Substance abuse in women affects individuals, families, and communities. Naturally, it’s never a good thing when someone develops an addiction. But women experience addiction differently than men or transgender individuals, and the reasons why are often overlooked.
At Wisconsin Recovery Institute, we see every day how substance abuse can look different in women compared to men. Understanding these differences helps us to provide the most effective support and treatment to those seeking help.
Understanding Substance Abuse in Women
Substance abuse is defined as using addictive substances in ways that harm a person’s physical health, mental well-being, or daily life. It’s often accompanied by physical dependence, wherein the person uses the addictive substance to feel “normal” because their body has adjusted to accommodate for its presence (even if doing so provides them with no pleasure or uplift). Addiction is a chronic disease, where the addicted person is unable to stop using substances even when it causes serious problems.
The gender gap between people who struggle with substance use has been narrowing over recent years. Women now represent nearly half of all people with substance use disorders, yet their experiences often differ significantly from those of other genders.
Key warning signs of substance abuse in women include:
- Physical changes: Sudden weight loss or gain, unexplained injuries, or changes in overall appearance.
- Behavioral shifts: Withdrawing from family and favorite activities, decline in work performance, or secretive behavior.
- Emotional symptoms: Mood swings, increased anxiety or depression, change in social circles, or loss of interest in once-enjoyed activities.
Women often develop substance use problems for different reasons than men. Stress, trauma, mental health concerns, and relationship issues frequently play larger roles in women’s substance use patterns.
Why Women Experience Addiction Differently
When it comes to the actual usage of addictive substances, women experience what researchers call “telescoping.” This means that they move from first using a substance to developing an addiction much faster than men. Women can develop serious problems with addiction in a shorter timeframe, and often with smaller amounts of substances.
The telescoping effect occurs for multiple reasons, including:
- Biological differences: Women have less body mass, more body fat, and typically less water in their bodies than cisgender men. This means that substances can become more concentrated in their bodies.
- Hormonal influences: Female hormones can affect how the body processes drugs and alcohol.
- Metabolic factors: Women’s metabolisms work at different rates than men, so they break down certain substances slower.
Women are more likely to use substances as a way to cope with emotional pain, trauma, or mental health symptoms. Men are more likely to start using substances for social reasons or thrill-seeking, while women often turn to drugs to manage difficult feelings or memories of past experiences.
Research shows that women often face greater health risks due to substance use. They develop liver problems, heart disease, and other medical complications faster and at lower consumption levels than men who are addicted to substances. But substance abuse can also disrupt menstrual cycles, reduce fertility, and cause serious pregnancy complications (including miscarriage, premature birth, and developmental problems in babies).
Biological and Psychological Factors
Hormones like estrogen and progesterone directly impact how the body responds to substances. These hormones change throughout the menstrual cycle, which can affect the intensity of drug cravings and the effects of certain substances.
During certain phases of the menstrual cycle, a cisgender woman may feel stronger effects from stimulants like cocaine or experience different responses when drinking alcohol. Estrogen can increase the “rewarding” feelings from addictive substances, while progesterone can actually provide protection against these effects. The different stages of the menstrual cycle feature different ratios of these hormones throughout the woman’s body.
Women’s brains also respond to stress differently than those of other genders. The stress response system can become disrupted in women with substance use disorders, making emotional distress feel more intense and increasing the likelihood that they use substances to cope.
Common emotional triggers for women to use drugs include:
- Relationship conflicts
- Parenting stress
- Work pressures
- Memories of past trauma
Co-occurring Mental Health Conditions
Many people working to heal from addiction also have a co-existing mental health disorder, known in clinical settings as a dual diagnosis. But the conditions that affect women in these circumstances often differ from those that affect men working through addiction.
Between 55% and 99% of women seeking substance abuse treatment report histories of physical or sexual abuse. Post-traumatic stress disorder (PTSD) can develop after experiencing or witnessing traumatic events and commonly occurs alongside substance use disorders in women.
Many women use drug use to numb emotional pain from trauma, or to reduce symptoms like flashbacks, nightmares, and severe anxiety. This can create a cycle where trauma symptoms drive substance use, which then worsens their overall mental health over time.
About 30% of women with addiction also struggle with depression disorders, compared to lower rates in men with similar substance use problems.
Common signs of depression in women with substance use disorders include:
- Persistent sadness: Feeling hopeless or empty most days
- Loss of interest: No longer enjoying activities that once brought pleasure
- Physical symptoms: Changes in sleep, appetite, or energy levels
- Emotional numbness: Not feeling moved to any particular emotion
Anxiety disorders also frequently occur with substance abuse in women. Generalized anxiety, panic disorder, and social anxiety all have the potential to drive women to use substances for self-medication.
Substances Commonly Abused by Women
Women are prescribed medications at higher rates than men. What often starts as legitimate medical use can gradually become problematic. Common prescription drugs misused by women include:
- Opioid: These are often prescribed for chronic pain conditions, which are more common in women.
- Benzodiazepines: Anti-anxiety medications like Xanax or Ativan can be easily abused, sometimes without any intent to do so from the user.
- Stimulants: ADHD medications can be abused for weight control or to provide energy.
Women’s bodies process alcohol differently than men’s bodies. With less body water and lower levels of enzymes that break down alcohol, women can reach higher blood alcohol levels than men even from drinking the same amount.
Women are more likely to drink alone or in secret, and often use alcohol to cope with stress, depression, or relationship problems. They can develop alcohol-related health problems faster than men, even when drinking smaller amounts.
Women most often use stimulants like cocaine and methamphetamine (meth) for different reasons than men. Weight control, increased energy for managing responsibilities, and mood improvement are common motivations. But women who use stimulants also face unique health risks, including heart problems, anxiety, and complications during pregnancy.
Barriers to Treatment for Women
Society often judges women with substance use disorders more harshly than men, especially mothers. This stigma leads to feelings of shame that make it harder for women to admit they have a problem or ask for help. Women report hiding their substance use more often than men, and delaying treatment for various reasons.
Most women entering substance abuse treatment are mothers, and childcare responsibilities can create significant barriers to getting help. Fear of losing custody of children or not having someone to care for them during treatment prevents many women from seeking the help they need. They may have fear around being labeled as “bad mothers” or losing social support once it is revealed that they have problems with addiction.
Treatment Approaches for Women
Women have the potential to benefit from addiction treatment just as much as people of other genders. But certain modalities or approaches to treatment may be particularly helpful for women.
Trauma-informed care recognizes that most women with substance use disorders have experienced trauma, and addresses both issues together. This approach helps to create safe environments where women can heal from past experiences while working on recovery.
Since women commonly have both substance use disorders and mental health conditions, effective treatment addresses both simultaneously. Integrated care prevents the cycle where untreated mental health symptoms lead to relapse.
Women-only treatment groups and programs address issues that may be difficult to discuss in mixed-gender settings, such as domestic violence, sexual trauma, parenting concerns, and relationship problems. Research shows women in gender-specific programs report higher satisfaction, stay in treatment longer, and have better outcomes compared to those in mixed-gender programs.
Find Hope and Healing at Wisconsin Recovery Institute
Recovery from substance abuse is absolutely possible for women. With the right support and treatment approach, women can rebuild their lives and relationships while maintaining their sobriety.
At Wisconsin Recovery Institute, we understand the unique challenges women face in overcoming addiction. Our specialized programs integrate trauma-informed care and mental health treatment designed to speak to women’s needs.
If you or someone you love is struggling with substance abuse, compassionate help is available. Reach out to us at Wisconsin Recovery Institute, and we’ll help you find comprehensive, understanding care that supports lasting recovery.
