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Women and Substance Abuse

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Woman with substance abuse problem sitting at table looking down

Some people assume that drug addiction is more of a problem in males than in females. And while men in the United States do report higher rates of drug abuse (7.7% of American men vs. 5% of American women), millions of women also suffer from the negative consequences of substance abuse and addiction—many of which can be more damaging than those commonly experienced by males.1  

Some facts about women and substance abuse you may not know are:2,3

  • Every 3 minutes, a woman goes to the emergency room after abusing prescription painkillers.
  • Approximately 15.8 million adult women reported using illicit drugs in the past year.
  • According to the TEDS report in 2014 (TEDS is a census of all admissions to treatment facilities reported by state substance abuse agencies), women entered substance abuse treatment for the following primary substances of abuse:
    • Alcohol (33.3%)
    • Heroin (15.3%)
    • Marijuana (14.6%)
    • Prescription painkillers (13.8%)
    • Cocaine (9.3%)
    • Methamphetamine/amphetamines (8.6%)
    • Other substances (5%)

Symptoms Women Display

Substance use can present itself differently in women than it does in men. While women typically have a shorter history of abusing alcohol and drugs than men, they often enter addiction treatment with a more severe clinical profile, meaning they have more significant physical, emotional, behavioral, and social problems than men. This is commonly the case even when men have abused the substance for longer and in greater amounts than their female counterparts.2,4

Because substance abuse affects women differently than it does men, the signs and symptoms of drug addiction aren’t always the same.

Women are also more likely than men to suffer from co-morbid mental health issues, such as depression, anxiety, post-traumatic stress disorder (PTSD), and eating disorders, such as anorexia and bulimia. What’s more, many women begin abusing drugs as a means of self-medication for these disorders.4,5

Issues that women may be more likely than men to display or experience include:2,4,5

  • Depression.
  • Anxiety.
  • Panic attacks.
  • Trauma symptoms (flashbacks, nightmares, difficulty sleeping, hyper arousal, and trauma avoidance).
  • Differences in drug effects due to fluctuations in hormones during menstrual cycle.
  • Hoarding unused medications to use later.
  • Combining drugs to increase effectiveness.

Consequences They Face

While both men and women face negative consequences of substance abuse—such as social problems, financial issues, mental and behavioral health disorders, malnutrition, hepatitis, AIDS, and other sexually transmitted diseases—there are many adverse effects of drug addiction that are unique to women, including:1,2,4

Woman portraying addict using calculator dealing with financial issues

  • Physical consequences: Women who abuse drugs are more likely than men to experience adverse physical effects on their heart and blood vessels. Women also seem to be more sensitive to certain substances and may be more likely to overdose or go to the emergency room following substance abuse.
  • Financial and legal problems: Women with drug and alcohol addiction may be more likely to face certain financial and legal problems. They may have difficulties financing addiction treatment or maintaining household expenses, such as rent or mortgage, food, utilities, and childcare. They may also have legal issues surrounding child custody or face issues with child protective services as a result of their substance abuse.
  • Rape: Women with substance abuse problems may be more susceptible to rape as a result of being in vulnerable states of consciousness, environments, and situations. According to a recent study, approximately 73% of female drug abusers surveyed had a history of rape. Of the women surveyed, 35% were raped while under the influence of drugs or alcohol.
  • Unplanned pregnancies: Women engaging in substance abuse may face unplanned pregnancies as a result of poor safe sex practices while under the influence.
  • Pregnancy complications/adverse effects to fetus: Substance abuse during pregnancy can pose many complications and negative outcomes for both the mother and the developing baby. Mothers who abuse drugs during pregnancy are more likely to experience high blood pressure, migraines, and seizures. There are many adverse effects for the fetus, including low birth weight, birth defects, developmental delays, and premature labor. The risks of stillbirth are 2-3 times higher in babies whose mothers smoke tobacco or marijuana, take prescription drugs, or use other illicit drugs during pregnancy.
  • Barriers to treatment: Women are statistically less likely to seek treatment than men. This may be due to the many gender-specific treatment barriers that they face, including:
    • Social stigmas.
    • Childcare responsibilities.
    • Financial difficulties.
    • Transportation issues.
    • Lack of interpersonal or familial support.

Types of Treatment

A variety of addiction treatment options exist for women struggling with substance abuse, including:

Women portraying addict and therapist discussing substance abuse

  • Detox: Professional detox centers provide medical support and supervision during the detoxification process from drugs or alcohol. They can help minimize the severity and duration of withdrawal symptoms through the use of medications and other medical interventions. Detox centers play a crucial role in addiction treatment for women. First and foremost, they can offer a place of safety. Entering a professional detox program can help women safely withdrawal from substances and reduce the risk of relapse and complications due to withdrawal. Detox centers can also provide a place of refuge for women who have been dealing with prostitution, rape, domestic violence, or other safety concerns as a result of their substance abuse. Women who are pregnant and suffering from drug addiction should seek professional detox services as soon as possible to minimize the potential harm done to the fetus.
  • Inpatient treatment: Women with severe addictions may choose to enter inpatient treatment and reside in the rehab center full-time. These programs typically consist of some combination of individual and group counseling, 12-step programs, support groups, medication-assisted treatment, and other complementary therapies. Inpatient treatment can last anywhere from 30 days to a year or more depending on the severity of addiction and the person’s ability to pay.
  • Outpatient treatment: Outpatient programs offer similar treatment regimens as inpatient centers, except care takes place on a part-time basis while patients continue to live at home. Women with children may prefer intensive outpatient rehab programs over similar inpatient facilities since they allow them to remain at home with their families while going through treatment.
  • Aftercare: Many people assume that treatment is finished once the initial rehabilitation process is complete, but aftercare plays a crucial role in sustaining long-term sobriety. Various aftercare program elements to help prevent relapse and maintain sobriety include:
    • Sober living communities.
    • Ongoing individual and group therapy.
    • Family counseling.
    • Support groups.
    • 12-step meetings.
    • Employment assistance programs.
    • Peer support.

Female-Specific Treatment

Many treatment facilities offer female-specific treatment on all levels, including detox, inpatient, outpatient, and aftercare. Research has shown that women-only treatment produces higher satisfaction ratings and lower instances of relapse than traditional addiction treatment programs.4 Some treatment options unique to women with substance abuse include:2,4,5

  • Onsite childcare.
  • Parenting classes.
  • Supportive therapies specific to mothers; victims of rape, prostitution, or domestic violence; women with eating disorders; and other mental health conditions.
  • Care for pregnant or lactating women.
  • Vocational training.
  • Income support.
  • Housing assistance.
  • Social services.
  • Family and couples therapy.


  1. Khajedaluee, M., Dadgarmoghaddam, M., et al. (2015). Women, Drug Dependency and Consequences: A Study from a Developing Country. Journal of Addiction.
  2. National Institute on Drug Abuse. (2015). Sex and Gender Differences in Substance Use.
  3. Substance Abuse and Mental Health Services Administration. (2014). The TEDS Report: Gender Differences in Primary Substances of Abuse across Age Groups.
  4. Greenfield, S., Back, S., et al. (2010). Substance Abuse in Women. Psychiatric Clinics of North America, 33(2), 339–355.
  5. Brady, K.T. & Randall, C.L. (1999). Gender differences in substance use disorders. The Psychiatric Clinics of North America, 22(2), 241–252.

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