Until the 1990s, most research on addiction focused on men, as did a lot of medical research. More recently, research has expanded to include women, allowing us to learn more about differences in trends between the genders as it applies to substance misuse. Understanding the differences that biological gender plays in addiction can improve treatment outcomes for both men and women. At Safe Harbor Recovery Center in Portsmouth, Virginia, we strive to provide treatment that is responsive to the needs of every individual we serve.

Susceptibility to Addiction 

Men and people who were assigned male at birth are more likely to develop an addiction than women and female-assigned people; however, women are more likely than men to face rapid medical and social consequences for substance misuse and to have more difficulty quitting.


Some drugs are likely to have a more profound health impact on women than on men. These included:

  • Prescription Drugs – women have been almost twice as likely to die as a result of misusing prescription drugs as men. From 1999-2010, 48,000 women died from overdosing on prescription drugs.
  • Alcohol – 26,000 women die every year from alcohol use, about twice as many those who die from opioids. Because of differences in body composition, female bodies are more prone to liver and brain damage from heavy drinking than male bodies. Women also develop alcohol dependence faster than men do.
  • Nicotine – Female smokers find it harder to quit and are more likely to develop lung cancer or have a heart attack as a result of smoking. They are also less likely to respond to nicotine replacement therapy.

Reasons for Use 

The reasons why someone uses drugs can have a huge impact on their ability to quit using them. Men are generally more likely to misuse drugs than women and are more likely to use them as a rite of passage into adulthood and a desire to fit in. Women are more likely to use due to chronic pain and emotional issues that they are attempting to self-medicate. Female drug users who use meth have indicated that they did so because they thought it would increase their energy levels and help them manage exhaustion from balancing work, home, and other responsibilities, or help them lose weight. Women are more likely to develop mental health and substance misuse disorders following events like divorce, losing custody of children, or the death of their partner or child. 

Societal Response 

Men may be discouraged from seeking treatment because society expects them to be tough, and admitting they need help is not perceived as masculine behavior. Women tend to be more stigmatized for their substance use through the lens of being a bad caregiver for misusing drugs. Women may also attempt to hide their substance abuse for fear of losing their children. One social consequence women may face that men do not is criminal punishment for using while pregnant, which can delay their access to treatment. 

Impact on Physical Health.

Because body composition varies between the genders, women are more likely to have trouble metabolizing alcohol and other drugs, which can lead to more rapid health consequences, especially including reproductive issues, hormonal problems, and some forms of cancer. Men are more likely to develop heart problems or be injured in accidents.

Co-occurring Diagnoses 

Both genders are at heightened risk for mental health concerns when addiction is present, but the mental illnesses they experience are different. For women, depression, anxiety, PTSD, and eating disorders are the most common co-occurring mental health conditions. Men with substance use disorder are more likely to have co-occurring conditions like conduct or antisocial personality disorders. These differences in diagnoses can change why a person uses drugs, what drugs they are likely to use, and how they respond to different treatment approaches.

Treatment Approaches 

Women are more likely to successfully complete treatment if supports like childcare, job training, transportation, housing, medical care, and parenting classes are provided. Inpatient treatment programs have also sometimes found success in allowing women to bring their children with them to treatment. While confrontation is often a successful approach for men, women often do better with empowerment, support, and skill-building. Building relationships among women is often helpful, both among the peers in treatment and with female staff members.

Relapse triggers 

Cravings, relationship issues, and trauma are a bigger cause of relapse for women than men. Men more commonly relapse due to environmental cues or peer pressure. 

At Safe Harbor Recovery Center, we recognize that these trends are true about groups as a whole, but that individuals may have their own unique situations and experiences that shape their addiction story and recovery journey. For example, members of the LGBT community and ethnic minorities experience traumas that are unique from other people of their assigned gender, and this can influence their specific needs. We are dedicated to meeting each person where they are and developing customized treatment plans that meet their needs.