowing. Women account for approximately one-third of adults reporting an SUD in the U.S.
Recent studies suggest that in 2023, about 27.7 million men (20%) and 20.7 million women aged 12 and older (14.3%) in the United States had a past-year substance use disorder.
Women More Likely to Seek Treatment
While more men are in treatment for substance use disorders, women are more likely to seek treatment for dependence on sedatives. The rate of women seeking treatment for heroin use has increased.
Women account for approximately one-third of people with an SUD but only one-fifth are in SUD treatment, highlighting a treatment disparity. Women may face unique barriers to treatment, including lack of childcare, family obligations, and a quicker progression from substance use to dependence. Additionally, women with SUDs may experience greater physical, psychological, and social harms compared to men, including higher rates of injection drug use and associated infections.
Physiological Reactions to Alcohol and Drug Use in Women
Women’s physiological reactions to alcohol and drug use are different than men’s reactions along several important and unique dimensions. While both men and women metabolize alcohol and other drugs in the liver, women may metabolize alcohol slightly slower than men. Several studies highlight differences in the pharmacokinetics of drugs between men and women. These differences stem from physiological differences in body composition, plasma protein concentrations, and liver and kidney function that affect drug distribution and elimination.
Women experience higher blood alcohol concentrations (BACs) than men after consuming the same amount of alcohol due to differences in body composition, enzyme activity, and metabolism, leading to a greater physiological impact. Women generally have a higher percentage of body fat and lower percentage of body water compared to men. Since alcohol is distributed in body water, a smaller water volume in women means alcohol becomes more concentrated in their blood, leading to higher BACs.
Women have lower levels of alcohol dehydrogenase (ADH), an enzyme that metabolizes alcohol in the stomach, compared to men. This means less alcohol is broken down before it reaches the bloodstream, resulting in a faster rise in BAC. The higher BACs in women can lead to a faster onset of intoxication, increased vulnerability to alcohol-related health problems, and a greater risk of developing alcohol-related diseases like liver damage. Studies suggest that women may become more impaired than men after consuming equivalent amounts of alcohol, even when adjusted for body weight.
Women’s relatively rapid intoxication (compared to men) often renders them susceptible to sexual and other kinds of assault. Consequently, the results from a night of overindulging can have serious, long-term physiological, emotional, and/or physical results on women, such as unwanted pregnancy. Also, women must be careful about what they are drinking or taking. GHB (gamma-hydroxybutyric acid) and other “date rape” type drugs are still around and, indeed, are making somewhat of a comeback now among the younger crowd.
Prescription Drug Abuse in Women
Prescription medications are particularly dangerous for women. Approximately 48,000 women died from prescription pain reliever overdoses from 1999 to 2010. However, in just a 5-year span, from 2010 to 2015, over 50,000 women died from a drug overdose (excluding alcohol related deaths and causes). Research shows that women are more likely to have chronic pain, be prescribed prescription pain relievers by their doctors, be prescribed higher doses of pain relievers by their doctors and use them for longer periods of time than men.
The Stigma of Substance Abuse Among Women
Women often experience greater levels of stigmatization around substance use because of their traditional societal roles as gatekeepers, mothers, caregivers, and often serving as the central organizing factor in their family units. With the integration of women into the mainstream workforce in most middle and high-income countries like the U.S., women have also begun consuming alcohol and drugs at intensities and frequencies that are quickly catching up to that of their male counterparts.
ReDiscovery Non-Residential Program for Women
ReDiscovery is a community-based program for women in recovery. The program meets weekly to provide important material, instruction, support, and accountability for women in recovery. ReDiscovery is a Christian environment led by His Way staff and volunteers designed to help participants build the spiritual and behavioral foundation required to overcome drug and alcohol addiction.
Don Phillips is a Licensed Professional Counselor (LPC) with more than 27 years of experience in behavioral health and 35 years of personal recovery from chemical addiction. He holds a Bachelor’s degree in General Psychology from Athens State University and a Master’s degree in Counseling Psychology from Alabama A&M University. He is an Advanced Alcohol & Drug Counselor (AADC) and Internationally Certified AADC (ICAADC).