Sex and Gender Differences in Substance Use National Institute on Drug Abuse NIDA
The barriers identified in the studies point to needs that should be realized to reduce drug use and make it easier for women suffering from addiction to decide on treatment, participate fully in the treatment process, and provide adequate support once completed. However, this was done consciously, knowing that the PubMed database is one of the databases containing high-quality peer-reviewed publications. In addition, the choice of PubMed as the primary database to look for relevant data was influenced by the fact that this database provides free access to scientific publications found in MEDLINE and some articles from other scientific journals. In our opinion, it is a rich data source conducive to the reliable exploration of scientific materials 22. The authors do not rule out conducting additional similar studies in other databases, e.g., to check for differences in the number and value of publications on similar topics; this, however, may be an idea for a separate study. The articles were selected in terms of their descriptions of women’s problems; that is, the publications had to fit within the predetermined inclusion criteria strictly and describe actual research on the needs of women suffering from drug abuse, but also on the barriers that make it difficult for them to get treatment and change their difficult situation.
Racially and Ethnically Diverse Women
First, the NSDUH data are self-reported and thus subject to recall and social desirability biases, which may vary by racial or ethnic group and type of substance use. However, NSDUH response rates are fairly high, ranging from 69.3% in 2015 to 66.6% in 2018 (CBHSQ, 2016, 2018, 2019). Second, the sample excludes active-duty military personnel, people in prisons and jails, and people who do not have homes and do not use shelters (CBHSQ, 2019).
Rates of Substance Use and Misuse by Race and Ethnicity
- Attention should be paid to the individual’s social environment, which significantly influences the behavior in question 68.
- According to the National Institute of Alcohol Abuse and Alcoholism, mounting evidence suggests that women are at higher risk for some of alcohol’s negative effects, such as liver disease, cardiovascular disease and neurotoxicity.
- In relation to assessing and treating women’s medical issues, a gender perspective is required, transcending anatomical and biological aspects concerning health and sickness through life.
- We chose difficulties related to the abuse of psychoactive substances other than alcohol because problems related to alcohol use that researchers more frequently described in the scientific literature; in addition, the use of psychoactive substances other than alcohol is met with intense social stigma, especially against women 17.
- Results showed that the barriers are mainly stigma but also deficits in the therapeutic offerings for this group.
We also computed rates of heavy alcohol use in the past month, defined as consuming five or more drinks on the same occasion for men or four or more drinks on the same occasion for women on each of five or more days in the past 30 days. In 2003, women accounted for 58 percent of the population aged 65 and older (Federal Interagency Forum on Aging-Related Statistics FIFARS 2004); women older than age 65 constitute 7.3 percent of the total population. The oldest of the population (persons 85 years and older) are among the most rapidly growing age cohort in the Nation.
Results of the Literature Search
- In addition to the continued inquiry into oppression-based stress, motivational and positive reinforcement models (e.g., drinking to celebrate, be sexual, connect with others) should be examined to provide a comprehensive understanding of mechanisms driving drinking among SGM people.
- Alaska Native/American Indian is the smallest of the four major racial/ethnic groups currently recognized in the United States.
Older years are filled with many adjustments and challenges, often including loss of spouse and close friends, retirement, and reduced income. Because many older women live alone (40 percent of those aged 65 and older FIFARS 2004), their substance use is difficult to measure (Moore et al. 1989). Older women tend to hide their substance use because they attach greater stigma to it than men do (CSAT 1998d). Older women are less likely than older men to drink or use drugs in public, so they are less likely to drive while intoxicated or engage Women and Alcoholism in other behavior that might reveal a substance use disorder (SAMHSA 2008). Several factors prevent an accurate measure of the number of women who identify as lesbian or bisexual, among them the absence of standardized terms and definitions of sexual orientation and gender identity (Dean et al. 2000).
Oppression and Drinking Motivations Among SGM People
Gender has implications for health across the course of a person’s life in terms of norms, roles, and relations. It influences a person’s risk-taking and health-seeking behaviors, exposure to health risks, and vulnerability to diseases. In general, women through all their lifetime face more barriers to access to services, and this issue is more prominent in addictive disorders; such barriers include the higher stigma attached to substance use among women, the lack of childcare, the absence of gender-sensitive protocols and treatments, and the lack of family support among others.
These include age; the duration of heavy drinking over the life course; the widening disparity in cumulative socioeconomic disadvantage and health in middle adulthood; social status; sociocultural context; genetic factors that affect alcohol metabolism; and access to and quality of alcohol treatment services and health care. To inform the development of interventions that might mitigate disparities among women, research is needed to identify the factors and mechanisms that contribute most to a group’s elevated risk for a given alcohol-related problem. Several weaknesses and much heterogeneity in the reviewed studies’ drinking inclusion criteria and assessment of different types of oppression-based stressors in the SGM populations may contribute to inconsistent patterns of results. First, the majority of cross-sectional and longitudinal studies, as well as some of the experience sampling studies, did not have alcohol use as an inclusion criterion. As such, study samples included SGM individuals who had never initiated or had abstained from alcohol use as well as individuals who used alcohol and had a wide range of drinking patterns (i.e., experimental, infrequent, occasional, frequent, and heavy use). This obscures understanding of the associations between oppression-based stressors and alcohol outcomes.
Dual HIV risk and vulnerabilities among women who use or inject drugs: no single prevention strategy is the answer
In England, on the other hand, structural challenges include poor access to doctors’ offices and counseling related to both treatments of substance abuse problems and sexual health issues, as well as access to related institutions, e.g., related to anti-violence and sexual assault 37. Although this review focuses on sexual minority women, the newly emerging literature on alcohol use among gender minority women (i.e., noncisgender and nonbinary women) should be noted. A systematic review of transgender individuals (including gender minority women) by Gilbert and colleagues found estimates of binge drinking among transgender individuals ranging from 7% to 65%, with estimates of lifetime and past-year DSM-IV AUD prevalence at 26% and 11%, respectively.29 More research is needed on these groups.