Gender Differences in Substance Use Disorders

Last Updated: November 3, 2023

Editorial Policy | Research Policy

While men and women may use drugs for varying reasons, gender differences in substance use disorders can also impact how men and women experience addiction.

Sex and gender differences in substance use disorders substantially impact how men and women experience addiction. Gender plays a role in how likely it is for a person to develop a substance use disorder and how specific drugs affect the people who take them.

While there are significant individual differences in drug use patterns and symptoms, substance abuse statistics on gender show stark differences in how men and women experience addiction.

Substance Abuse Statistics by Gender

Men and women experience substance use disorders at different rates. Specifically, men have a higher rate of substance use disorder than women.

According to the 2020 National Survey on Drug Use and Health (NSDUH), 17.7% of men over 18 and 13.2% of women over 18 had a substance use disorder in the past year. However, this gap in substance use disorders has been shrinking over several years.

This is because men are more likely to use illegal drugs or misuse prescription drugs than women. Across nearly every category of illicit substance, men are more likely to report using it in their lifetime or the past year, except for opioids, benzodiazepines and sedatives.

Addiction in Men vs. Women

Though men are more likely to use nearly every type of drug, women are just as likely as men to develop a substance use disorder once they start using substances. However, the courses of these disorders are often divergent across gender lines. Not only do men and women use substances for different reasons, but they can experience certain symptoms to differing degrees.


Evidence shows the transition from alcohol or drug use to dependence differs between men and women. Specifically, substantial research has shown that women often have a shorter period between drug use initiation and developing a substance use disorder.

Certain substances, such as cocainenicotine and alcohol, reach higher peak plasma levels in women than men. This can lead to a more rapid onset of substance use disorder after the initiation of drug use.

However, men are more likely to begin substance use at an earlier age and have an earlier onset of substance use disorders. Across a large study examining alcohol treatment, researchers found that men were diagnosed with alcohol use disorders roughly three years earlier than women.


Historically, men were much more likely to seek treatment for substance use disorders than women. In 2011, less than a third of admissions to substance use treatment were female.

Thankfully, this disparity has closed in recent years. In 2020, 1.6% of men and 1.3% of women in the U.S. received treatment for substance use disorders.

Risk of Relapse

Relapse rates differ between men and women. Generally speaking, men are more likely to relapse than women, though women will often suffer worse consequences due to relapse.

How Does Gender Affect Substance Abuse?

Historically, substance use research focused exclusively on men and assumed the findings carried over to women. Yet, for women, drug addiction can take a very different course than for men.

Not only do men and women use drugs and alcohol for different reasons, but physiological distinctions mean the genders can metabolize and react differently to various substances and benefit from specialized treatment plans to help them achieve abstinence.


Alcohol use between men and women differs significantly, partly due to diverse guidelines for what is considered moderate or heavy alcohol use, delineated by gender.

Heavy alcohol use for men is defined as drinking four drinks in one day or 14 per week. For women, heavy drinking is consuming more than three drinks in one day or seven in a week. Similarly, binge drinking typically corresponds to five drinks in two hours for men and four drinks in two hours for women.

The guidelines for men’s and women’s alcohol use differ for several reasons. Most significantly, women typically have less body water than men of the same weight. Therefore, a woman drinking the same number of drinks as a man can have a higher blood alcohol concentration.

Women and alcoholism can also have worse outcomes than men. Women face higher rates of alcohol-related consequences, including:

  • Higher rates of liver disease
  • Faster cognitive decline
  • Increased risk of cardiovascular damage
  • Increased risk of breast cancer

Despite these impacts, men are more likely to develop alcohol use disorder (AUD). Research shows that 12.7% of men 18 or older have alcohol use disorder, while only 9.4% of women 18 or older meet the criteria for AUD.

Interestingly, this relationship is reversed for people aged 18–25. More women are diagnosed with alcohol use disorder in this age bracket than men.


Stimulant use is where the motivation for use differs between men and women. Women are more likely to use methamphetamine for reasons such as:

  • Weight loss
  • Energy
  • For fun

In contrast, men are more likely to use meth to:

  • Work more
  • Experiment with new drugs
  • Have better sex

Gender roles and incentives play a significant role in stimulant use. For example, men may be motivated to fulfill the gender role of being a provider, whereas women may use stimulants to decrease the exhaustion associated with childcare and family responsibilities. Drug addiction signs in men or women often adhere to these gender roles.


Hypnotics, sedatives and benzodiazepines are prescription medications often used illicitly. Although men typically misuse illegal substances at a much higher rate than women, depressant use rates are higher for women than men.


Opioids include illicit substances such as heroin and fentanyl and prescription painkillers. In 2019, 1.3% of men and 1.0% of women used opioids. However, in 2020, this relationship flipped. The most recent data indicates that women are more likely to misuse illicit or prescription opioids than men.


Marijuana use is more prevalent among men than women. Additionally, men experience stronger subjective effects from marijuana use. Researchers believe this results from women’s higher body fat percentage, which can retain cannabinoids more readily.

Factors Influencing SUDs in Men and Women

While certain substances affect men and women differently due to differences in biology and metabolism, other factors play a role. Just a few include:

  • Gender norms
  • Peer pressure
  • Masculinity or femininity ideals
  • Mental health disorders
  • Traumatic experiences

While many of these differences may fall along gender lines, each individual will have unique substance use experiences that color their future behavior.

Substance Abuse Addiction Treatment in New Jersey

If you or a loved one is struggling with a substance use disorder, the time to act is now. Getting professional addiction treatment to start your path to recovery is the best thing you can do for your holistic and physical health.

When you’re ready to feel better, live healthier and overcome your substance use disorder, reach out to the team at The Recovery Village Cherry Hill at Cooper, in New Jersey. From the moment you call, our team will help you work toward a thriving life in recovery. Contact us today.


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Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

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