Substance abuse in women.
Gender differences in substance use disorders (SUDs) and treatment outcomes for women with SUDs have been a focus of research in the last 15 years. This article reviews gender differences in the epidemiology of SUDs, highlighting the convergence of male/female prevalence ratios of SUDs in the last 20 years. The telescoping course of SUDs, recent research on the role of neuroactive gonadal steroid hormones in craving and relapse, and sex differences in stress reactivity and relapse to substance abuse are described. The role of co-occurring mood and anxiety, eating, and posttraumatic stress disorders is considered in the epidemiology, natural history, and treatment of women with SUDs. Women's use of alcohol, stimulants, opioids, cannabis, and nicotine are examined in terms of recent epidemiology, biologic and psychosocial effects, and treatment. Although women may be less likely to enter substance abuse treatment than men over the course of the lifetime, once they enter treatment, gender itself is not a predictor of treatment retention, completion, or outcome. Research on gender-specific treatments for women with SUDs and behavioral couples treatment has yielded promising results for substance abuse treatment outcomes in women.
Greenfield
Shelly F
SF
Alcohol and Drug Abuse Treatment Program, McLean Hospital, Harvard Medical School, 115 Mill Street, Belmont, MA 02478, USA.
Back
Sudie E
SE
Lawson
Katie
K
Brady
Kathleen T
KT
D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D001068:Feeding and Eating Disorders / Q000453:epidemiology / Q000523:psychology; D005260:Female; D012739:Gonadal Steroid Hormones / Q000378:metabolism*; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000453:epidemiology / Q000523:psychology; D011613:Psychotherapy / Q000379:methods; D012307:Risk Factors; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications* / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism / Q000523:psychology* / Q000628:therapy; D016896:Treatment Outcome
D012739:Gonadal Steroid Hormones
Alcohol Clin Exp Res. 1989 Aug;13(4):499-504
2679204
Arch Gen Psychiatry. 2005 Jun;62(6):617-27
15939839
J Clin Psychiatry. 2006 Feb;67(2):247-57
16566620
Arch Gen Psychiatry. 2001 Oct;58(10):909-15
11576028
Psychiatr Serv. 2008 Sep;59(9):1056-9
18757602
Nicotine Tob Res. 2004 Oct;6(5):769-76
15700912
Clin J Pain. 2009 Jul-Aug;25(6):477-84
19542794
J Offender Rehabil. 2009 Jul 1;48(5):388-401
19710949
Subst Use Misuse. 2004 Jan;39(1):1-23
15002942
Drug Alcohol Rev. 2007 May;26(3):287-93
17454018
Am J Drug Alcohol Abuse. 2008;34(5):594-602
18821452
J Psychoactive Drugs. 1995 Oct-Dec;27(4):357-73
8788692
J Subst Abuse Treat. 2002 Dec;23(4):285-95
12495790
Nicotine Tob Res. 2008 Jul;10(7):1245-50
18629735
Int J Eat Disord. 2002 Dec;32(4):389-400
12386904
Am J Drug Alcohol Abuse. 2003;29(1):117-31
12731684
J Subst Abuse Treat. 2005 Jan;28(1):77-85
15723735
Exp Clin Psychopharmacol. 1999 Aug;7(3):274-83
10472516
Psychopharmacology (Berl). 2006 Mar;184(3-4):600-7
16075290
J Clin Psychiatry. 1995 Nov;56(11):502-5
7592501
Subst Use Misuse. 1996 Apr;31(5):529-43
8777737
J Consult Clin Psychol. 2006 Jun;74(3):579-91
16822114
J Subst Abuse. 1998;10(1):27-42
9720004
Drug Alcohol Depend. 2006 Sep 1;84(1):1-13
16413143
Alcohol Clin Exp Res. 2008 Aug;32(8):1493-501
18564104
J Stud Alcohol. 1999 Mar;60(2):252-60
10091964
Issues Ment Health Nurs. 2001 Apr-May;22(3):287-304
11885213
Am J Drug Alcohol Abuse. 2003;29(1):19-53
12731680
Am J Addict. 2005 May-Jun;14(3):223-33
16019973
Health Soc Work. 1997 Feb;22(1):38-46
9021417
Psychoneuroendocrinology. 2008 Jun;33(5):560-8
18321653
Psychother Psychosom. 1997;66(4):179-84
9259040
Alcohol Clin Exp Res. 2005 Mar;29(3):395-401
15770115
Arch Gen Psychiatry. 2007 May;64(5):566-76
17485608
Psychopharmacology (Berl). 2002 Sep;163(2):194-201
12202966
Drug Alcohol Depend. 2007 Sep 6;90(1):39-47
17446014
Recent Dev Alcohol. 1995;12:309-34
7624551
Am J Addict. 1997 Fall;6(4):273-83
9398925
J Consult Clin Psychol. 2000 Dec;68(6):1051-61
11142539
J Subst Abuse Treat. 2001 Jul;21(1):47-54
11516926
Respir Med. 2006 Jun;100(6):1110-6
16236491
J Consult Clin Psychol. 2004 Aug;72(4):712-22
15301656
Addict Behav. 1990;15(2):165-8
2343790
Drug Alcohol Depend. 2004 Jun 11;74(3):265-72
15194204
Am J Psychiatry. 2006 Apr;163(4):652-8
16585440
Pharmacol Biochem Behav. 2004 Aug;78(4):699-705
15301924
Neuropsychopharmacology. 2006 Mar;31(3):659-74
16160708
Am J Psychiatry. 1992 May;149(5):664-70
1575258
Obstet Gynecol. 2009 Jun;113(6):1285-1291
19461424
J Subst Abuse Treat. 2001 Jul;21(1):35-45
11516925
Addiction. 2005 Jan;100(1):60-9
15598193
Drug Alcohol Depend. 2007 Jul 10;89(2-3):145-52
17276623
Addict Behav. 2007 Mar;32(3):562-75
16843611
Alcohol Clin Exp Res. 2000 Aug;24(8):1320-1
10968672
Psychopharmacology (Berl). 1984;84(2):178-87
6438677
Psychopharmacology (Berl). 2000 Jul;150(4):374-82
10958078
Addiction. 2004 Nov;99(11):1462-9
15500599
Drug Alcohol Rev. 2005 Jul;24(4):353-8
16234131
Int J Eat Disord. 1994 Jul;16(1):1-34
7920577
Am J Drug Alcohol Abuse. 2009;35(1):38-42
19152205
J Consult Clin Psychol. 2004 Jun;72(3):455-66
15279529
Exp Clin Psychopharmacol. 2007 Oct;15(5):445-52
17924778
Drug Alcohol Depend. 2002 Mar 1;66(1):61-9
11850137
Psychopharmacology (Berl). 2001 Dec;158(4):343-59
11797055
Subst Use Misuse. 2003 Jun;38(8):1109-31
12901451
Am J Addict. 2004 May-Jun;13(3):236-47
15370943
Neuropsychopharmacology. 2008 Apr;33(5):1162-70
17581531
Am J Drug Alcohol Abuse. 1987;13(3):231-51
3687889
Psychiatr Clin North Am. 1999 Jun;22(2):241-52
10385931
J Subst Abuse Treat. 2008 Jun;34(4):378-90
17664051
Am J Drug Alcohol Abuse. 2007;33(1):5-11
17366241
Neuropsychopharmacology. 2004 Jan;29(1):158-70
14560320
Drug Alcohol Depend. 1986 Oct;18(2):213-24
3780416
J Clin Epidemiol. 1993 Sep;46(9):1041-53
8263577
Neuropsychopharmacology. 2006 Oct;31(10):2231-6
16421515
Drug Alcohol Depend. 1999 Apr 1;54(2):117-25
10217551
Addiction. 2008 Feb;103(2):258-68
18042194
J Subst Abuse Treat. 2000 Jan;18(1):41-9
10636605
Compr Psychiatry. 2004 Jul-Aug;45(4):304-10
15224273
Matern Child Health J. 2010 Jul;14(4):519-27
19565330
Am J Drug Alcohol Abuse. 2004;30(1):85-100
15083555
Exp Clin Psychopharmacol. 2006 Feb;14(1):34-41
16503703
Psychiatr Serv. 2009 Jul;60(7):880-882
26650590
Nicotine Tob Res. 2007 Oct;9(10):1005-13
17852766
J Consult Clin Psychol. 2000 Feb;68(1):176-180
10710853
Am J Drug Alcohol Abuse. 2000 Nov;26(4):523-35
11097190
Neth J Med. 1989 Feb;34(1-2):22-8
2563572
Nicotine Tob Res. 2001 May;3(2):141-50
11403728
MMWR Morb Mortal Wkly Rep. 2006 Oct 27;55(42):1145-8
17065979
BMJ. 1998 Apr 4;316(7137):1043-7
9552903
Psychopharmacology (Berl). 2003 Jan;165(2):157-65
12439626
J Subst Abuse Treat. 2000 Jun;18(4):395-407
10812314
Exp Clin Psychopharmacol. 2006 Feb;14(1):12-9
16503701
Psychopharmacology (Berl). 2008 Jan;195(4):527-36
17891383
JAMA. 2006 Jul 5;296(1):47-55
16820546
J Groups Addict Recover. 2010;5(1):4-16
21753920
Am J Public Health. 1991 Mar;81(3):324-7
1994740
Nicotine Tob Res. 2007 Jul;9(7):781-4
17577808
Am J Drug Alcohol Abuse. 2002;28(3):453-75
12211360
Drug Alcohol Depend. 2008 Jan 11;93(1-2):21-9
17980512
Biol Psychiatry. 2007 Feb 1;61(3):348-58
16815322
Drug Alcohol Depend. 2007 Jan 12;86(2-3):191-8
17029825
JAMA. 2006 Jul 12;296(2):180-4
16835423
Drug Alcohol Depend. 2007 Oct 8;90(2-3):252-60
17513069
Drug Alcohol Depend. 2007 Jan 5;86(1):1-21
16759822
Arch Gen Psychiatry. 2007 Jul;64(7):830-42
17606817