Substance Use Disorders: Differences Between Women and Men PDF

# Ways Substance Use Disorders Differ Between Women and Men ## Physical Effects - women experience negative physiological consequences sooner with less use than men. - women have more medical, psychiatric and social consequences of substance use than men. - treatment needs of women are different th...

# Ways Substance Use Disorders Differ Between Women and Men ## Physical Effects - women experience negative physiological consequences sooner with less use than men. - women have more medical, psychiatric and social consequences of substance use than men. - treatment needs of women are different than men. ## Co-existing Psychiatric Disorders - parental stress - trauma history ## Specific Barriers - in some countries, fewer women than men overdose - when given help, women can respond to treatment better and have better outcomes than men. ## Say: Women can have different physical effects than men from substances. For example, women become more intoxicated than men do after drinking the same amount of alcohol. This is true even when differences in body weight are accounted for in the analysis. This difference in effect because women's bodies have less water than men's bodies. Another example of how the physical effects of alcohol are worse for women than men is that women can develop alcohol-induced liver and brain damage more quickly than men from the same amount of alcohol. ## Say: For example, they may have more drug cravings and may be more likely to relapse after treatment. Sex hormones make women more sensitive than men to the effects of some drugs. ## Say: 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. ## Say: Women are 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. In some countries, women are less likely to experience overdose than men. ## Say: When given help, women can respond to treatment better and have better outcomes than men. Women can have increased motivation to overcome substance use disorders, especially when they are becoming a parent. # Lunch - 60 minutes - Let's now take the next 60 minutes for lunch. - Note where lunch is held - Tell participants the exact time to return. # Alcohol and Health Effects on Women - Alcohol is one of the five (5) leading causes of morbidity and mortality worldwide. - Women compared to men: - are more susceptible to alcohol-related organ damage. - develop damage at lower levels of consumption over a shorter period of time. - experience an increased severity, greater number and faster rate of development of health-related complications. - develop alcohol use disorders in less time than do men: telescoping. ## Say: Given how prevalent alcohol is in most parts of the world, it is important to talk about it. Alcohol is one of the five (5) leading causes of morbidity and mortality worldwide. # Stimulants and Health Effects on Women - Hormonal changes across the menstrual cycle have a strong effect on stimulant drugs. - The phase of the menstrual cycle matters - Overall, women who use cocaine report more positive subjective drug effects, including greater euphoria and desire to use, while physiological responses to the drug did not change. - Psychoactive effects of methamphetamine (also known as ecstasy) are more intense for women than men. - Prevalence of energy drink misuse is increasing. ## Say: Now we will look at stimulants like cocaine, amphetamines, and others that rev up the body and provide euphoria. - Examples of how women and men differ include that hormonal changes across the menstrual cycle have the greatest effect on stimulant drugs, particularly cocaine and amphetamine. ## Say: Evans et al., investigated whether cocaine effects vary as a function of menstrual cycle phase. Heart rate and subjective “good drug effect” were increased more during the follicular phase than the luteal phase. ## Say: Overall, women who use cocaine report more positive subjective drug effects, including greater euphoria and desire to use, while physiological responses to the drug did not change- this is in contrast to men who do not have the same hormonal cycles. Methamphetamine use has an array of possible adverse effects but data regarding specific gender differences are limited. ## Say: Psychoactive effects of ecstasy appear more intense in women than in men with women reporting a higher degree of perceptual changes, thought disturbances, and fear of the loss of control of their bodies. Women appear to be more sensitive to the psychomotor-related behavioral and subjective effects of methamphetamine (e.g., reports of more vigor and less sedation were greater in women than in men). - Acute adverse effects, such as jaw clenching, dry mouth, and lack or loss of appetite, are more common among women than men. - The prevalence of energy drink consumption around the world is rising. Energy drinks have negative health effects, including heart palpitations, elevated blood pressure, and sleep disturbances. Further, they are often used in combination with alcohol. ## Teaching Instructions: If participants want more details, it can be noted that consistent and greater mood-altering effect of stimulant use during the follicular phase of the cycle (for review, see Terner and de Wit 2006), and the fluctuations in progesterone levels may account, in part, for this sex difference (see Evans 2007; Evans and Foltin 2006). # Opioids and Health Effects on Women - No menstrual cycle differences in women's subjective experience or physiological reaction to opioids. - Women using heroin or methadone do experience menstrual abnormalities, particularly amenorrhea or an irregular menstrual cycle. - Deficits in sexual desire and performance are also consequences of heroin use. These deficits are true for both men and women, but the issues affect men and women differently. These symptoms probably are related to the lower levels of luteinizing hormone, estradiol, and progesterone. - Amenorrhea and other symptoms often make women believe they are permanently sterile, a fear that can be lessened with education. Like we should do for all women and men, discussing reproductive life issues can be a time for including a discussion about contraceptive practices. - One study found that women are more at risk than men for overdose death due to injecting heroin in the first few years. One reason for this finding is that women who inject heroin are more likely than their male counterparts to also use prescription drugs. ## Say: Research is lacking that would allow definitive conclusions about gender similarities or differences in the effects of heroin use: such as scarred and collapsed veins, bacterial infections of blood vessels and heart valves, abscesses, cellulitis, and liver or kidney disease. ## Say: Research suggests that there are no menstrual cycle differences in women's subjective experience or physiological reaction to opioids, but women using heroin or methadone do experience menstrual abnormalities, particularly amenorrhea or an irregular menstrual cycle. ## Say: It can take up to a year for regular menstrual cycles to resume after drug use is stopped. Deficits in sexual desire and performance are also consequences of heroin use. These deficits are true for both men and women, but the issues affect men and women differently. These symptoms probably are related to the lower levels of luteinizing hormone, estradiol, and progesterone. ## Say: Amenorrhea and other symptoms often make women believe they are permanently sterile, a fear that can be lessened with education. Like we should do for all women and men, discussing reproductive life issues can be a time for including a discussion about contraceptive practices. ## Say: One study found that women are more at risk than men for overdose death due to injecting heroin in the first few years. One reason for this finding is that women who inject heroin are more likely than their male counterparts to also use prescription drugs. - Women who do not overdose within these first few years are more likely than men to survive in the long term. This could be due to differences in treatment and other environmental factors that impact heroin use. # Cannabis and Health Effects on Women - Studies on cannabis have focused specifically on gender differences. - Findings suggest that the effects of cannabis do not vary markedly across the menstrual cycle. - Men appear to be more sensitive to the analgesic effects of cannabis than women. - Women show greater improvements in appetite with cannabis compared to men, but other outcomes, including ratings of nausea or quality of life measures were not different. ## Say: Studies on cannabis effects have always focused specifically on gender differences; Little is known about how cannabis affects men and women differently. In studies evaluating hormonal changes and the physiological and psychological effects of cannabis use, findings suggest that the effects of cannabis do not vary markedly across the menstrual cycle. # Trainer Manual - Module 1 - Core Competencies Needed to Help Women and What Makes Women Unique Compared to Men in Their Illness Trajectory