While it is true that men in the United States report higher rates of drug abuse (7.7% of American men vs. 5% of American women), substance use disorder is a significant problem for women as well. A woman goes to the emergency room after abusing prescription painkillers every 3 minutes in the USA. There are approximately 15.8 million adult women per year reported to be using illicit drugs. The most commonly used substance is alcohol (33.3%), followed by heroin (15.3%), marijuana (14.6%), prescription painkillers (13.8%), cocaine (9.3%), methamphetamine/amphetamines (8.6%), etc.
Women have a different clinical presentation of their substance use disorder. They tend to have a shorter history of abusing alcohol and drugs than men, yet they are likely to develop more severe physical, emotional, behavioral, and social problems compared to men. The spectrum of symptoms and signs may also differ between women and men in any given substance use disorder. Women are also more likely than men to suffer from comorbid mental health issues, including depression, anxiety, post-traumatic stress disorder (PTSD), panic attacks, eating disorders and particularly polysubstance abuse. It has also been noted that many women begin abusing drugs as a means of self-medication for these disorders.
All patients of substance use disorder, regardless of their gender, suffer from social problems, financial issues, mental and behavioral health disorders, malnutrition, hepatitis, AIDS, and other sexually transmitted diseases. However, female patients have these additional unique challenges, including having a higher rate of adverse physical effects on their cardiovascular system. They are also more likely to overdose and more sensitive to certain substances. Women with drug and alcohol addiction may be more likely to face certain financial and legal problems. This becomes even more problematic when they have children. Women with substance abuse problems may be more susceptible to rape, given their vulnerable state overall. A recent study reported that approximately 73% of female drug abusers that were surveyed had a history of rape, of whom 35% were raped while under the influence of drugs or alcohol. To makes matters worse, women engaging in substance abuse may face unplanned pregnancies as a result of poor safe sex practices due to lack of awareness/resources or while under the influence.
Female patients are also prone to pregnancy complications, leading to negative outcomes for both the mother and the developing baby. These women who abuse drugs during pregnancy are more likely to experience high blood pressure, migraines, and seizures. Their fetuses are prone to having low birth weight, birth defects, developmental delays, etc. There is a 2-3 times higher risk of stillbirths in these cases.
All of these problems are made worse by several barriers to treatment faced by women. To begin with, women are generally less likely to seek treatment than men, which may be in part due to social stigmas, childcare responsibilities, financial difficulties, transportation issues, lack of interpersonal or familial support, just to name a few.
Special care should be provided to female patients in order to improve compliance, comfort and overall chance of recovery. Some female-specific supportive approaches include onsite childcare, parenting classes, special care for pregnant/nursing mothers or those who are victims of rape, domestic violence, etc. In addition, vocational training, income support, housing assistance, social services, family and couples therapy are also very useful in helping these patients.