Substance Use Disorder in Women

Substance use disorders (SUDs) do not discriminate; they can affect anyone, across every demographic. Women, in particular, face unique challenges when it comes to substance use.¹ Some differences are based on a woman’s biology while other issues are more social or environmental in nature and based on cultural norms.¹

This article will help you gain an understanding of the ways women are affected by addiction, as well as the multiple issues they face in addiction recovery.

Are Women More Prone to Addiction?

Addiction demographics show that while men may be more likely than women to experiment with almost all types of illicit drugs, women are just as likely as men to develop a substance use disorder.²

In fact, research shows the progression from substance use to addiction happens faster in women than men, even when the average amount of substance use is similar or sometimes less.^1,3 Women may also be more susceptible to cravings and relapse, key stages in the cycle of addiction.²

What Causes Substance Use Disorder in Women?

It is unclear why some women develop substance use disorders while others do not.³ However, many variables can increase the risk of SUDs in women. Some of these risk factors include:

• Co-occurring mental health conditions: Women are more likely than men to suffer from diagnosed depression, anxiety, eating disorders, and PTSD. Women with these mental health disorders are more likely to develop substance use disorders.³
• Domestic violence: More than 1 in 3 women have experienced violence at the hands of an intimate partner. Victims of violence are at an increased risk of developing a mental health or substance use disorder.⁴
• Race and ethnicity: Women of color face even more challenges, in part because African American and American Indian/Alaska Native women are more likely to be victims of physical violence, rape, and stalking in their lifetime, than women of other racial and ethnic groups.⁴
• Discrimination: Women may experience various types of discrimination that can ultimately influence their substance use and impact their recovery. To cope with the additional stresses associated with a range of discriminatory acts, some women may turn to substance use.³
• Having a partner with a substance use disorder: A partner’s substance use can influence and be a risk factor for the development of a substance use disorder in a woman.³
• Divorce/child custody issues: Experiencing divorce, loss of child custody, or the death of a partner or child can make women more vulnerable than men to developing a substance use or mental health disorder.⁴

How Substance Use Disorders Affect Women Differently Than Men

Sex and gender differences can play a significant role in the way substance use disorders are experienced in men and women.

Sex hormones may cause women to be more sensitive than men to the effects of certain drugs.¹

Women face reproductive consequences as well. For instance, heavy drinking has been associated with higher rates of infertility in some women.³

The risk of adverse neurological consequences may be higher for women too. Women appear to be more susceptible than men to the toxic effects of alcohol on the central nervous system and more vulnerable to alcohol-induced brain damage.³

Women who use drugs may also experience more cardiovascular consequences than men, and depending on the substance, women are more likely than men to have panic attacks, anxiety, or depression as a result of drug use.¹ They are also more likely to go to the emergency room or die from overdose than men.¹

Women and Alcohol Addiction

Alcohol is a leading cause of debilitating health issues and mortality worldwide for both men and women, with the risk of several adverse health effects being particularly pronounced in women.³ Compared to men, women not only become more cognitively impaired by alcohol, but they are also more susceptible to liver and other organ damage resulting from alcohol use over time.³

Even when men and women who are the same size consume the same amount of alcohol, women may experience higher blood alcohol concentrations (BACs). This is due, in part, to the fact that women on average have a lower volume of water in their bodies, with such a difference in body composition effectively resulting in relatively higher BAC levels after drinking.³

Chronic alcohol use in women increases their risk of cardiac-related conditions and certain types of cancer including cervical cancer and breast cancer.³

Alcohol, more than any other drug, disrupts the development and/or causes malformation of the embryo or fetus in pregnant women.³

Alcohol use puts women at a greater physiological risk of contracting a sexually transmitted disease (STD). This is because heavy consumption of alcohol use in women causes them to have drier mucous membranes, resulting in small tears or abrasions during intercourse that increases their risk of HIV or other STDs entering their bloodstream.³

Women and Drug Addiction

Women may also face a somewhat different set of drug-related health issues than men.

For women, heroin use can cause abnormalities in a woman’s menstrual cycle such as it becoming irregular or stopping altogether. In some cases, it can take up to a year for their cycle to return to normal after heroin use has stopped.³

Hormonal fluctuations that occur during a woman’s menstrual cycle can have a significant impact on the effects of stimulant drugs, such as amphetamines and cocaine.³ Some studies indicate that women report greater mood-altering effects of some stimulant drugs during certain phases in their cycle.³

Cocaine use during pregnancy can have adverse developmental effects, with some studies suggesting cocaine-exposed infants being at risk of issues such as: ³

• Irritability.
• Poor interactive abilities.
• A smaller head circumference.
• Lower birth length and weight.
• Increased risk of premature birth, stillbirth, and sudden infant death syndrome (SIDS).

Currently, little is known about how marijuana use affects men and women differently.³ Though, like other substances, studies suggest that women may progress more quickly than men from cannabis use to cannabis use disorder.⁵

Women are significantly more likely than men to use (and misuse) prescription medications, such as anti-anxiety, pain medications, and prescription opioids.^2,3 Studies show women are more likely to have chronic pain and be more sensitive to pain than men. There is a greater likelihood of a woman misusing prescription opioids to self-treat pain or other problems like anxiety.²

Women who use opioids while pregnant are at risk of many complications that may include: ³

• Premature labor and delivery.
• Pre-eclampsia (high blood pressure during pregnancy).
• Spontaneous abortion.
• Higher rates of fetal distress and mortality.

Infants born to mothers who are addicted to opioids are also at risk for neonatal abstinence syndrome (NAS), essentially being born with many symptoms of withdrawal.³

Women and Substance Use Disorder Treatment

While gender is not a significant factor in whether someone remains in treatment, there are barriers to treatment and treatment needs that are specific to women.³

Treatment Engagement Barriers for Women

Women with a substance use disorder may experience any number of the following women’s issues when seeking addiction recovery:

• Interpersonal obstacles: Since women are usually the primary caregivers of children and other family members, this responsibility can be a barrier to seeking treatment. Fear of losing their partner can also keep a woman from getting treatment or affect treatment retention for many women.³ Trauma is a common experience for women with substance use disorders. Women who have experienced violence are more likely to face difficulties in recovery.³
• Sociocultural obstacles: Women are often more stigmatized than men for having substance use disorders. Women with SUDs may be characterized as sexually promiscuous or neglectful mothers, adding to additional fear, guilt, and shame surrounding their substance use. They may worry that by admitting they have a substance use disorder they could lose custody of their children.³
• Structural obstacles: Pregnancy status can also influence a woman’s engagement and retention in treatment for substance use disorder. Less than half (about 41%) of treatment facilities provide special programs or groups exclusively for women and only about 17% of treatment facilities offer services for pregnant or post-partum women.³
• Systems obstacles: Many women in need of treatment for SUDs are often involved in other social service programs. As many as 50-80% are also involved in child welfare programs. Collaboration across various social services programs is often difficult, adding another layer of complexity to women’s issues when seeking help for substance use disorders.³

How to Meet the Needs of Women in Substance Use Disorder Treatment

To meet the unique treatment needs of women with substance use disorder, treatment programs should utilize the following approaches:⁶

• Promote a caring, safe treatment environment that takes both positive and negative partner and family relationships into consideration.
• Ensure an integrated approach to treatment is used that acknowledges the whole person, including a person’s parenting and family responsibilities.
• Use trauma-informed approaches that screen and assess for any history of trauma.
• Identify and address co-occurring mental health and substance use disorders.
• Improve engagement and retention by recognizing the cultural expectations of women.

Women’s needs include services beyond those typically provided in standard substance use disorder treatment and may include those below:³

• Medical care: This includes gynecological care, family planning, prenatal care, and more.
• Health and wellness promotion: Educational topics may involve nutritional counseling, reproductive health, infectious diseases, sleep, dental hygiene, preventive healthcare, and wellness.
• Psychoeducation: Skills training on assertiveness, sexuality education, effects of substances on prenatal and child development education.
• Language and cultural needs: Programming that is culturally appropriate, availability of translation or native language services.
• Daily life skills: Coping skills training, stress reduction, financial budgeting.
• Gender-specific needs: Consider whether the patient may benefit from women-only treatment settings. Offer specialized programming for LGBTQ+ patients.
• Child-related and family services: Childcare, preschool programming, couples counseling, parenting education, and more.
• Comprehensive case management: A range of services and links to services should be provided to match the patient’s needs. These may include links to employment opportunities, housing, and the welfare system. Also included are legal, transportation, and domestic violence services. Includes support in obtaining funding for substance use disorder treatment and assistance in completing further education.
• Mental health services: Co-occurring disorder treatment services, including for eating disorders, mood, and anxiety disorders. Trauma-informed services and mental health services for children also fall into this category.
• Disability services: Accommodations for disabilities, resources for learning disabilities and illiteracy, and services for women receiving methadone treatment.

Addiction Recovery for Women at AdCare

At AdCare Treatment Centers, we understand that treating substance use disorders in women requires programming that is individualized and addresses the needs of each patient.

If you or someone you love is ready for recovery, AdCare Treatment Centers offer multiple levels of addiction treatment, including medical detox, residential/inpatient treatment, and aftercare planning. Our facility provides inpatient rehab in Rhode Island that is personalized and can address co-occurring disorders.

During treatment for addiction, various types of evidence-based behavioral therapies are employed in both individual and group settings.

The following specialized addiction treatment programs are also available at AdCare:

• Veterans and First Responders Program.
• Enhanced Methadone MAT Program.

Get admitted today by calling one of our compassionate admissions navigators at . If you plan on using insurance to pay for rehab, simply fill out our online insurance verification form to .

There are also other ways to pay for rehab, and our admissions navigators will discuss all of your options with you to determine what makes the most sense for your situation.