Substance Use in Women DrugFacts | National Institute on Drug Abuse (2023)

Sex and gender differences in substance use


Substance Use in Women DrugFacts | National Institute on Drug Abuse (1)

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Women face unique issues when it comes to substance use, in part influenced by:

  • sex—differences based on biology
  • gender—differences based on culturally defined roles for men and women

Scientists who study substance use have discovered that women who use drugs can have issues related to hormones, menstrual cycle, fertility, pregnancy, breastfeeding, and menopause. In addition, women themselves describe unique reasons for using drugs, including controlling weight, fighting exhaustion, coping with pain, and attempts to self-treat mental health problems.

Science has also found that:

19.5 million females (or 15.4 percent) ages 18 or older have used illicit* drugs in the past year.1 *The term "illicit" refers to the use of illegal drugs, including marijuana according to federal law, and misuse of prescription medications.

  • Women often use substances differently than men, such as using smaller amounts of certain drugs for less time before they become addicted.
  • Women can respond to substances differently. For example, they may have more drug cravings and may be more likely to relapse after treatment.
  • Sex hormones can make women more sensitive than men to the effects of some drugs.
  • Women who use drugs may also experience more physical effects on their heart and blood vessels.
  • Brain changes in women who use drugs can be different from those in men.
  • Women may be more likely to go to the emergency room or die from overdose or other effects of certain substances.
  • Women who are victims of domestic violence are at increased risk of substance use.
  • Divorce, loss of child custody, or the death of a partner or child can trigger women's substance use or other mental health disorders.
  • Women who use certain substances may be more likely to have panic attacks, anxiety, or depression.

Substance use while pregnant and breastfeeding

8.4 million females (or 6.6 percent) ages 18 and older have misused prescription drugs in the past year.1

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The number of women with opioid use disorder at labor and delivery quadrupled from 1999-2014.3

Substance use during pregnancy can be risky to the woman’s health and that of her children in both the short and long term. Most drugs, including opioids and stimulants, could potentially harm an unborn baby. Use of some substances can increase the risk of miscarriage and can cause migraines, seizures, or high blood pressure in the mother, which may affect her fetus. In addition, the risk of stillbirth is 2 to 3 times greater in women who smoke tobacco or marijuana, take prescription pain relievers, or use illegal drugs during pregnancy.2 Surveys suggest that more women are using marijuana during pregnancy, which has health professionals concerned. The American College of Obstetrics and Gynecology (ACOG) suggests that marijuana can result in smaller babies, especially in women who use marijuana frequently in the first and second trimesters. ACOG recommends that pregnant women or women wanting to get pregnant should stop using marijuana, even if it is for medical purposes, and discuss options with their doctors that will be healthier for their babies.4Pregnant women should check with their health care provider before using any medicines or substances.

When a woman uses some drugs regularly during pregnancy, the baby can go through withdrawal after birth, a condition called neonatal abstinence syndrome (NAS). Research has shown that NAS can occur with a pregnant woman's use of opioids, alcohol, caffeine, and some prescription sedatives. The type and severity of a baby’s withdrawal symptoms depend on the drug(s) used, how long and how often the mother used, how her body breaks down the drug, and if the baby was born full-term or prematurely.

Symptoms of NAS in a newborn can develop immediately or up to 14 days after birth. Some of these symptoms include:

  • blotchy skin coloring
  • diarrhea
  • excessive or high-pitched crying
  • fever
  • increased heart rate
  • irritability
  • poor feeding
  • rapid breathing
  • seizures
  • sleep problems
  • slow weight gain
  • trembling
  • vomiting

Also, substance use by the pregnant mother can lead to long-term and even fatal effects, including:

Smoking tobacco during pregnancy is estimated to have caused 1,015 infant deaths per year from 2005 through 2009.5

  • birth defects
  • low birth weight
  • premature birth
  • small head size
  • sudden infant death syndrome

Some substances, such as marijuana, alcohol, nicotine, and certain medicines, can be found in breast milk. However, little is known about the long-term effects on a child who is exposed to these substances through the mother’s milk. Scientists do know that teens who use drugs while their brains are still developing could be damaging their brain’s learning abilities. Therefore, similar risks for brain problems could exist for drug-exposed babies. Given the potential of all drugs to affect a baby’s developing brain, women who are breastfeeding should talk with a health care provider about all of their substance use.

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Sex and gender differences in substance use disorder treatment

If a pregnant woman attempts to suddenly stop using drugs and alcohol without medical help, she can put her fetus at risk.

It is important to note that treatment for substance use disorders in women may progress differently than for men. Women report using some substances for a shorter period of time when they enter treatment. However, women's substance use tends to progress more quickly from first use to addiction. Withdrawal may also be more intense for women. In some cases, women respond differently than men to certain treatments. For instance, nicotine replacement (patch or gum) does not work as well for women as for men.

It can be hard for any person with a substance use disorder to quit. But women in particular may be afraid to get help during or after pregnancy due to possible legal or social fears and lack of child care while in treatment. Women in treatment often need support for handling the burdens of work, home care, child care, and other family responsibilities.

Specific programs can help pregnant women safely stop drug use and also provide prenatal care. Certain types of treatment have shown positive results, especially if they provide services such as child care, parenting classes, and job training. Medications such as methadone and buprenorphine, combined with the treatments described above, can improve outcomes. Some babies will still need treatment for withdrawal symptoms. However, outcomes are better for the baby if the mother takes treatment medicine during pregnancy than if she continues to use opioids.

For more information about sex and gender issues for women related to substance use, read the Substance Use in Women Research Report.

The importance of including women in research

In the past, women were not included in most research because of the belief that women are more biologically complicated than men and that women were too busy caring for their children to participate in studies. However, excluding specific subgroups from research produces knowledge that only helps a portion of the public. Federal agencies, including the National Institutes of Health (NIH), have been instrumental in pushing for women to be included in clinical research. These efforts have ensured that broader public health issues related to sex and gender are studied.

Points to Remember

  • Women face unique issues when it comes to substance use. These differences are influenced by sex (differences based on biology) and gender (differences based on culturally defined roles).
  • Research has found many differences in how women and men use substances and react to substances. For example, women use drugs in smaller amounts than men, but they can experience the effects more strongly.
  • Using substances while pregnant can harm the health of a pregnant woman and her fetus.
  • More women are using marijuana during pregnancy than in past years, which could result in smaller babies and goes against the advice from the top medical group representing obstetricians.
  • The use or misuse of some drugs while pregnant, especially opioids, can cause a newborn infant to experience withdrawal symptoms, a condition known as Neonatal Abstinence Syndrome (NAS).
  • Substance use in women tends to develop into addiction more quickly than in men.
  • It can be difficult for women to get help for a substance use problem during or after pregnancy because of social or legal fears. They may also lack child care while in treatment.
  • Treatment programs should take these issues into consideration and offer child care, job training, and parenting classes.
  • In the past, women were not included in clinical research. Federal agencies have made significant efforts to ensure that all subgroups of people are included and that issues related to sex and gender are being studied.
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Learn More

For more information about substance use in women, visit:


  1. Center for Behavioral Health Statistics and Quality. Results from the 2016 National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2017. Accessed November 7, 2017.
  2. Tobacco, drug use in pregnancy can double risk of stillbirth. Eunice Kennedy Shriver National Institute of Child Health and Human Development. Published December 11, 2013. Accessed January 31, 2018.
  3. Haight SC, Ko JY, Tong VT, Bohm MK, Callaghan WM. Opioid Use Disorder Documented at Delivery Hospitalization — United States, 1999–2014. MMWR Morb Mortal Wkly Rep 2018;67:845–849. DOI:
  4. Study finds increased cannabis use during
  5. National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2014.

This publication is available for your use and may be reproduced in its entirety without permission from NIDA. Citation of the source is appreciated, using the following language: Source:National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services.


What are the 5 factors influencing substance use and abuse? ›

Risk factors
  • Family history of addiction. Drug addiction is more common in some families and likely involves genetic predisposition. ...
  • Mental health disorder. ...
  • Peer pressure. ...
  • Lack of family involvement. ...
  • Early use. ...
  • Taking a highly addictive drug.

What are the factors that lead to substance abuse among university students? ›

Some of the factors predisposing students to abuse drugs were; easy accessibility to drugs, peer pressure, availability of funds, excess freedom, male gender, stress, not being active in religious activities, poor parenting and the African culture that uphold substances such as alcohol as an acceptable social drink.

What are the 6 types of substance abuse? ›

What are the 6 different types of drug dependence? Within the above categories are six types of drug dependency: alcohol dependence, opioid dependence, hypnotics/sedative dependence, cannabis dependence, hallucinogen dependence, and cocaine abuse.

What are the factors of substance use and abuse? ›

Risk Factors for High-Risk Substance Use
  • Family history of substance use.
  • Favorable parental attitudes towards the behavior.
  • Poor parental monitoring.
  • Parental substance use.
  • Family rejection of sexual orientation or gender identity.
  • Association with delinquent or substance using peers.
  • Lack of school connectedness.

What are the ways to solve the problem of drug abuse? ›

Here are the top five ways to prevent substance abuse:
  • Understand how substance abuse develops. ...
  • Avoid Temptation and Peer Pressure. ...
  • Seek help for mental illness. ...
  • Examine the risk factors. ...
  • Keep a well-balanced life.
7 Jul 2021

Who is most at risk for substance abuse? ›

People who have experienced physical, emotional or sexual abuse or trauma are more likely to develop a substance use disorder. Others who have friends who use, or those subjected to peer pressure, may also be at a greater risk.

How does substance abuse affect students? ›

Substance-using students, compared with non-users, are at increased risk for academic failure, including dropout, especially when the use is frequent and heavy. Marijuana use negatively impacts academic outcomes (lower GPA and higher rates of dropout) somewhat more than does alcohol.

How does substance abuse impact college students? ›

Some of the short- and long-term impacts of drug and alcohol abuse in college students can include: Decreased academic performance. Substance abuse can lead to a lower GPA, less time spent studying, missing class, getting behind on assignments, dropping out, or being expelled. Risky or dangerous behaviors.

What are the causes and effects of alcohol and drug abuse on students? ›

Addicted minors may miss school more often and may have difficulty focusing on school when in class. Drinking and drug use can lead juveniles to become withdrawn from their peer group and can increase depression, which has a significant effect on a child's academic performance.

How can we prevent drug abuse among youth? ›

Consider other strategies to prevent teen drug abuse:
  1. Know your teen's activities. Pay attention to your teen's whereabouts. ...
  2. Establish rules and consequences. ...
  3. Know your teen's friends. ...
  4. Keep track of prescription drugs. ...
  5. Provide support. ...
  6. Set a good example.

What is the difference between drug abuse and substance abuse? ›

Drug abuse or substance abuse is when you use a drug, even when you know it is harmful to your health. It includes taking illegal drugs and using prescription medicine differently from how your doctor prescribes. Taking illicit drugs like heroin or cocaine is substance abuse.

What are the dangers of substance use? ›

Risks of Substance Use

Affect the growth and development of teens, especially brain development. Occur more frequently with other risky behaviors, such as unprotected sex and dangerous driving. Contribute to the development of adult health problems, such as heart disease, high blood pressure, and sleep disorders.

What are three risk of drug abuse? ›

The more risks a child is exposed to, the more likely the child will abuse drugs.
Risk FactorsDomainProtective Factors
Early Aggressive BehaviorIndividualSelf-Control
Lack of Parental SupervisionFamilyParental Monitoring
Substance AbusePeerAcademic Competence
Drug AvailabilitySchoolAnti-drug Use Policies
1 more row

What are symptoms of substance use disorder? ›

Signs and symptoms of substance use disorder
  • sudden weight loss or gain.
  • pupils that are smaller or larger than usual.
  • bloodshot eyes.
  • changes in appetite and sleeping patterns.
  • slurred speech.
  • impaired coordination or tremors.
  • deterioration of physical appearance or changes in grooming practices.
  • runny nose.

What is a substance use disorder? ›

Substance use disorders occur when the recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home.

What are the 10 ways to say no to drugs? ›

How to Say No to Drugs and Alcohol
  1. Make an excuse.
  2. Use a little humor.
  3. Change the subject.
  4. Offer to be the designated driver.
  5. Act like you're too busy.
  6. Explain the dangers of drugs and alcohol.
  7. Be honest.
  8. Keep saying no.

What is the purpose of the substance abuse Act? ›

This Act provides for the implementation of comprehensive and integrated service delivery amongst all government departments. The emphasis of this Act is the promotion of community based and early intervention programmes as well as the registration of all therapeutic interventions in respect of substance abuse.

How does addiction affect mental health? ›

If you or someone you care about is chronically using drugs or alcohol it can lead to changes in the brain, which can lead to mental health issues including paranoia, depression, anxiety, aggression, hallucinations, and other problems.

What are protective factors in substance abuse? ›

The protective factors include high self-esteem, religiosity, grit, peer factors, self-control, parental monitoring, academic competence, anti-drug use policies, and strong neighborhood attachment [10,11,12,13,14,15].

What are three types of risk factors? ›

A risk factor is a characteristic, condition, or behaviour that increases the likelihood of getting a disease or injury.
In general, risk factors can be categorised into the following groups:
  • Behavioural.
  • Physiological.
  • Demographic.
  • Environmental.
  • Genetic.

What are the effects of drug abuse to the society? ›

Communities also suffer from the effects of drug addiction. Overall, substance abuse costs the United States more than $740 billion a year in terms of health care, work productivity and crime; of that figure, illicit drug abuse costs $193 billion and prescription opioid abuse costs another $78.5 billion.

What is the impact of substance abuse in the community? ›

Besides personal and family distress, additional healthcare costs and loss of future productivity place burdens on the community. Mental health problems such as depression, developmental lags, apathy, withdrawal, and other psychosocial dysfunctions frequently are linked to substance abuse among adolescents.

What can be done to reduce drug abuse in schools? ›

Elements of Good Practice for Drug Prevention
  • Information dissemination programs which teach primarily about drugs and their effects;
  • Fear arousal programs that emphasize risks associated with drug use;
  • Moral appeal programs that teach about the evils of use and;
21 Jul 2022

What drugs do students take? ›

They also increase heart rate, breathing rate, and blood pressure. Prescription stimulants used as study drugs include: amphetamines like Adderall, Dexedrine, or Vyvanse. methylphenidates like Ritalin or Concerta.

What percent of students use drugs? ›

Nearly 2.0 million full-time college students (22.2 percent) used an illicit drug in the past month.

How many students use drugs in school? ›

A new survey finds an estimated 17 percent of American high school students say they drink, smoke or use drugs during the school day.

What is the main effect of a drug? ›

The drug affects chemicals and receptors within the brain, causing different effects depending on the type of drug. Your body then metabolises the drug or breaks it down into simpler molecules (known as metabolites) which can be more easily eliminated. Sometimes these metabolites can also affect your body.

How can we reduce the use and abuse of drugs? ›

Know your triggers
  1. avoiding places where you know drugs and alcohol will be available.
  2. surrounding yourself with friends who don't use drugs.
  3. knowing how to resist temptation.
  4. learning how to cope with stress and relax without drugs.
  5. distracting yourself with activities like exercise or listening to music.
4 Mar 2020

What is the best solution to drug abuse and misuse? ›

Prevention is the best strategy. These prevention programs work to boost protective factors and eliminate or reduce risk factors for drug use. The programs are designed for various ages and can be used in individual or group settings, such as the school and home.

What is the importance of drug awareness? ›

When it comes to drug prevention, knowledge is power. You can learn about why people use drugs and alcohol and how use of the substances can turn into an addiction. Using this information, you can teach your children to help prevent them from falling into use and addiction themselves.

What are the 5 forms of substance abuse? ›

Believe they should lie to others to hide the effects of their parents problems.
  • Prescription Drug Abuse.
  • Illegal Drug Abuse.
  • Alcohol Abuse.
  • Solvent Abuse.
  • “Legal High” Abuse.
3 Aug 2016

What are 2 types of substance abuse? ›

There are two main types of substance use disorders: alcohol use disorder and drug use disorder. Some people abuse both substances, while others are addicted to one or the other.

What are the Nine lifestyle diseases caused by substance abuse? ›

The Impact of Addiction Can Be Far-Reaching
  • Cardiovascular disease.
  • Stroke.
  • Cancer.
  • Hepatitis B and C.
  • Lung disease.
  • Mental disorders.
10 Jul 2020

What is the main problem of substance abuse? ›

They can cause physical problems such as liver disease, lung disease, heart disease, vitamin deficiencies, and brain damage. Some substances can cause birth defects and others can damage the immune system, increasing the risk of infections.

What are four social factors that contribute to substance abuse? ›

Social factors that contribute to increased risk for adolescent substance use include deviant peer relationships, popularity, bullying, and association with gangs. Social influences and familial influences are often present simultaneously.

What are some social factors that contribute to the risks of addiction? ›

For example, some of the risk factors for addiction include: a person's genes, the way a person's brain functions, previous experiences of trauma, cultural influences, or social issues such as poverty and other barriers to accessing the social determinants of health.

What are risk factors and protective factors? ›

Risk factors are characteristics at the biological, psychological, family, community, or cultural level that precede and are associated with a higher likelihood of negative outcomes. Protective factors are characteristics associated with a lower likelihood of negative outcomes or that reduce a risk factor's impact.

What are intrapersonal factors of substance abuse? ›

These factors include (but are not limited to) personality, cognitions, affect, problem behaviors, demographics, and bonding. We explore the potential role of each of these intrapersonal factors in a larger, biopsychosocial model of drug use and abuse.

How can we prevent drug abuse among youth? ›

Consider other strategies to prevent teen drug abuse:
  1. Know your teen's activities. Pay attention to your teen's whereabouts. ...
  2. Establish rules and consequences. ...
  3. Know your teen's friends. ...
  4. Keep track of prescription drugs. ...
  5. Provide support. ...
  6. Set a good example.

What are two forms of substance abuse? ›

Substance abuse, as a recognized medical brain disorder, refers to the abuse of illegal substances, such as marijuana, heroin, cocaine, or methamphetamine. Or it may be the abuse of legal substances, such as alcohol, nicotine, or prescription medicines. Alcohol is the most common legal drug of abuse.

What are three forms of substance abuse? ›

Believe they should lie to others to hide the effects of their parents problems.
  • Prescription Drug Abuse.
  • Illegal Drug Abuse.
  • Alcohol Abuse.
  • Solvent Abuse.
  • “Legal High” Abuse.
3 Aug 2016

What are the consequences of abusing drugs? ›

Substance abuse can lead to abnormal heart rates and heart attacks, and injecting drugs can result in collapsed veins and infections in your heart valves. Some drugs can also stop your bones from growing properly, while others result in severe muscle cramping and general weakness.

How can substance abuse affect your education? ›

Substance-using students, compared with non-users, are at increased risk for academic failure, including dropout, especially when the use is frequent and heavy. Marijuana use negatively impacts academic outcomes (lower GPA and higher rates of dropout) somewhat more than does alcohol.

How does addiction affect the brain? ›

In a person who becomes addicted, brain receptors become overwhelmed. The brain responds by producing less dopamine or eliminating dopamine receptors—an adaptation similar to turning the volume down on a loudspeaker when noise becomes too loud.

What is a protective factor for drug use? ›

The protective factors include high self-esteem, religiosity, grit, peer factors, self-control, parental monitoring, academic competence, anti-drug use policies, and strong neighborhood attachment [10,11,12,13,14,15].

What are risk Behaviours? ›

Risk behaviours: Behaviours that increase the likelihood of a negative health outcome, now or in the future—for example, excessive alcohol use. Risk conditions: Conditions such as overweight/obesity, which are not behaviours but that nonetheless contribute to diseases, disability or death.

What are mental health protective factors? ›

Protective factors include individuals, families or communities that support resilience, help people more effectively manage stressful events, and strengthen other characteristics that minimize the risk of mental health or substance use challenges.

What are the social and economic effects of drug abuse? ›

$120 billion in lost productivity, mainly due to labor participation costs, participation in drugabuse treatment, incarceration, and premature death; $11 billion in healthcare costs – for drug treatment and drug‐related medical consequences; and.

What are the social factors that contribute to substance? ›

Social Risk Factors Of Substance Abuse

Social Factors that increase risk for adolescent substance use can include popularity, bullying, peer relationships, and association with gangs. Other possible factors are social and familial influences are often present simultaneously.

How do risk and protective factors influence drug abuse? ›

Risk factors can increase a person's chances for drug abuse, while protective factors can reduce the risk. Please note, however, that most individuals at risk for drug abuse do not start using drugs or become addicted. Also, a risk factor for one person may not be for another.


1. Understanding the Intersection of HIV and Substance Use Disorder
(National Institute on Drug Abuse (NIDA/NIH))
2. The Alcohol and Drug Abuse Institute (ADAI)
3. Sex, Gender and Addiction
(National Institute on Drug Abuse (NIDA/NIH))
4. 2018: Substance Use Disorders in Women
(Southern Medical Association)
5. Substance Use Disorders 101: The Overview
(Educational Videos for Addiction Care Teams)
6. Overcoming Addiction: Why It's Different for Women
(Hazelden Betty Ford Foundation)
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