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Women and Substance Abuse: Overcoming Addiction

Addiction recovery programs should take into account all aspects of a women’s journey to treatment instead of following a generic approach. Substance abuse disorder (SUD) among women involves unique risks and patterns. Recognizing these can help improve the prevention and treatment of SUD.

Let’s take a closer look at women and substance abuse and the crucial role biology plays in addiction.

How Women’s Bodies React to Addictive Substances

The issue of substance abuse and women boils down to physiological differences.

Body Mass and Composition

Women generally have lower body mass and blood volume than males. After taking similar doses, a woman would have higher concentrations of an addictive substance. This predisposition makes women prone to addiction.

Some substances like alcohol and marijuana can be stored in fat cells. Since women have proportionally more fat than men, these substances could remain longer in their bodies.

Hormonal Changes

In addition, hormonal changes during menstruation can increase cravings. A lot of women need pain relief for menstrual cramps and medication to manage fluctuating moods. In some cases, this dependence may eventually lead to substance abuse.

Some studies show a link between ovulation and addiction, which implies that the time of substance exposure impacts women’s vulnerability to addiction. This could be associated with higher estrogen levels during ovulation. Estrogen boosts dopamine, a neurotransmitter involved in the perception of reward.

Increased dopamine levels can enhance the “high” of substances. The resulting wave of euphoria can reinforce the link between the addictive substance and pleasure, thus hijacking the normal reward system.

A pregnant woman showing her belly

Women and Substance Abuse Risk Factors

Both men and women might reach for addictive substances when suffering from grief or trauma. For women, the common factors for substance abuse include the following:

  • Self-medicating for pain relief (emotional or physical)
  • Exposure to potentially addictive drugs (e.g., legally administered by a physician during treatment)
  • Grief over the death of a loved one
  • Major lifestyle changes
  • Trauma (domestic abuse, sexual assault or rape, gender-based violence, etc.)
  • Concurrent disorders (PTSD, bipolar disorder, generalized anxiety, depression, body image or eating disorders, postpartum depression, etc.)
  • Racial and gender discrimination
  • Genetic predisposition (e.g., one parent has an addiction)

What Substances Are Most Commonly Abused by Gender?

Women who use drugs typically start using substances later than men, but once they start, they tend to consume alcohol, cannabis, cocaine, and opioids at a greater rate than men. An accelerated progression of substance use to the development of SUDs and treatment is called “telescoping.”


Compared to boys, girls aged 12 to 20 report alcohol as their primary addiction as a coping mechanism for combating anxiety, depression, and other negative feelings. Among older adults (25 to 34 years old), the statistics are reversed, with fewer women than men reporting alcohol as their primary substance of abuse.


Apart from alcohol, marijuana is also reported as a primary substance of abuse. The usage is higher in men than women.

Prescription Drugs

In some types of drugs, use is more prevalent in women than in men, for example, in weight loss pills and sedatives. In the case of prescription and non-prescription opioids, recent trends have found that the use of heroin is increasing in women at a higher rate than men, and they are also more likely to start with a legal prescription for the treatment of pain than men.

Women’s use of methamphetamines can also be associated with depression.


There is a higher incidence of cannabis use by transgender persons. Research also shows they use more cocaine and amphetamine compared to non-transgender individuals. Transphobic assault, social exclusion, homelessness, and sex work seem to motivate the use of these drugs among the transgender group, regardless of their orientation.

women in a group therapy setting

Gender-Specific Treatment Services for Women With Addiction

Women are more likely to seek treatment for psychological disorders. Unfortunately, being prescribed medication may lead them to develop addiction. During treatment, women with addiction may experience more severe withdrawal symptoms than men. Women are also more sensitive to the side effects of medication, again due to how they are wired.

Since women are more sensitive to addictive substances, they usually seek treatment earlier than men. Despite this earlier intervention, women usually have symptoms that are as severe as those in men who enter rehabilitation at a later time.

To achieve the best possible outcomes, treatment approaches tailored to those who identify as women are necessary.

   1. Trauma-Informed Care

Depression and trauma seem to be common among women with substance abuse disorder. This is why the incidence of women and substance abuse together could indicate other serious issues.

It is important that trauma-informed care is implemented during every aspect of the path to recovery—from evaluation to treatment and post-rehab. This will help prevent further trauma to the patient, whether male or female.

Keep in mind that women who have experienced abuse from male assailants might benefit from an all-female crew and support group. Topics such as rape, domestic abuse, and the like should be approached with great care and empathy. An uninformed approach could potentially trigger the patient and increase their risk of suicidal behaviour, especially in patients with concurrent disorders.

   2. Pregnant and Breastfeeding Mothers

Patients who are pregnant or breastfeeding need to be monitored closely, not just for their sake but also for the health of their babies.

The baby of an addict can go through withdrawal, a condition called neonatal abstinence syndrome (NAS), after leaving the mother’s womb. This can happen if the mother abused opioids, alcohol, caffeine, or prescription drugs during pregnancy.

Usually, the symptoms of NAS can be observed right after birth, but they can also appear up to two weeks after delivery. The frequency of use determines the severity of the baby’s condition.

A female doctor attending to a female patient

   3. Relapse Risk

Relapse among women tends to be related to stress, although the stress could also be a withdrawal symptom. Some of the common stressors include sole responsibility for child care, divorce, and maintaining a job in the presence of extenuating circumstances.

According to research, family plays a crucial role in women and substance abuse. That’s why experts suggest that a family-centred approach may be beneficial. Family-based services, stress mitigation techniques, and parenting and life skills training can encourage women to seek treatment and remain sober after rehabilitation.

Women and Substance Abuse: On the Road to Recovery

When it comes to treating women with addiction, keep in mind that they have different needs and motivations.

Women and substance abuse treatment should not remain as a “one-size-fits-all” approach. Providing appropriate, patient-specific treatment should be the goal of any practitioner.

If you identify as a woman and need immediate assistance for your addiction, our Ontario facility provides a wide variety of treatment programs tailored to your specific needs.

Call us now or leave a message to get the care you deserve.


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