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Men and Substance Abuse

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man with substance abuse displaying issuesAddiction does not discriminate. It affects both men and women. However, there are distinct differences in why and how men use and abuse drugs or alcohol.

While sex differences are the direct result of being genetically male or female, many recognized gender differences are based on various culturally defined roles for men and women. Gender affects how we perceive ourselves and how others perceive us.1 Our societal perceptions of men play an important role in understanding drug use and abuse.

Drug abuse can take men through many different phases, from early use to addiction to relapse.2 Below is a list of some of the most abused drugs and their related issues for men.

  • Alcohol. Alcohol is a drug. Many people think that because it is legal, it is not as serious of a drug to use or abuse. This may also lead to the idea that a man should be able to easily handle or control his alcohol use. Often used to relax or escape from everyday stressors, alcohol can also have strong negative effects in your life. Men have higher rates of alcohol use, including binge drinking—so, not only do men drink more alcohol than women, they also have an increased risk of drinking excessively.1,3
  • Marijuana. In a 2015 National Survey on Drug Use and Health, 22.2 million people reportedly used marijuana in the month prior to the survey, making it the most commonly used illegal drug.4 More men than women use marijuana, and that gender gap grew even wider between 2007 and 2014.4
  • Stimulants. Cocaine and methamphetamine are 2 stimulants commonly abused by men. Drugs in this class speed up several processes throughout the body, including functions that are normally regulated automatically by the body, such as heart rate, blood pressure, and pulse. Men are 2 times more likely to use cocaine compared to women.5
  • Pain relievers (opioids). Common opioids are heroin and oxycodone, and the CDC (Centers for Disease Control and Prevention) reports that more men die from opioid drug overdoses than women—though it notes that gap is closing.6
  • Nicotine. Nicotine is the primary addictive component of many tobacco products. About 1 in 6 men smoke cigarettes, and while smoking is more socially acceptable than using other drugs, nicotine is an addictive drug with long-term negative effects to your health and other aspects of life. Men who smoke have diminished overall health, increased risk of absenteeism at work, and an increase in health care needs and costs.7

Symptoms Men Display

Society often expects men to be tough and independent—asking for help can be seen as weakness. So when men don’t know how to cope with stressors, they may turn to drugs or alcohol to escape the pain.

Trying to function as a spouse, father, son, and employee while under the influence of drugs is very difficult, though. Once caught in a pattern of using, men may not know how to ask for help to stop an emerging addiction. Some men do not open up about their feelings and emotions as easily as women, so seeking help for addiction may cause them to feel weak, vulnerable, or even ashamed.8

As substance abuse increases, you may notice a corresponding increase in aggressive behaviors.

Men with substance use disorders may also be more likely to experience anger, which may show in the form of violent behavior toward themselves or others.8 As substance abuse increases, you may notice a corresponding increase in aggressive behaviors.

Some general signs and symptoms you may recognize in yourself or your loved one if you suspect he is using a drug include:8,9

  • Sudden change in behavior. The drug may affect the chemicals in your brain, causing unusual changes in behavior. These changes may also be compounded by a desire to hide the abuse or withdrawal symptoms. Some men may exhibit violent outbursts or violent behavior.
  • Mood swings. Similar to changes in behavior, mood swings may be related to chemical changes in the brain due to drug use. You may notice that you feel happy one moment and, for no obvious reason, are angry or sad the next.
  • Withdrawal from family and activities. As the abuse worsens, you may withdraw from close friends and family and activities you once enjoyed. You may escape from them to use the drug alone or with a different group of friends, or you may try to hide the symptoms of dependence and withdrawal.
  • Carelessness about personal grooming. As dependence on the drug increases, interest in personal hygiene often decreases. Extreme cravings can overpower the desire to do even the simplest of daily tasks.
  • Changes in sleeping patterns. Changes in sleeping patterns may be related to the effect of the drug or could be a symptom of withdrawal when you are not actively using the drug.
  • Red or glassy eyes. This physical symptom could be an indicator of drug use depending on the type of drug being used.
  • Running nose. A runny or sniffling nose is a common symptom of drug use in those who snort or inhale drugs often.

Consequences They Face

The use of any drug comes with consequences—the type, amount, and duration of drug use affects the severity of the consequences. Men experience specific physical effects as a result of substance abuse, including:3,10

  • A disruption of testosterone production and testicular function, which can result in impotence, infertility, and reduced chest or facial hair.
  • An increased risk of mouth, throat, esophagus, liver, and colon cancer compared with women.

Additional consequences that men tend to experience more than women include:3

  • Men are hospitalized and die more frequently due to alcohol-related causes than women.
  • Men instigate more physical assaults due to alcohol-related aggression than do women.
  • Men initiate more sexual assaults than women, too, and often take greater risks such as unprotected sex or sex with more than one person.
  • Men are more likely to commit suicide after drinking than are women.
  • Men are nearly twice as likely to be involved in a fatal car accident than women as a result of being drunk.

Psychological and social consequences also occur with addiction, but these effects are felt not only by the user, but by those closest to him as well. When drug abuse increases, the likelihood of other negative and even illegal behaviors also increases.

When drug abuse increases, the likelihood of other negative and even illegal behaviors also increases.

Men may face legal problems related to buying, selling, or possessing the drug, or due to behaviors that occurred while under the influence of the drug, such as fighting or soliciting prostitutes. This could lead to encounters with police, court, and even jail.

Users who are addicted sometimes engage in behaviors that would otherwise not make sense. For instance, they may buy the drug regardless of a lack of finances, which can lead to an inability to pay for necessities—such as food and housing—and increased debt.


Male-Specific Treatment

Many programs are designed specifically for men that consider both sex and gender when creating detox and treatment plans. These treatment programs provide for the physical, mental, and emotional health needs that affect you as a man.

two men talk closely in a treatment settingSome men choose to voluntarily seek and start treatment, while many men begin treatment after criminal justice involvement, referrals from behavioral health centers, or pressures at work or home.8 Whatever the circumstances that bring a man to treatment, programs specializing in men’s health are prepared to address these issues.

As you face the uncertainty of starting treatment and dealing with the personal and professional consequences of your addiction being known by others, the need to feel masculine, independent, and invulnerable may come into play.8 Below are a few of the unique approaches to male-specific treatment that seek to address some of these fears and issues:8

  • Maintaining privacy: Male users may worry about who will be told that they are in treatment for addiction; counselors reassure them that treatment is confidential and will pose no threat to their image or standing.
  • Decreasing confrontation: Confronting right or wrong decisions almost always increases resistance. By using certain techniques such as open-ended questions, counselors encourage engagement instead of confrontation between themselves and their client. Some men may do better in individual therapy versus group therapy, since this may decrease conflict with other men.
  • Acknowledging strength: Male users may need to be acknowledged for the strength shown in making the decision to begin treatment. When counselors actively praise this, they may encourage engagement in treatment. Men may also be uncomfortable sharing their emotions and struggle with feelings of not fulfilling their role of husband, father, or worker while in treatment. Helping the user to believe they are where they need be may help them to engage with the treatment program as a whole.
  • Emphasizing free choice: While choices may be limited in treatment, allowing the man to make as many choices for himself as possible is an important part of male-specific treatment. Men are usually goal-oriented and need to feel independent; they may feel uncomfortable accepting help, which may make them feel weak or even ashamed. Emphasizing choices often facilitates engagement.
  • Addressing violent behaviors: Men are more likely than women to be the perpetrators as well as the victims of violent crime because abusing alcohol and other substances is often linked with violent behaviors and crime. The treatment center will have specific behavior expectations and consequences that must be followed to stay in treatment, and these may be stricter in a male-specific context.
  • Building positive support: Treatment will likely have an improved outcome if the man’s partner or family are involved. Counselors may suggest couples therapy or family therapy to help him and his loved ones through this difficult journey. If the man has close male friends who are not using, including them in treatment may be beneficial.

As a man prepares for treatment, he may worry about the gender of the counselor since stereotypes are one of the most important issues to consider when choosing one.8 While one man may be comfortable speaking with a female counselor, another man will not. This may be related to their own gender biases, upbringing, or culture.8

Counselors are trained to help you through this difficult conversation about who you are most comfortable with assisting you along this journey of recovery. Being open and honest about your preferences, past counseling experiences, and your own gender biases can help in identifying and placing you in the best client-counselor relationship. Learn about Alcohol and Drug Detox Helplines

Types of Treatment

The main goals of any substance abuse treatment are to help you stop using the drug, develop strategies to remain drug-free, and become productive members of your family, work, and society again.11

  • Detox. Detoxification is the process by which the body rids itself of the drug.When you first stop using the drug, your body goes through physical withdrawal, which can be uncomfortable and cause many physical and mental symptoms. Men may fear the discomfort of the process of detoxification and the loss of the drug itself. Detox is the first step toward recovery and is best completed in a treatment facility where trained medical professionals can assist you and keep you safe.
  • Inpatient treatment. Inpatient treatment is medical and psychological care received in a facility 24 hours a day. Some inpatient facilities offer group therapy, while others offer individual therapy, and most offer both. Your length of stay depends on the severity of your addiction.
  • Outpatient treatment. Outpatient treatment is ideal if you do not have medical needs that require 24-hour supervision and you have a safe and supportive home environment. You go into the facility to see an addiction counselor and to participate in counseling sessions at set times.
  • Aftercare. Recovery from chronic conditions such as addiction often requires long-term attention, even after the initial treatment period. Substance abuse aftercare is often comprised of individual counseling, group counseling, or 12-step program participation—or a combination of these things. A large part of aftercare treatment is about relationships, so these programs are designed to help you establish relationships with others who can help you remain on the road to recovery.

If you or someone you love is a man struggling with addiction, seeking treatment may be a necessary step to leading a happier and healthier life.


  1. National Institute on Drug Abuse. (2016). Substance Use in Women.
  2. Becker, Jill B. & Hu, Ming. (2008). Sex Differences in Drug Abuse. Front Neuroendocrinol. 29(1), 36–47.
  3. Centers for Disease Control. (2016). Fact Sheet – Excessive Alcohol Use: Risks to Men’s Health.
  4. National Institute on Drug Abuse. (2017). What is the scope of marijuana use in the United States?
  5. Substance Abuse and Mental Health Services Administration. (2016). Stimulants.
  6. Centers for Disease Control. (2016). Prescription Opioid Overdose Data.
  7. Food and Drug Administration. (2017). Men’s Health and Smoking.
  8. Center for Substance Abuse Treatment. (2013). Addressing the Specific Behavioral Health Needs of Men: Treatment Issues for Men. Treatment Improvement Protocol (TIP) Series, 56.
  9. National Institute on Drug Abuse. Signs of Drug Use and Addiction.
  10. National Institute on Drug Abuse. (2017). Health Consequences of Drug Misuse.
  11. National Institute on Drug Abuse. (2016). Treatment Approaches for Drug Addiction.

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