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Women and Substance Abuse
Author: Phil Kosanovich
Published: August 5, 2021

Women make up approximately two-thirds of all people with serious substance abuse problems. Women are more likely to experience stigma and economic disadvantage due to substance misuse, have a substance-using partner and are more likely to have experienced sexual and physical abuse.

The differences between men and women suffering from substance abuse stem from sociological and biological differences. Sociological differences include gender stigmatization, childcare responsibilities, addiction stigmatization, relationship dynamics, and social responsibilities. The biological differences are primarily due to the varying diverse effects of substances on the bodies of men and women due to average body size and composition, the metabolization of drugs and alcohol, and the roles and effects of testosterone and estrogen.

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As defined by Harvard Medical School, the differences in substance abuse between men and women center primarily around “susceptibility, recovery, and risk of relapse.” This is explored in more detail below:

  1. Susceptibility:
    1. Men: It has been found that men are more likely to develop substance abuse disorders and are more likely to misuse substances due to peer pressure or conformity.
    2. Women: Women tend to transition from misuse to substance abuse disorder faster than men and tend to be more likely to use substances to self-medicate.
  2. Recovery:
    1. Men: More likely to stabilize their substance abuse with lower doses of substances than women.
    2. Women: More likely to experience health complications such as liver damage and overdose.
  3. Risk of Relapse:
    1. Men: Experience longer periods of abstinence and are therefore less likely to relapse.
    2. Women: Experience intense cravings, which increase the risk of relapse.

Gender-Specific Sensitivities

Women have unique challenges, issues, and needs when facing substance abuse. To achieve long-term recovery, the following factors must be understood and explored.


The stigma associated with addiction is often stronger for women, with stigma being a known barrier to seeking treatment. Women have traditionally filled the roles of caregivers within the family unit, focusing on others before themselves. Substance abuse is perceived by many as a selfish act, which for a mother or a caregiver, is likely to cause intense feelings of shame and guilt.


A higher percentage of women with a substance abuse disorder have been the victims of sexual, physical, or verbal abuse. More than half of the women in treatment for substance abuse reported having had traumatic experiences and used substances to alleviate difficult emotions or painful memories.

Financial Inequalities

It is understood that women are more likely to experience financial barriers to treatment as women tend to have a lower income than men, are more likely to work part-time to fulfill their caregiver roles at home and have reduced access to financial resources.  Women are additionally more likely to live in poverty prior to substance misuse.


The majority of women receiving treatment for substance abuse have children; a reported statistic of 70%. These women are also likely to be the primary caregiver for their children, unlike the majority of men who seek treatment.

Women are less likely to attend regular treatment sessions because of their familial responsibilities. Many are wary of seeking treatment due to a fear of legal action and the involvement of social services.


Women with a substance abuse disorder are significantly more likely to face multiple unique challenges. This is both in their experience of substance misuse, physiological and psychological effects of substance use, and accessing treatment. Women are less likely to seek treatment or receive treatment and are more likely to relapse. Far more needs to be done to understand the barriers women face and support them in achieving and maintaining long-term recovery.