"Substance Abuse in Women: Does Gender Matter? By Sudie E. Back, PhD, Regana Contini, MD, and Kathleen T. Brady, MD, PhD , Psychiatric Times URL:http://www.psychiatrictimes.com/article/showArticle.jhtml?articleId=196902111 January 2007, Vol. XXIV, No. 1Converging lines of evidence suggest that a relationship between trauma , post traumatic stress disorder, and substance use disorders also may be particularly important for women. Early life stress, particularly sexual abuse, is more common in girls than in boys and is associated with a risk of substance use disorders. Women exposed to violence in adulthood also demonstrate a higher risk for drug and alcohol dependence. Moreover, alcohol and drug abuse place women at risk for repeated victimization, thus perpetuating the cycle of victimization and substance use.
There has been a growing awareness in recent years of the importance of gender in medical treatment and research. While much past research in addiction focused on men, there is now recognition that biologic and psychosocial differences between men and women influence the prevalence,presentation, comorbidity, and treatment of substance use disorders.
There has been a growing awareness in recent years of the importance of gender in medical treatment and research. While much past research in addiction focused on men, there is now recognition that biologic and psychosocial differences between men and women influence the prevalence,presentation, comorbidity, and treatment of substance use disorders.
For instance, Greenfield and colleagues conducted an extensive review of the literature published from 1975 to 2005 on substance abuse treatment in women. They found a tremendous increase in attention to gender differences in the literature during the past 15 years; 90% of the articles discussing gender had been published since 1990.This increase in awareness of gender-specific issues is also seen in the clinical sector, with about 40% of substance abuse treatment facilities now providing special programs or groups for women.
In this article, we summarize and discuss the findings of various studies that have looked at the epidemiology; relationship of comorbidity and victimization; diagnostic and screening issues; course of illness; psychosocial and biologic influences; and treatment of substance abuse in terms of the influence of female gender.
Epidemiology
A number of epidemiologic survey studies have demonstrated that the prevalence rates of drug and alcohol use disorders are consistently higher among men than among women.
The most recent of these studies, the National Institute on Alcohol Abuse and Alcoholism's National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), surveyed more than 40,000adults and found that men are twice as likely as women to meet lifetime DSM-IV criteria for any drug use disorder (13.8% of men vs 7.1% of women).
Twelve-month prevalence rates of alcohol abuse are almost 3 times as high among men as they are among women (6.9% of men vs 2.6% of women).
These ratios are consistent with the findings of other past epidemiologic surveys, showing that the gender differential for alcohol use disorders is higher than that for drug use disorders.
In contrast, prescription drug abuse in women closely approaches that of men. The National Survey on Drug Use and Health reported 12-month prevalence rates of abuse or dependence for nonmedical use of pain relievers to be 1.4% for men and 1.1% for women 18 to 25 years old, and 0.5% for men and 0.4% for woman 26 years and older.
The differential for tobacco use and dependence is substantially less than for any other drug of abuse; only slightly more men than women report tobacco use (13.5% men vs 10.2% women) and meet criteria for tobacco dependence (31% men vs 27% women).
Psychiatric comorbidity and victimization
One area that has received considerable attention is gender differences in psychiatric comorbidity. Both epidemiologic studies and studies of treatment-seeking patients indicate that gender differences in the patterns of comorbid psychiatric disorders in substance users follow the same patterns seen in the general population, with women more likely to meet criteria for anxiety, depression, eating disorders, and borderline personality disorder and men more likely to meet criteria for antisocial personality disorder.
However, a number of studies indicate that for women, the onset of the psychiatric disorder is more likely to antedate the onset of the substance use disorder. This suggests gender differences in the relationship between psychiatric and substance use disorders.
For complete article go to:http://www.psychiatrictimes.com/article/showArticle.jhtml?articleId=196902111
Contributor: Don Phillips
In this article, we summarize and discuss the findings of various studies that have looked at the epidemiology; relationship of comorbidity and victimization; diagnostic and screening issues; course of illness; psychosocial and biologic influences; and treatment of substance abuse in terms of the influence of female gender.
Epidemiology
A number of epidemiologic survey studies have demonstrated that the prevalence rates of drug and alcohol use disorders are consistently higher among men than among women.
The most recent of these studies, the National Institute on Alcohol Abuse and Alcoholism's National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), surveyed more than 40,000adults and found that men are twice as likely as women to meet lifetime DSM-IV criteria for any drug use disorder (13.8% of men vs 7.1% of women).
Twelve-month prevalence rates of alcohol abuse are almost 3 times as high among men as they are among women (6.9% of men vs 2.6% of women).
These ratios are consistent with the findings of other past epidemiologic surveys, showing that the gender differential for alcohol use disorders is higher than that for drug use disorders.
In contrast, prescription drug abuse in women closely approaches that of men. The National Survey on Drug Use and Health reported 12-month prevalence rates of abuse or dependence for nonmedical use of pain relievers to be 1.4% for men and 1.1% for women 18 to 25 years old, and 0.5% for men and 0.4% for woman 26 years and older.
The differential for tobacco use and dependence is substantially less than for any other drug of abuse; only slightly more men than women report tobacco use (13.5% men vs 10.2% women) and meet criteria for tobacco dependence (31% men vs 27% women).
Psychiatric comorbidity and victimization
One area that has received considerable attention is gender differences in psychiatric comorbidity. Both epidemiologic studies and studies of treatment-seeking patients indicate that gender differences in the patterns of comorbid psychiatric disorders in substance users follow the same patterns seen in the general population, with women more likely to meet criteria for anxiety, depression, eating disorders, and borderline personality disorder and men more likely to meet criteria for antisocial personality disorder.
However, a number of studies indicate that for women, the onset of the psychiatric disorder is more likely to antedate the onset of the substance use disorder. This suggests gender differences in the relationship between psychiatric and substance use disorders.
For complete article go to:http://www.psychiatrictimes.com/article/showArticle.jhtml?articleId=196902111
Contributor: Don Phillips
