Your session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Table Reference Number

The overall prevalence rates of drug and alcohol use disorders are higher among men than among women. However, for prescription drugs and nicotine, prevalence rates of women closely approach those of men.

One of the most consistent findings in studies focused on gender differences in substance use disorders is the increased vulnerability of women to the adverse medical and psychosocial consequences of substance use. This has been coined the "telescoping" of substance use disorders in women.

Women become intoxicated after drinking smaller amounts of alcohol and achieve higher blood-alcohol concentration after drinking equivalent amounts of alcohol as compared with men. This is primarily because women have less total body water than do men of comparable size and a lower concentration of gastric alcohol dehydrogenase, which metabolizes alcohol.

Patterns of comorbid psychiatric disorders found in men and women with addiction parallel those found in the general population. Epidemiological and treatment studies show that, regardless of substance use disorder status, women evidence higher rates of anxiety, depression, eating disorders, and borderline personality disorder, whereas men evidence higher rates of antisocial personality disorder.

Among substance users, gender differences in the temporal onset of comorbid psychiatric conditions have been observed. Women more often than men have a primary mental health disorder (e.g., depression) that precedes the onset of their substance use disorder. This suggests differences in the etiological relationship of substance use and comorbid psychiatric conditions among men and women.

Women are less likely than men are to enter substance abuse treatment. Possible reasons for lower rates include sociocultural factors (e.g., stigma, lack of partner/family support to enter treatment), socioeconomic factors (e.g., child care), pregnancy, and fears concerning incarceration and child custody issues.

Although fewer women enter substance abuse treatment, treatment outcomes for women appear comparable with those for men. Few consistent gender differences have been observed in outcomes, retention rates, or relapse rates.

It is unclear whether women-focused or gender-specific treatments are more effective than standard substance abuse treatments. Programs that allow women to be accompanied by their children may result in higher rates of retention, which is important in predicting treatment outcome. Programs that pay special attention to psychiatric comorbidity, family and parenting issues, victimization, and gender-specific barriers to treatment are likely to be more successful.

Maternal substance use during pregnancy remains a significant problem. Self-report measures, such as the Alcohol Use Disorders Identification Test or the CAGE Questionnaire, are useful for screening in primary health care and obstetric clinics. Psychosocial and pharmacological interventions may be helpful in reducing substance use and associated issues (e.g., depression, posttraumatic stress disorder, criminal behavior) among pregnant and postpartum substance-dependent women.


Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Related Content
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 36.  >
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 39.  >
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 40.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 1.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 2.  >
Psychiatric News
PubMed Articles
Sleep problems in children with prenatal substance exposure: the Maternal Lifestyle study. Arch Pediatr Adolesc Med 2010;164(5):452-6.doi:10.1001/archpediatrics.2010.52.
Chronic ethanol exposure during development: disturbances of breathing and adaptation. Respir Physiol Neurobiol 2013;189(2):250-60.doi:10.1016/j.resp.2013.06.015.
  • Print
  • PDF
  • E-mail
  • Chapter Alerts
  • Get Citation