Addiction can strike anyone given the right set of factors, but the way addiction affects different groups of people are not the same. Women and men are both susceptible to becoming addicted, but the reasons they try drugs or alcohol, the physical effects of addiction, and the ways they seek and receive treatment can differ widely.
Some of the differences in how addiction affects men versus women appear to be the result of biological gender differences. Men and women have very different hormone balances, and abused substances interplay with these natural chemical systems in different ways. Some studies appear to suggest that estrogen is linked to the brain mechanism that interprets the effects of drugs as pleasurable and leads the body to want more of them. Both male and female bodies contain estrogen, but the naturally higher levels in female bodies may create a higher susceptibility to developing addictions.
Women’s bodies are on average smaller than men’s bodies, which also has implications for drug use and addiction. A smaller body needs less of a drug to feel an effect. If a smaller-bodied person (whether female or male) takes the same amount of a drug as a larger person, the effect of the drug is heightened because there is more of the chemical substance relative to the amount of tissue in the body. Many drugs cause more damage with higher doses. By taking the same amount of a drug as men, women can actually run a higher risk of addiction and physical damage because the dose is comparatively higher for a person with a smaller body.
Men and women differ in more than biology. Differing societal expectations and patterns of behavior have serious implications for how men and women abuse drugs.
Men in modern culture are more likely to be socially rewarded for impulsive or risky behaviors. This can make them more likely to experiment with drugs on a whim when the occasion presents itself. Men are also more likely to feel competitive pressure to try harder drugs or to take larger quantities of drugs or alcohol to prove their strength, daring, or other qualities considered “manly.” Binging on drugs in this way can lead to fast addiction. The signs of addiction in men tend to be more visual and external, including a range of aggressive behaviors toward other people. Societally, men are also often discouraged from expressing or experiencing their emotions, which can lead to suppressing emotions or covering them up with alcohol or drugs.
Women, on the other hand, are more likely to try a drug because of feeling pressure to conform to group expectations. A woman is also more likely to try a drug because a male companion introduces it to her, rather than the reverse. Women can live with addictions for a long time because they are surrounded by people who abuse substances, making it hard to break the trend and seek help. Women’s symptoms of addiction tend to be internalized, including feelings of shame, anxiety or depression.
Culturally, it is easier for a woman to admit she needs help, and women are more likely to listen to a friend, doctor, counselor or other trusted person and seek treatment. Men are typically more likely to deny the problems caused by their addiction and to try to manage it alone because there is a greater cultural expectation for men to be stoic and strong in the face of all kinds of problems.
Just as women and men often become addicted in varying circumstances and for different reasons, effective treatment needs to take into account gender differences, especially social and cultural differences. For example, men are more likely to enter treatment because they are pushed into it in some way, such as a requirement from the criminal justice system or an ultimatum from a boss or significant other. Women, on the other hand, are more likely to be referred to treatment by a social worker or doctor after seeking help with a different issue.
Men may benefit more from confrontational therapies, where women may find better success from supportive therapies and those based on networks. In order to stick with therapy, women are also more likely to need extra support, including child care, because women are more likely to be the primary caregivers for their children.