Substance Abuse among women is on the rise. Here are some statistics reflecting information gathered in the most recent national surveys and studies.

Substance Abuse Statistics for Women 

The following statistics are from the National Center for Drug Abuse Statistics (https://drugabusestatistics.org/) and from the National Institute on Alcohol Abuse and Alcoholism (https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics/alcohol-facts-and-statistics/alcohol-use-disorder-aud-united-states-age-groups-and-demographic-characteristics).

• An estimated 12 million women in the United States qualify for Alcohol Use Disorder, about 8% of all women in America
• 17% of women have used drugs in the past year
• 5% of women abuse opioids
• 2% of women use heroin
• 4% of women abuse prescription pain killers; 9 million women have a prescription opioid abuse problem
• 4 million women abuse Hydrocodone
• 4 million women abuse Oxycodone
• 125,000 women abuse Fentanyl
• 5% of women use cocaine
• 4% of women use methamphetamines
• 6% of women misuse prescription stimulants
• 5% of women use marijuana
• 0% of women abuse prescription tranquilizers
• 5% of women abuse prescription sedatives
• 20% of people in drug treatment are women

Substance Abuse Differences between Men and Women

There are gender differences among men and women with substance use disorders. According to statistics gathered in large-scale studies comparing the genders (https://pmc.ncbi.nlm.nih.gov/articles/PMC3124962/#R6), men are around twice as likely as women to abuse substances, except in the case of prescription narcotics (opioid medications) and tranquilizers, where the numbers are more equal.

Though men are more likely than women to abuse substances, women who do abuse substances are more likely than men to develop tolerance, become dependent, and develop an addiction. Women are also more likely to have adverse health effects from using substances, such as liver damage and psychological problems like depression and anxiety. Women progress more quickly than men from initial exposure to a substance to needing substance abuse treatment, a phenomenon called telescoping.

When women enter treatment, they present in worse condition than men, in spite of having used a smaller amount of the substance, for a shorter period of time. Women who use substances are more likely than men who use substances to have additional psychological, behavioral, medical, and social problems alongside their substance use disorder, and to qualify for a diagnosis of PTSD.

Hormonal differences between men and women are currently believed to have a role in women’s greater sensitivity to substances, as well as their greater vulnerability to relapse. Ovarian steroid hormones (estrogen and progesterone) and sex differences in how GABA-A and DHEA are processed may have an influence on drug related behavior. During phases of the menstrual cycle when progesterone is low and estrogen is higher, women are more sensitive to the effects of substances. They are also more likely to experience vulnerability to cravings, negative emotions, and impulsive behavior which can interfere with progress towards sobriety.

Relapse vulnerability may also be explained in part by sex differences in neuroendocrine adaptations to stress. Women are more likely than men to have what’s called hypothalamic-pituitary-adreonocortical (HPA) dysregulation, which means that women experience greater emotional intensity at lower levels of arousal of the stress system. This means women subjectively experience the triggered state more vividly than men with a comparable substance use history.

The role of co-occurring disorders is also important to consider. Women are significantly more likely than men to have a lifelong diagnosis of a mood or anxiety disorder than men. Women who use substances are also significantly more likely to have a co-occurring eating disorder, such as bulimia. Finally, the link between post-traumatic stress disorders and substance abuse in women is critical to acknowledge, with the majority of women who enter treatment qualifying for PTSD or complex PTSD.

Alcohol

Alcohol is the most commonly abused substance in the United States. In the past, cultural norms that inhibited women from drinking alcohol meant that women were less likely to become addicted to alcohol than men. The gap between the genders when it comes to alcohol abuse has lessened over time, and the number of women presenting with a need for treatment for their alcohol use is ever on the rise.

Particularly troublesome is the fact that women are more likely to develop dependence on alcohol than men, while consuming lower levels of alcohol. Women progress through the phases of alcohol addiction more swiftly, and are more vulnerable to relapse once sober.

Health impacts of alcohol abuse are also stronger on women, with women more likely to manifest disease and tissue damage. Among people diagnosed with alcohol use disorder, women have a higher death rate, due to suicide, alcohol-related accidents, stroke, and liver disease.

Women are more likely than men to struggle with co-occurring conditions that complicate recovery, such as trauma and mental health disorders. Women are less likely than men to seek treatment, and to face gender specific barriers in treatment, such as financial problems and childcare issues.

Benzodiazepines

Alcohol use may have been socially unacceptable, but women have always been prone to becoming addicted to prescription depressants with similar effects to alcohol, such as tranquilizers and sedatives prescribed by their doctors to treat “nervous disorders”.

Contemporary prescription depressants, like the benzodiazepine class of drugs (Xanax and Klonopin, for example), continue to be popular drugs of abuse among women, often leading to severe dependency with multiple health impacts.

This situation may be owed in part to the ways that trauma is misunderstood and the ways that gender affects expressions of distress externally; women are more likely than men to be diagnosed with an anxiety disorder, and consequently to be prescribed addictive pharmaceuticals as a way to reign in symptoms of chronic nervous system hyperarousal.

Opioids

Opioids are a serious problem for both genders. However, women are generally more sensitive to pain, and more likely to be diagnosed with a chronic pain related syndrome, which can lead to a prescription for opioid pharmaceuticals, introducing the addictive substance to the more substance-sensitive and habit-forming female body.

Given the same exposure levels, women are faster to develop tolerance, dependence, and to spiral into addiction. Nevertheless, men are more likely to die from an opioid overdose than women, though recent death tolls indicate that female death by opioid overdose is rising by faster numbers than male opioid deaths. Women are less likely to inject an opioid intravenously, such as heroin or fentanyl. However, if they do, they are more likely to overdose.

Marijuana

Marijuana is the most popular illicit substance in the United States, with almost 100 million Americans self-reporting that they have tried it – about 40% of the population at the time of the 2003 National Study on Drug Use and Health (https://pmc.ncbi.nlm.nih.gov/articles/PMC3124962/#R76). Women are less likely than men to use marijuana daily, and begin using marijuana at a later age, on average. Marijuana use may be linked, for some women, to stages of the menstrual cycle, particularly for women who have severe PMS or a diagnosis of Premenstrual Dysphoric Disorder.

The effects of marijuana may also be different for men and women. Women are more likely to move faster through the stages of addiction, developing dependency after a shorter period of use than a male using the same amount. Adverse impacts on memory and attention have been observed to affect women more strongly than men, as well.

Stimulants: Cocaine and Meth

The interactions between hormones and the effects of stimulants may explain why women are more sensitive to cocaine’s effects, including its addictiveness, than men. There is a link between estrogen and sensitivity to stimulants according to one study on cocaine, which may reinforce the addiction cycle in women.

As with other classes of addictive substances, women are generally less likely than men to try stimulants. If they do experiment with stimulants, however, including prescription stimulants like Ritalin, women tend to progress through the stages of addiction more quickly than men.

Women experience greater effects and stronger dependence from lower levels of the substance, as well as worse health impacts. Women struggle more with mood dysregulation, cravings, and relapse once sober.

Ecstasy

MDMA, or Ecstasy, is a stimulant and hallucinogen. Some findings suggest that women experience more euphoria under the influence of ecstasy, stronger hallucinations, and more depression following ecstasy use, than men do.

Prescription Drugs

There are three categories of prescription drugs which represent a serious risk of addiction: benzodiazepines, opioids, and stimulants.

The benzodiazepine class of drugs (tranquilizers and sedatives, such as Xanax and Klonopin), is a common source of addiction among women.

Prescription opioids are also a widespread problem. Although men and women suffer in equal numbers, it’s important to recognize that medications like OxyContin have been widely diagnosed to women due to their greater sensitivity to pain and their greater likelihood of being diagnosed with chronic pain.

Prescription stimulants like Ritalin and Adderal, commonly used to manage symptoms of ADHD, are also prone to abuse and addiction. While women are still less likely than men to be diagnosed with ADHD, more and more women are being diagnosed as criteria are expanded to include less obviously disruptive symptoms of the disorder.

If prescribed a stimulant for their ADHD, or if experimenting recreationally with ADHD medications, women are more likely to have an addictive response to it, more likely to move from use to abuse, and on to dependence.

Why are women in recovery more susceptible to cravings and relapse?

Once women enter treatment and begin a life in recovery, they are more prone to experience intense cravings and to succumb to relapse than men. This difference is owed to a few factors, including fluctuations in hormones that mean women experience changes in mood and levels of stress each month, as well as throughout different life stages and transitions.

Estrogen, as a hormone linked to feelings of pleasure and well-being, is linked to women’s greater sensitivity to habit forming experiences of euphoria. Progesterone, on the flip side, is linked to greater feelings of stress, irritability, and depressed mood. The complicated dance between female hormones and the other key neurotransmitters responsible for mood, motivation, reward, pain, and stress, create a greater overall risk, due to more vivid cravings and stronger urges to self-medicate for emotional reasons.

Beyond hormonal considerations, women are more likely to suffer from co-occurring mental health disorders and traumatization than men. This means that upon achieving a measure of basic sobriety and stability, more women than men have the immediate and challenging task of facing a pre-existing condition of chronic painful emotions and states.

The high incidence of sexual trauma history among women who use substances also explains the challenges many women face once they stop using substances. They must quickly stabilize new behaviors and coping tools that really work to reduce the severe distress of trauma symptoms, or they will find themselves turning to substances again to modulate their intense experiences as before.

Overcome Substance Abuse in Women

Everything about addiction is different for women, and recovery is different too. Women report different reasons for using drugs and alcohol in the first place. Women have different pre-existing conditions, from the basics of biology to the many vulnerabilities inherent to being female in our society. What drives a woman to latch on to certain substances as a strategy for coping with chronically disturbed emotions, can be quite opposite from the reasons the man next to her reaches for the same tool. Once in recovery, the intense, ever-changing emotional waters that women are immersed in by nature, affect and inform their experiences of recovery. Our more emotional and relationship-oriented connection styles, once healed, become vast resources for profound transformation.

For all of these reasons, and more, we believe in our hearts that supporting women in gender specific treatment environments is the key to healing womankind from the triple burdens of addiction, mental illness, and trauma. Our many programs for women reflect the value we place on women’s experiences, and how much we want to do to help women to flourish in this world, for the benefit of all.