Desperate woman crying on mountain

Women and Drug Abuse

At almost every conceivable level, women experience drugs and drug abuse differently than men on both the physical and psychological level.
Women become chemically dependent much faster than men do, despite the fact that women usually take smaller amounts of substances than men when they begin taking a drug (this effect is also known as “telescoping”).  
The cultural, and societal impact of drug abuse is yet another sphere that differs from how it is for men. Women most typically experience the social and legal consequences of drug abuse faster and in different forms than men.

Women with substance abuse problems are also more likely to be suffering from a behavioral health disorder like depression or anxiety, making their treatment all the more difficult to apply.

The preceding has not been a series of hyperbolic claims, but statements borne out by facts. There are ways that drug abuse can impact women, while not having the same effect on men.

This is, of course, due to differences between men and women in two areas:

  • Sex the biological differences and processes that separate men and women, physically
  • Gender – the cultural, social and psychological differences between men and women

Studies by the CDC, the National Institute on Drug Abuse and other scientific bodies have found the following regarding the ways (both physically and psychosocially) women experience drug abuse:

Spilled red wine and pills

The preceding has not been a series of hyperbolic claims, but statements borne out by facts. There are ways that drug abuse can impact women, while not having the same effect on men.

This is, of course, due to differences between men and women in two areas:

  • Sex – the biological differences and processes that separate men and women, physically
  • Gender – the cultural, social and psychological differences between men and women

Studies by the CDC, the National Institute on Drug Abuse and other scientific bodies have found the following regarding the ways (both physically and psychosocially) women experience drug abuse:

Physical Effects of Drug Abuse on Women

  • Changes in the brain due to chemical dependency are more apparent in women than men
  • Pregnant women with chemical dependencies experience another layer of health-related complications due to drugs and drug abuse
  • Drug abuse can hurt a woman’s fertility, her hormones, and her menstrual cycle
  • Women are likely to find it harder to quit and relapse more often than men

That just shows how drug abuse impacts a woman’s biology and health. There are also numbers that illustrate the breadth of this problem.

  • In a 2012 study, women accounted for 42% of all drug abusers in the United States
  • 15.8 million women, over the age of 18, have used illegal drugs in the past 12 months
  • 4.6 million women over the age of 18 have misused a prescription drug in the past 12 months

Social/Psychosocial Effects of Drug Abuse on Women

  • Women become dependent at a faster rate than men, something that is known as “telescoping”.
  • Women report self-medicating to overcome increased levels of stress, fight fatigue or treat a mental health disorder
  • Women are more likely to visit emergency rooms because of an opioid or prescription drug overdose
  • Women who experience domestic violence are more likely to become substance abusers

A Different Road

In a strictly physical sense, drug abuse has a more definable and measurable impact on a woman’s body than a man’s. Taking a look at specific substances and their physical effects on men and women can be one way to substantiate this claim.

  • Alcohol is the number one abused substance in the United States. While men abuse alcohol more often than women, the gap between male and female alcohol abuse has been slowly closing over the years, since it has become more socially acceptable for women to drink alcohol, especially in public. However, this rise in female drinkers has also given rise to cases of alcoholism among this demographic. This can be attributed to alcohol’s different effect on women than men. Since women statistically weigh less than men, an equal amount of alcohol will prove to have a stronger effect on a woman. The sexes also have varying amounts of two crucial alcohol processing enzymes, that influence the absorption of alcohol into the bloodstream, the lower levels occurring in women. This means that this process transpires at a faster rate in their organisms than in those of men, who have more of the same chemical.

  • There are more reported male smokers than there are female smokers, but again, women have greater risks associated with tobacco smoking. They face higher chances of developing lung cancer and are more at risk of having a heart attack, if they smoke. Statistically, while trying to quit, they experience more relapses than men. This can be attributed to the fluctuation of hormones during a woman’s menstrual cycle. And some studies have shown that nicotine replacement therapies may work more for men than they do for women. Women respond more to the ritual of smoking (lighting up, opening a pack, or social drinking) than men do to nicotine, which is easier to treat. Prescription drugs to help quit smoking have proven to work equally well for both men and women.

  • Estrogen levels make women more susceptible to the “pleasing” effects of THC found in cannabinoids. The sensitivity to THC in marijuana makes women more at risk of developing an addiction and, by extension, making them more predisposed to develop addictions to other substances.

  • Large amounts of both men and women have, in the past few years, started to abuse prescription drugs more and more. Evidence has shown that men become addicted to prescription drugs more through experimentation and a desire to get “high.” Women, on the other hand, develop addictions by over medicating when faced with numerous other medical and social concerns. Women are also prescribed more habit-forming medications because they statistically suffer from a higher number of chronic illnesses, such as fibromyalgia or mental disorders, like depression.

  • In general, women use smaller amounts of heroin and use for shorter periods of time than men; women also do not inject heroin as often as men. However, they are more likely to be affected by their sexual partner’s opioid abuse behavior than men. Research has shown that sexual partners exert a disproportionate amount of influence over their (female) partners. Almost half of all female intravenous drug users report having started injecting drugs because their partner first injected them. Women also visit emergency rooms more often for opioid addictions than men.

Women comforting and giving helping hand

The Hard Way Out

Advances have been made, however, in how men and women are treated for substance abuse. And the amount of men and women currently receiving some form of substance abuse treatment has been more or less equal for the last decade.

Factors specific to women, however, sometimes do hamper their efforts to get into treatment. Women might lack both childcare and financial resources. They might also have to undergo treatments that have yet to be proven effective for women.

Once women have entered treatment, they show about the same amount of success as men. Only once women have gone through treatment, do they present with a higher risk of relapsing, due to a higher than average rate of drug cravings.

Many early treatments for addiction were inadvertently targeted toward men because scientists only considered studying men to discover ways of treating drug abuse. Women were left out of early studies, and so, gender-specific treatment was yet to be made available or studied.

Woman taking white pill

Prescribing to Women

Prescription drug abuse among women has different traits than prescription abuse among men. As we stated before, the “reasons” men and women begin taking drugs are as different as men and women themselves.

  • Men will typically start to misuse prescription narcotics for the sheer experimentation factor involved; men look for a different “high” when they begin abusing prescription drugs.
  • Women, on the other hand, will begin self-medicating (especially with antidepressants and sedatives) by taking increased dosages or attempting to treat a separate condition, like trying to control weight or fight off insomnia.
  • Women get prescribed more medications that are more addiction-forming than men do, because women experience higher rates of depression, anxiety and insomnia.

Some studies have also linked the prevalence of traumatic experiences in the lives of women that endanger them in terms of precluding the development of a co-occurring substance abuse disorder.

Women already in the throes of a chemical dependency can also run the risk of developing other self-destructive behaviors, whether an eating disorder or a self-harming behavior.

The role trauma (specifically, sexual abuse) and mental health, play in causing or determining substance abuse in women will be explored in the following sections.

The Seeds of Abuse

The statistics on past experiences with trauma show a definitive skewing towards women than to men.

Trauma - an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life-threatening and that has lasting adverse effects on the individual's functioning and mental, physical, social, emotional, or spiritual well-being

Women can experience “trauma” in a variety of ways, although some of the more common forms include:

  • 15% to 25% of women, from various age groups, from girls to women, report having a sustained history of sexual assault in their lifetimes 30% to 50% of survivors of sexual assault develop PTSD (post-traumatic stress disorder

  • 37.3% of American women experienced some form of violence originating from their intimate partner during their lifetimes, compared to 30.9% for men 1.3 million women experience some form of partner abuse annually compared to 835,000 men

  • 51.9% of women and 66.4% of men report having been abused as a child by a primary caretaker Women in the United States report being raped at earlier and earlier ages, with over half (54%) of all attempted and completed sexual assaults occurring before the age of eighteen

Of course, traumatic experiences affect everyone differently, regardless of age, race, or gender. There is substantial evidence, however, that shows a direct correlation between a traumatic event, the development of PTSD and ultimately the creation of a substance abuse problem, in that order.

With more and more addicted men and women reporting early childhood abuse (both physical and sexual), it seems that an early familiarity with violence and trauma, in general, is a reliable indicator of future substance abuse problems.

Women, unfortunately, experience increased incidences of both early childhood sexual assault as well as incidences of sexual assault in adulthood, making them twice as susceptible to addictive disorders.

One study noted that:

  • Between 30% to 57% of female substance abusers also met the criteria for exhibiting symptoms of post-traumatic stress disorder
  • Higher incidences of substance use and post-traumatic stress disorders are directly related to early childhood physical and sexual abuse, which women experience in more significant numbers than men
  • PTSD symptoms were more commonly found among female alcoholics than in male alcoholics
  • Studies have shown that a presence of PTSD symptoms is a better predictor of a future addiction disorder than vice-versa, meaning that, people with PTSD are more likely to develop an addiction, rather than people with addictions developing PTSD

From all the above data, a clear line can then be drawn between different variables, which paints a bleaker picture for women, in general, regarding their relationship with substance abuse and trauma.

A singular case of early childhood sexual abuse paints a revelatory picture of how exactly trauma, PTSD and substance abuse in women are connected. One study surveyed a woman named Margaret, who had experienced sexual abuse early and often in her life, from a mix of familiar and unknown perpetrators.

Taking the case of Margaret as an example, researchers found that during a traumatic event (like childhood sexual assault):

  • The body begins to release endorphins, which temporarily alleviate symptoms like stress and fear associated with the trauma
  • These endorphin levels drop, however, immediately following the traumatic event, which then brings on symptoms of withdrawal in the brain, which conversely lead to alcohol or drug abuse to compensate for that sudden endorphin deficiency

Post-traumatic stress disorder is known by at least three significant symptoms:

  • The victim experiences regular flashbacks and nightmares or an intense reliving of the traumatic event
  • Victims consciously try to avoid the places, people or things that they associate with the traumatic event, on a psychological level, victims intentionally try to avoid reckoning with the emotional responses generated by thinking about the event
  • Victims report “being on edge,” along with cases of being hyper-vigilant and a general state of constant arousal

While the case of Margaret is only one among many, her example is illustrative of how trauma, assault, and substance abuse play off of each other in harmful and destructive ways, for, most notably, women.

By her own admission, Margaret relayed increased alcohol consumption as a way to deal with the painful memories of her assault. She also consumed a great deal of alcohol to avoid any instances where she might start to relive her experience (when she went to sleep, for example) or whenever an everyday occurrence triggered a flashback in her mind.

Both Margaret’s story and the evidence that shows higher incidences of sexual assault and PTSD symptoms present among women start to reveal something even more troubling. Substance abuse among women is not only a danger in and of itself.

If we should derive anything from the above personal account and the scientific analysis, it should be that more attention should be paid to the reasons women end up with substance use disorders, which can also go a long way to preventing chemical dependencies in women as well.

Changing attitudes toward girls and women, in general, must then be the most promising, prospective prevention measure to ensure both reduced instances of sexual and physical assault as well as addiction disorders.

All the evidence seems to argue that preventing early childhood physical and sexual violence among women will not only add to their quality of life but can also lead to their lessened chances of developing substance abuse disorders later on in life.

The critical question now is how this radical, social change is supposed to occur on a grand-level when faced with the ever-daunting specter of sexual assaults on women at institutions of higher learning?

Woman looking outside the window

NSFW (Not Safe for Women)

Having previously drawn the lines from drug abuse to trauma and then back again, it might now be fitting to examine a particular sector of society where the two factors collide in a quiet, yet devastating, fashion.

For many young people, college represents a whole new way of living. Boundaries are tested – sometimes, broken – young people begin experimenting, and exploring different ways of behaving.

For some, this includes trying drugs and alcohol. And for others, mostly young women, the intersection of where alcohol and sexual assault meet, namely, a college campus, can prove to be life-changing.

In 2016, a study by the Justice Department discovered that:

  • Almost 21% of women across a sample of nine schools reported having experienced a sexual assault since their first year in university
  • Over 6.4% of women across the same nine schools reported being victims of domestic violence

Another study from 2007 found that:

  • Nearly 6 million college-attending women have been raped
  • In the year of reporting, almost 300,000 college women were raped
  • Broken down by type of rape, almost 200,000 college women were forcibly raped, and 100,000 women were incapacitated rape (substance-induced)
  • Almost half of all campus sexual assaults involved either the consensual or nonconsensual ingestion of alcohol by either the victim or the perpetrator

This last statistic is useful since it shows a direct line between a substance (alcohol) and its relation to campus sexual assault. The presence of alcohol in almost half of all cases of campus sexual assault warrants a deeper understanding of how these two variables relate to each other.

Woman refusing

Communication Breakdown

The relationship between alcohol and campus sexual assault is both porous and concrete. While no one is saying that alcohol causes campus sexual assault or sexual assault in general, studies have shown that intoxicated persons commit a high proportion of violent crimes (nearly half).

To break it down by gender and by victim and perpetrator, one study found that:

  • Half of all sexual assaults are committed by men who are intoxicated
  • Among men who commit sexual assault, a range of between 34 and 79 percent were intoxicated while they were committing the act
  • Between 30 and 70 percent of women report having been drinking at the time of their assault
  • Besides the actual attack, the one link that the victim and the perpetrator very often share is alcohol

So, even leaving out the factor of being located within a college campus, men and women who have been drinking in a public place, heighten their chances, unfortunately, of becoming victims and perpetrators of sexual assault.

This is not to suggest, however, that mixing men and women in an environment where alcohol is served immediately translates to a sexual assault. Neither should the inference be made that women who drink are responsible for their victimization, while men who drink are not responsible for their behaviors. Far from it.

If anything, the above statistics further complicates the problem of untangling the messy connections between alcohol and campus sexual assault. One of the main issues has been and continues to be how women are made to feel that their alcohol consumption somehow led, and even excuses, this type of sexual aggression.

If anything, research shows that there are factors other than just alcohol consumption that plays important roles in campus sexual assault. In fact, research has shown that alcohol muddies the waters, if you will, between men and women.

Alcohol changes perceptions; it leads to mixed signals or signals not being received; alcohol decreases cognitive functions and leads to a physical incapacitation which intoxicated men ultimately take advantage of.

Throughout all this, however, it is important to remember something that was articulated by Professor Kate B. Carey, a researcher on a study released by the Journal of Studies on Alcohol and Drugs. She stated that

We all need to agree that drinking to the point of intoxication is not 'asking' to be assaulted

Woman silencing with a finger on lips

A Catastrophe of Silence

The perception of women who drink or are intoxicated as women who are “asking for it”, is a belief common among perpetrators of sexual assault and is often used as an excuse for their actions. Perceptions, it turns out, and the unintentional (or intentional, in some cases) blurring of those perceptions have a major role to play regarding the other reasons, besides, alcohol, why campus sexual assaults take place.


Men who sexually assault enter the situation already believing one of few things:

  • They have less empathy for women and see a majority of women in a negative light
  • They have traditional gender stereotypes on the roles of men and women in society

Men who already present these kinds of attitudes are further sent on the path towards committing sexual assault, when alcohol begins to take its effect, mostly because:

  • Alcohol can lead to misinterpretation of a woman’s desire to initiate sexual relations
  • Alcohol impairment can then lead to an aggressive response to what he perceives as resistance from a woman who he thought was consenting to his physical contact, because he misread social cues

The inverse of this diminished ability to perceive and understand cues is found in women as well. On the woman’s side, alcohol reduces a woman’s ability to perceive if a man has understood the meaning behind her social cues (that rebuff sexual advances).

This, in turn, leads to a situation where a woman continues sending these same cues, unaware that the man is understanding something completely different.

While the woman keeps sending the same signals believing they are being understood, and the man continues believing the cues mean something they don’t, they are both misreading the situation, what then invariably, leads to the subsequent assault.

Of course, this is in no way meant to suggest that sexual assault is a simple “misunderstanding.” Alcohol does not explain away sexual assault, neither does it absolve the perpetrator of their culpability in committing such a heinous act.

If anything, the previous findings showed that men with misogynist and negative attitudes toward women were, when drinking, more liable to commit sexual assault than just being men driven to rape because of alcohol.

This finding can then lend more credence to the argument that preventing college rapes has more to do with shifting attitudes and perceptions about women than anything that has to do with alcohol in and of itself.

College graduation hats

A Culture Change

Sexual assaults on college campuses have increasingly gained the public’s attention due not only to their prevalence but also because of how little has been done to prevent them in the first place.

Underreporting by victims of sexual assault has only enabled the problem to get worse. And yet, the very reasons some victims give for not reporting their assault is something also borne out by the facts.

College-attending women do not report a sexual assault for:

  • Fear of stigmatization
  • Fear of not being believed
  • Fear of being further degraded
  • Fear of retribution
  • Fear of the attacker(s) who may be another student on campus

And because of alcohol, and alcohol impairment, many women believe their assault was the result of their recklessness and irresponsibility. This attitude can even lead them to believe that no assault took place.

But, recently, things have begun to change. In 2010, the Obama White House started a nationwide campaign called “It’s on Us”, which aims to place campus sexual assaults in the sphere of public responsibility, and therefore, make it a collective problem.

Some of the measures that the “It’s on Us” campaign has put forward as possible preventative measures include:

  • Bystander interventions, wherein people who witness behavior that looks criminal or has the potential of becoming an assault alert the proper authorities to stop it
  • Campuswide educational initiatives, particularly targeted toward men and their pre-existing attitudes toward women
  • Making it easier for women to report incidences of sexual assault to impartial authorities
  • Educating women on the risks of unrestrained alcohol consumption
  • Disassociating alcohol from positive sexual encounters, which is something young people (men and women) believe exists

The Real Culprit

Hopefully, this article has pointed toward what many believe to be the main cause of all sexual assaults, not just those that take place on college campuses or have alcohol involved in them, which is rape culture.

A culture of permissiveness towards sexual assault and deference to gendered stereotypes regarding women who drink as “easy” and “loose” combine to create the conditions of rape culture.

Woman standing with crossed arms

Men who believe that alcohol consumption somehow relaxes the rules when it comes to acceptable sexual behavior are not easy to spot. In fact, over 80% of sexual assaults occur between people who know each other.

As ludicrous, and as simple as it sounds, the best way, it appears, to prevent sexual assaults is to teach men that rape is never, under any circumstances, acceptable.

Defeating rape culture and its pervasiveness is what seems to be a woman’s best bet to ensure she doesn’t have to endure a life fraught with trauma and abuse.