Additional authors: Dominica Applegate, Kasey Cook, Elizabeth Seward, and Jennifer Wezensky

Traditionally, alcohol use disorders have been more associated with men than women. Today, however, the gap has narrowed (some say it has completely closed), as women are drinking alcohol at historically high rates.

Unfortunately, women may be more susceptible to both the obvious and hidden dangers associated with drinking. They also tend to be less likely to ask for help and to receive the appropriate treatment.

What Stops Women from Getting Help for Alcohol Use Disorder and Addiction?

Research suggests that women who have an alcohol use disorder (AUD) are less likely to seek help. Concerns such as lack of support, the heightened stigma of being a female addict, home and work responsibilities, cost, and child-care arrangements are the major hurdles women face.

Financial Obstacles: Women are more likely to experience financial obstacles that impact the addiction treatment process. These financial obstacles may include needing to work, raising children, or lack of support from other family members.

Family and Social Obligations: Married and single mothers alike have a particularly challenging time seeking treatment. This is usually due to the responsibility of raising their children, as they may not have another form of childcare available. The fear of losing their children may hinder them from finding outside treatment.

Social Stigmas: High levels of guilt, shame, or humiliation related to addiction stigma can also pose serious barriers. Some cultures may not react favorably to medical or psychiatric treatment. These models may evoke even more negative feelings for women in suffering.

Co-occurring Disorders: Women have higher rates of mood and anxiety disorders. These disorders have their own set of challenges, which alcohol problems can exacerbate. These issues may prevent women from seeking appropriate treatment.

Women and Alcohol Use Disorder Facts and Factors

While men may still have higher rates of alcohol use disorders, women are using alcohol in hazardous ways more than ever.

• Rates of alcohol use disorder have increased in women by 84% over the past ten years relative to a 35% increase in men, according to a 2019 paper by the Journal Neurobiology Stress.
• High-risk drinking (having 4 or more drinks at least one day per week) skyrocketed almost 60% between 2002 and 2013, according to a study published by JAMA Psychiatry.
• In 2019, about 32% of high school girls consumed alcohol compared with 26% of boys. Binge drinking was also more common among girls (15%) than boys (13%), according to the Centers for Disease Control.

What's worse is women tend to develop an addiction to alcohol faster than men and are more prone to experiencing the inevitable consequences of their alcohol use soon after their drinking starts progressing. By the time many women get to rehab, their symptoms may be as severe as men's despite being addicted for shorter periods and using smaller amounts.

Women's Biology and Alcohol

On a basic level, women absorb and metabolize alcohol differently than men. Because they typically have less body water than men, they reach higher and faster alcohol concentrations. As an example, female college students are more likely to suffer alcohol poisoning because they experience more effects from alcohol consumption.

The progress of chemical dependence and the consequences of addiction also happens faster for women than men. When left untreated, alcoholism tends to progress. That means drinking more and, often, facing more consequences as a result. It's one of the most compelling motivators to seek sobriety.

Physical Consequences of Substance Use Disorder for Women

Women drinkers are more apt to suffer brain atrophy, heart disease, and liver damage, according to the CDC. Women who drink also have an increased risk of breast cancer.

The likelihood of developing depression, victimization, and post-traumatic stress disorder is also higher for women, so adding alcohol or drugs to the mix can cause the number of women suffering to rise over men.

For women and girls in college, substance use and especially binge drinking puts them at an even higher risk of sexual assault and physical harm. Shockingly, one out of every 20 college women is sexually assaulted in America, and if both the attacker and victim have alcohol, the risk of rape runs higher.

Social Consequences of Substance Use Disorder for Women (Especially Mothers)

Women also suffer greater social consequences with alcohol use. Jowita Bydlowska, the author of the 2014 memoir Drunk Mom, emphasized the shame and disdain she experienced as a mom who drank too much.

In a 2014 interview with The Fix, Bydlowska said there’s more shame for women alcoholics because it’s not “lady-like.” “We’re supposed to be more composed, socialized, and so on,” she said. “This is the reason why a lot of women drink secretly, after everyone goes to bed, the same way I used to. A man who is drunk is often perceived as funny, social—he drinks in pubs with buddies and he pukes in alleys and laughs about it the next day.”

The social consequences of alcohol use can be even higher for people of color and those of lower economic status. Laura A. Schmidt, Ph.D., a professor of health policy at the University of California, San Francisco’s School of Medicine, says "there is a 'war' on minority and low-income female addicts through a more punitive court system, negative impact on child custody, drug testing that violates civil rights, and more."

How Women Benefit from Treatment for Addiction

The factors that predispose women to alcohol or drug use are different compared to men. Women tend to use drugs to counter psychological and emotional issues, while men are more likely to cope with behavioral issues, amplify positive moods and counter social problems. Alcohol treatment can provide women with the support and resources needed to start recovery and sustain sobriety. Comprehensive treatment may include:

• Medical detox
• Medication evaluating and monitoring
• Individual and family psychotherapy
• Group therapy
• Support groups
• Holistic options (meditation, yoga, acupuncture)

Furthermore, treatment provides a safe and supervised space for women to connect with other like-minded women. Many gender-specific programs cater specifically to women for this very reason.

Treatment can also provide support for co-occurring disorders and issues. Recovery often entails a mind-body transformation. While getting sober is one part of the process, long-term change requires changing how you think, act, and behave daily.

One silver lining is that women tend to have the upper hand in treatment and recovery in the long run, research shows. Once women decide to get help, they tend to really make an effort to heal and get their lives back together. And when a woman relapses, her relapse tends to be shorter than a man’s, and she usually gets back into treatment sooner.

How Relapse Differs Between Men and Women

When it comes to relapse, the triggers and treatment plan differ greatly between men and women.

Relapse Trends in Women

Women are less likely to relapse than men, but studies have shown that when a relapse does occur, it is caused by a trigger that differs from that of men. Some common triggers that lead women to relapse are:

• Undiagnosed psychiatric disorders such as depression, bipolar disorder, and schizophrenia
• Inadequate coping skills in handling pressure outside of recovery
• A lack of support from friends and family
• Loss of self by caring for others and/or responsibilities
• Entering into the dating world too soon after entering recovery

Treatment for relapse in women proves to be more successful when these components are addressed.

Relapse Trends in Men

Although women have more threats of relapse than men because of the number of triggers present in their daily lives, men actually fall victim to relapse slightly more than women.

One major reason for this is the strong need for men to self-medicate and their unwillingness to seek treatment for the cause of the self-medication. Even though society is becoming more receptive to mental health care and substance abuse treatment, the male demographic still seek treatment when needed. Peer pressure during celebratory occasions and the male inclination to control their addiction is another cause of relapse. This reason also coincides with most males' inability to give up certain relationships or connections that may contribute to their addiction. Without the help of a treatment plan, men are more likely to fall back into a pattern in which they feel comfortable and accepted.

When a male seeks treatment, the treatment plan must include a sense of community and belonging. Building healthy relationships with like-minded individuals will help men resist the urge to continue their toxic relationships and reduce the risk of a relapse. Combining these healthy relationship-building skills in conjunction with continued care for a specific duration can help men create healthy habits that will lead to abstinence.

Moving Forward After a Relapse

While men and women have noticeable differences between them regarding reasons for relapse, this does not rule out that every addiction—along with the person—is unique and should be treated as such, regardless of gender. Each person who suffers from addiction has his or her own personal triggers that can result in a relapse. It is important to have a thorough treatment plan that can equip people to handle their own specific triggers and achieve sustained abstinence from substances.

Knowing gender-specific patterns and each individual’s triggers may be the first step in creating such healthy behavioral changes.

Pregnant and Addicted: Now What?

For many women out there, pregnancy – or at least the news thereof – is a blissful part of life. But nurturing a tiny human within the womb is no easy task. Fetuses need all the right nutrients and protein and plenty of other good stuff that requires forethought from the mother. And while the jury is largely out on the use of mild drugs, herbs, or even an occasional drink during pregnancy, there isn’t any room in a healthy pregnancy for drug or alcohol addiction. This puts a mother who is addicted in a terribly difficult position.

Pregnant Women Require Immediate Change When it Comes to Problems with Substance Use

The need to get clean is urgent. Recovery is not something a pregnant woman should slowly transition into – it should take place immediately and, in some cases, under medical professionals' supervision.

Drinking and using drugs during pregnancy isn’t just dangerous for the fetus, increasing the risk of miscarriage, stillbirth, premature birth, and congenital disabilities. A mother who uses drugs during pregnancy is likely to lose custody of her child at birth if the infant tests positive for drugs. And in some states, these days, mothers whose drug use during pregnancy leads to the death of their fetus or infant may actually face prison time.

So what can you do if you or someone you know is pregnant but also addicted?

A Course of Action for Women Who Have an Addiction and are Pregnant

The first thing an addicted pregnant woman needs to do is assess her specific addiction. Is it impossible for the pregnant mom to stop using? Will an action like this result in physical complications? In the case of some substances, the answer may be no. Women who find themselves in situations like these can consider themselves lucky. With a good support group, accountability and commitment, they can give their baby the pregnancy he or she deserves.

For other women, figuring out how to navigate addiction amid pregnancy is not so easy. For women who are alcoholics, detoxification may need to occur where experienced medical professionals can guide the woman toward sobriety while dealing with the physical side effects of withdrawal. For women addicted to a drug like heroin, medical professionals' help will likely be needed. In some cases, pregnant women are treated with drugs considered less harmful to the fetus, like methadone, to treat an addiction.

Pregnant Women Face Added Challenges in Addiction Treatment

Women who are pregnant and also addicted face more hardships than most people can imagine. Pregnancy is physically trying for most women. From daily nausea and vomiting to deep muscle aches, the experience can take a toll on just about any part of the body. Detoxification is also a physically grating process. Added to these physical difficulties are the psychological difficulties a woman in this position faces. Most women in this situation – even those who can never deal with their addiction while pregnant fully – struggle with a great deal of shame, fear, humiliation, and self-loathing.

Remember to be patient, compassionate, and willing to look at the situation from all angles. Find help quitting the substance you are addicted to and talk to a medical professional you can trust immediately.

Taking Away the Shame in Treating Pregnant Women with Addiction

The risks of substance addiction for both mother and baby are well documented. Babies born to mothers who have a problem with alcohol or substance use face many dangerous symptoms.

Unfortunately, these genuine risks to infant health and well-being, as well as society’s false expectations about women, motherhood, and addiction—for instance, the idea that substance use is always recreational instead of related to physical and emotional dependency, or that a “good” mother would be able to overcome her addiction for the sake of her child easily—has brought on an approach often fraught with shaming and guilt-inducing tactics.

Luckily, some health care providers are placing both women’s and children’s health first by providing comprehensive programs to attend to the physical, mental and emotional needs of addicted mothers and their babies.

Programs, such as the Center for Addiction and Pregnancy at the Johns Hopkins Bayview Medical Center and the addiction recovery program at the Magee-Women’s Hospital of the University of Pittsburgh Medical Center, provide overnight care, medication-assisted treatment, individual and group therapy, psychiatric care, family planning services, obstetric care, and pediatric health care to women.

If you face addiction and are pregnant or may become pregnant, seek out medical treatment at a program you trust rather than trying to face your addiction alone. Don’t succumb to shame and guilt. Addiction is a complex problem faced by millions of people. You will only sabotage yourself and your child’s health by allowing yourself to buy into shaming rhetoric rather than bravely seeking the assistance you need.

If you or someone you know is seeking help from addiction, please visit our directory of treatment centers or call 800-772-8219 to speak to a treatment specialist.