Gender Trends In Substance Abuse

Perhaps no two words in the English language used in conjunction with each other have ever been quite so obvious yet so mysterious at the same time as “gender differences.” We inherently understand that men and women are different and often behave in vastly different ways under similar circumstances, yet best-selling books like John Gray’s Men Are From Mars, Women Are From Venus spend hundreds of pages discussing gender differences in opposite-sex relationships alone. But it’s not just in these types of relationships that gender differences play a role; when it comes to our relationships with drugs and alcohol, there appear to be gender differences there as well.

An April 2014 Treatment Episode Data Sheet (TEDS) Report – a census of all admissions to treatment facilities reported to the Substance Abuse and Mental Health Service Administration (SAMHSA) by state substance abuse agencies – found clear gender differences in substance abuse, based on data from 2011.


The most glaring difference was the sheer number of males versus females who entered treatment that year. Over twice as many men as women – 1.23 million versus 609,000 – were admitted to substance abuse treatment centers in 2011. These treatment center admission numbers are consistent with previous research that indicates women are less likely than men to seek treatment for substance abuse, including a study by Carla A. Green, Ph.D., M.P.H. In her paper, Dr. Green found that women were more likely to face multiple barriers to accessing treatment than men. She also found that when women did seek treatment, they tended to turn to primary care or mental health settings rather than seeking treatment from programs that specialized in substance abuse.


When it came to reporting the primary substance of abuse, the TEDS Report showed that men and women were united on that front. Alcohol ranked number one, with 33.3 percent of the female admissions and 42.3 percent of the male admissions reporting alcohol as their drug of choice. The sexes diverged in ranking the number-two primary substance of abuse, with 19.9 percent of male admissions reporting marijuana, and 15.3 percent of female admissions related to heroin. Heroin ranked third with men, followed by prescription pain relievers, while marijuana ranked third with women, also followed fourth by prescription pain relievers – albeit at a rate nearly 6 percent higher than that reported by men.


Gender wasn’t the only important factor influencing behavior. While the report found no meaningful gender differences by race or ethnicity, it did find significant differences in behavior by gender for different age groups. For example, 21.7 percent of the women in the 12 to 17 age group reported alcohol as their primary substance of abuse, while only 10.7 percent of men in the same age group did the same. But women 25 to 34 years old reported alcohol as their primary substance of abuse at a rate lower than men of the same age – 25.9 percent versus 36.5 percent. Women also reported marijuana as their primary substance of abuse at lower rates than men in both the 12 to 17 and 18 to 24 age groups; however, after age 25, there were no significant variations in marijuana abuse by gender.

Methamphetamine/amphetamines were reported by both sexes as the primary substance of abuse in similar proportions across all age groups except the 18 to 24 group, where females reported abusing these drugs at a rate over 5 percentage points higher than males did. And when it came to prescription pain relievers, age – older age, in particular – seemed to make a real difference by gender, with women aged 65 or older reporting prescription pain relievers as their primary substance of choice to abuse at a rate nearly triple that of men in the same age group.


So what do the findings of this TEDS Report and other studies really mean? Do they explain why men and women differ in their substance abuse?

No, but they shine light on the fact that gender differences do, in fact, exist, and this knowledge is extremely valuable. Recognizing gender differences can serve as an important step in helping to design and develop more effective treatment programs, as well as to refine existing ones and move away from one-size-fits-all approaches . It’s also useful in helping to better target prevention and outreach services so that the right services reach the right demographics. Whether it’s prevention or treatment, the ultimate goal is the same – to improve outcomes.