According to the Center for Behavioral Health Statistics and Quality, in 2015, 66.7 million people in the United States reported binge drinking in the past month and 27.1 million people were current users of illicit drugs or misused prescription drugs.1 Although the prevalence of substance misuse and substance use disorders differs by race, ethnicity and gender, there are certain physiological and biological factors that play a larger role in influencing how some people are more prone to addiction than others. While scientists from the National Institutes of Health are working to learn more about the biology of addiction by conducting linkage analysis on the human genome, there are three factors that are known to help increase the vulnerability of developing an addiction: Genetics, Comorbid Mental Illness, and Gender.
The term “genetics” is very broad and encompasses genes inherited – child from parent – over generations. Although no particular gene has been identified as the “addiction gene,” numerous scientific studies reveal that alcohol and drug dependence run in families with 40% to 60% of this predisposition attributed to genetics2. Children whose parents suffer from the disease of addiction have a 25% higher chance of developing an addiction than children of non-addicted parents. But as with heart disease or diabetes, there’s no one gene that can make some people more prone to addiction than others.
Comorbid Mental Illness
According to the National Institute on Drug Abuse (NIDA), surveys have shown that many individuals who struggle with substance abuse and addiction also suffer from one or more mental illness or vice-versa. Although researchers disagree in which comes first – the addiction or the mental illness – the presence of two or more coexisting disorders in a single individual is referred to as comorbidity, also known as co-occurring. In addiction treatment the most frequently comorbid mental illness is Bipolar Disorder (most common), followed by Post-Traumatic Stress Disorder (PTSD), and Major Depression and Anxiety Disorder.
Mental health disorders can increase the risk of alcohol and drug addiction as individuals try to self-medicate. On the other hand, substance addiction can lead to anxiety and depression. The two conditions are often intertwined, making it difficult to find out which condition is causing which symptom. While research is still being conducted to help us understand comorbidity, it is widely accepted among addiction treatment professional that mental illness can influence or shape the experience of addiction.
According to the National Center for Biotechnology Information, studies of individuals struggling with addiction indicate there are significant differences in addiction rates between men and women. In cases they assessed, it was shown these differences are present for all of the phases of substance abuse – initiation, escalation of use, addiction, and relapse. While there are differences among specific classes of abused substances (alcohol, heroin, prescription opioids, etc.) the pattern is the same for all substances of abuse. Women often begin self-administering licit and illicit substances at lower doses than do men, their substance use escalates more rapidly to addiction, and they are at higher risk for relapse than men.
In other studies at UCLA, the reason women are more apt to become addicted is due to the fact that they are more prone to psychological distress in particularly mood and anxiety disorders. In addition biological differences between the genders, hormones and menstrual cycles are “game” changers for women. Experiments done on rats showing how the response to estrogen levels are responsible for processing and anticipating pleasure and rewards. Various scientific publications, such as Psychopharmacology, the Journal of Substance Abuse Treatment and Drug & Alcohol Dependence, suggest that this is the reason why women have a greater responsiveness to cocaine and why women have a more severe use of cocaine. In this case estrogen appears to trigger receptors for drugs within the brain; when the receptors are activated, the effects of the drugs being consumed are more intense and quickly felt, which makes women abusing substances more vulnerable to give in to temptations so to experience those feelings again. Female hormones play a big part in determining the development and progression of addictions. Ongoing studies are being incorporated into new addiction treatment programs to address these vulnerabilities. For instance, study shows that women are more vulnerable to relapse during the follicular phase of their cycle, a concern that has no significance to male users of cocaine.
Studies about men and substance abuse and addiction also have shown that they men and women different responses to certain drugs. For example, in a Biological Psychiatry research it was discovered that when men consume alcohol they have a much greater release of dopamine in contrast with their women counterpart. Dopamine is the neurotransmitter that the brain produces and enables us not only to see rewards, but to take action to seek them.
To sum up, knowing the physiological and biological differences affecting the way addiction develops in both men and women, and understanding why addictive substances fall on gender lines; we need to stress the importance of developing treatment that addresses these differences and vulnerabilities.
- Center for Behavioral Health Statistics and Quality. (2016). Results from the 2015 National Survey on Drug Use and Health: Detailed tables. Rockville, MD: Substance Abuse and Mental Health Services Administration