Since the dawn of civilization, humanity has had an inherent determination to find ways to get high. Beginning in the days of ancient Mesopotamia extending to modern times, men have far outpaced women in nearly every measure of substance abuse and addiction. Because men abuse drugs and alcohol more than women, it factors into their higher number of injuries and deaths compared to women. While there’s no disputing these facts, it does beg the question, why?
Male and Female Substance Abuse Statistics
Accounting for Biological Factors
Men and women are quite obviously biologically different, and that difference begins with physiological characteristics. On average, men are larger and heavier than women. This allows them to consume more drugs and/or alcohol while avoiding many of the immediate negative effects such as nausea, vomiting, paranoia and others.
Male bodies are built to sustain more damage through substance abuse. This could be a reason why women generally take drugs and consume alcohol in smaller amounts than men, but advance to addiction more quickly once substance abuse is initiated.[3] Women also have proportionately more fat and less water in their bodies, which results in them processing drugs and alcohol more slowly.
There is also an enzyme in the body called alcohol dehydrogenase, which is supposed to break down alcohol in the stomach before it reaches the blood. Men have this enzyme in greater abundance than women and, as a result, about 30 percent more alcohol reaches the bloodstream in women when they drink. Women becoming intoxicated more quickly than men could help explain why men tend to abuse more drugs and alcohol.[4]
Another biological difference that could impact the initiation of substance abuse and subsequent development of addiction is pregnancy. Although it is inadvisable for a parent of either gender to abuse drugs or alcohol, it is especially dangerous to a fetus if an expecting mother consumes alcohol or uses drugs. Being that men cannot get pregnant, women alone shoulder the burden of keeping the prenatal environment drug-free. Additionally, even after birth, women in our society are more likely to be responsible for childcare than men. These biological roles may make it so women abuse drugs and alcohol at lower rates, lest they be viewed as bad mothers.

Differing Reasons for Abuse
Although it would be impossible to determine the specific reason for substance abuse and addiction in every single male and female, there are some theories as to what leads to the initiation of alcohol or drug use in each gender’s population.
Men often begin abusing drugs or alcohol as a result of being exposed to it at an early age by a close family member, though this may be a sociological factor. Continued use following initial exposure is primarily motivated by a desire to keep getting high. Women, on the other hand, are more likely to initiate substance abuse later in life and often as a means of self-medication for preexisting symptoms of mental illness. Simply put, men are motivated by trying to become intoxicated and women just want to feel better.[5] This theory is corroborated when you look at the fact that the only drugs women abuse at a level that rivals, and perhaps outpaces, men are prescriptions.[6]
In addition, women are also more likely to turn to drugs or alcohol if their male partner is a substance abuser. They struggle with dual diagnoses more (meaning they have a mental illness and a Substance Use Disorder) than men and are also more often the victim of trauma perpetrated by people close to them, which is also a potential catalyst for substance abuse.[7]
What Role Does Society Play?
We are all affected by the society we live in to varying degrees. To assume that this effect does not impact our substance abuse habits would be foolish. Throughout literature, movies and television, men have almost universally been depicted to be heavier substance abusers than women. It’s only natural to wonder how much societal portrayals of men and women have influenced our substance abusing tendencies. Socialization begins at birth, whether it’s in the different ways newborns are handled, dressed, spoken to or interacted with.
In general, men live riskier lifestyles than women, and this may cause them to ignore the potential dangers of substance abuse. Very often, men focus on reward while women focus on risk. Whether this is sociological, biological or a mixture of the two is unclear.[8] One thing that is clear is that in our society, masculinity is often associated with taking risks and femininity is
associated with ensuring safety.

Being a Man or Woman in America
When considering the societal influences that may be at work in the initiation of substance abuse between genders, one must take into account preexisting roles of femininity and masculinity. Whether we realize it or not, we are all somewhat influenced by stereotypes and predefined gender roles. These stereotypes penetrate all areas of society and do so subconsciously, meaning they impact many of the things we do without us actively realizing it.
“Males are more likely than females to have an opportunity to use drugs. There is no male-female difference with respect to trying a drug once an opportunity to do so has been experienced.”
Source: Dr. James Anthony, lead scientist for the National Institute on Drug Abuse and Johns Hopkins University.[9]
Women Are Not in The Clear
It should be noted that millions of women still struggle with substance abuse and it is a serious problem, despite the fact that their average usage is lower than men’s. One researcher hypothesized that men are not genetically predisposed to abuse more drugs or alcohol than women, but that men just have more opportunities to use at an earlier age.
As women’s earning and spending abilities have climbed through the decades, their substance abuse has also climbed. One trend found throughout many developed nations in the world where women have equal rights is that this freedom leads to more substance abuse. Without restrictions on their income or their abilities to exercise free will, women have begun closing the substance abuse and addiction gaps with men.[10]
Risk Factors for Substance Abuse Are the Same in Men and Women
Being male is a risk factor in itself for substance abuse and addiction, but it is not the only thing that makes a person more susceptible. Both men and women share many overlapping potential risk factors that could lead to the initiation of alcohol use and the escalation to addiction:[11][12]
- Family history
- Mental illness
- Peer pressure
- Lack of family involvement
- Poverty
- Poor education

Discussion and Conclusion
Though the gender gap in America is closing, men are still the leading substance abusers in our nation and around the world. While this fact is indisputable, it’s unclear what combination of sociological and biological factors have led to this. For one, being that men have been the dominant gender throughout much of human history, with women only recently (within the last 100 years) gaining equal rights, males have had more of a chance to create a culture of substance abuse. In the past, female drug or alcohol use would usually be at the mercy of the resources they were provided by men.

Biologically, it seems that men and women have different reasons for substance abuse, and these differences could contribute to men outpacing women. Many of these men are motivated by the effects of intoxication, while many of these women are motivated by the hope of improving short- and long-term symptoms of mental illness. This may indicate that in the absence of symptoms of mental illness, many women would have no reason to use drugs or alcohol, while men seem to need less of a reason to engage in substance abuse.
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[2] https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR2-2015/NSDUH-FFR2-2015.htm
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2235192/
[4] http://content.time.com/time/magazine/article/0,9171,153672,00.html
[5] https://www.ncbi.nlm.nih.gov/pubmed/19879058
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3164783/
[7] https://www.ncbi.nlm.nih.gov/pubmed/10385931
[8] http://journal.sjdm.org/jdm06016.pdf
[9] https://archives.drugabuse.gov/NIDA_Notes/NNVol15N4/Prevalence.html
[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4974746/
[11] http://www.mayoclinic.org/diseases-conditions/drug-addiction/basics/risk-factors/con-20020970
[12] https://www.drugabuse.gov/publications/preventing-drug-abuse-among-children-adolescents/chapter-1-risk-factors-protective-factors/what-are-risk-factors
[13] http://www.doiserbia.nb.rs/img/doi/0048-5705/2013/0048-57051302111L.pdf