Women's drug abuse and gender specificities of drug dependence

There is no doubt about the biological and personality differences between women and men. Traditionally, affective, anxiety, and cynical disorders are more common among women in the general population, so women are much more likely to abuse sedatives (usually tranquilizers) both independently and as prescribed by a doctor. Women abuse other psychoactive substances less often than men. In Russia, according to official statistics, the ratio of drug abusers in men and women in 2006 was 5:1.

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Causes of drug addiction in women

Among the biological features of drug addiction development in women, an important role is played by body type and hormonal differences that significantly affect drug pharmacokinetics. In general, women have lower activity of liver enzymes involved in drug metabolism. The consequence of lower body weight and a higher ratio of adipose tissue to muscle is a higher concentration of PAS in the blood of women compared to men when taking the same doses. A larger amount of adipose tissue significantly increases the absorption of lipophilic PAS (phencyclidine, marijuana) with their subsequent slow release. The effect of drugs on the central nervous system also significantly depends on a person's gender, this is due to the central mechanisms of neurotransmission of the mesocorticolimbic system in women, leading to a higher concentration of dopamine.

Premorbid personality factors that predispose women to drug addiction include: having drug addicts among friends and acquaintances, communicating with drug addicts, availability of drugs, early smoking and alcohol testing, antisocial behavior, risk-taking, early onset of sexual activity, propensity for promiscuous sexual relations, hostility, impulsivity, vulnerability, and low self-esteem. Physical and sexual abuse experienced in childhood, as well as post-traumatic stress disorders, can become risk factors for drug abuse among women.

In most cases, future drug addicts were brought up in conditions of low parental attention and experienced a significant lack of care and control over their behavior and genuine parental interest in their spiritual life. Among the personality traits of women who use heroin, as with all drug addicts, hysterical traits, pronounced infantilism of judgments and behavior predominate. Aggressiveness and delinquent behavior are less pronounced in the female population.

In general, men have more opportunities to try drugs during their lifetime, but once they have tried a drug, women are significantly more likely to abuse it. Differences in drug use between men and women in adolescence are insignificant and increase sharply with age. One of the main factors in the onset of heroin use in women is a partner who uses drugs. These are mainly sexual partners, but in some cases also men to whom patients experience emotional rather than sexual attachment. The influence of a sexual partner determines not only the onset of drug use (initiation and drug addiction), but also the formation of addiction. The overwhelming majority of women use heroin with a sexual partner. It should be especially noted that men who use drugs prefer to choose non-drug users as sexual partners. It is noteworthy that in more than a third of cases, women begin using heroin immediately with intravenous injection (2 times more often than men). Thanks to a drug-addicted sexual partner, the onset of heroin use by women in most cases means entering into an established drug-addicted lifestyle. In general, at the beginning of drug addiction, women are much less informed and aware of the doses and methods of drug administration, the choice of which they often “completely trusted” to their more experienced partners.

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Features of drug addiction in women

Women develop tolerance to opioids faster, and not only single doses of the drug used grow, but also the daily frequency of administration. The period of formation of abstinence syndrome in women is more than 2 times shorter than in men. In most cases, AS in women manifests itself with psychopathological disorders (anxiety, restlessness, irritability, mood swings, sleep disorders). Later, characteristic symptoms will be added to this. Upon admission to the clinic, some patients with systematic heroin use for 6 months or more still did not know "their" dose, since their sexual partners supplied the drugs and measured out the dose.

Personality changes resulting from drug use are observed in all patients, both women and men. Women and men are prone to develop psychopathic disorders during drug addiction. However, their structure in women is much more marked than in men by selfishness, thirst for attention, respect, sympathy, deceit, tendency to show off, posing, which determine the personality structure: at the same time, a volitional defect increases, instability traits are sharpened, conformity is increased. Female drug addicts become dependent on their environment much faster. They are more submissive, easily suggestible, very quickly lose their ability to work, lose interest in studying. The overwhelming majority of such patients live at the expense of their relatives, do not work or study anywhere. In general, women's criminal activity is lower than that of men and is limited to non-violent offenses: attempts to obtain drugs, money for them, petty "domestic" theft from parents and acquaintances.

Complications of injection drug use include viral hepatitis B and C, HIV infection, and signs of toxic liver damage. From a physiological point of view, women tend to have smaller and less prominent veins than men, and the distribution of fatty tissue is completely different. As a result, female drug addicts are forced to spend more time finding veins suitable for injection, and the process of intravenous drug infusion takes a long time.

In most cases, heroin use by women leads to sexual dysfunction: promiscuity, gradual decrease in sexual activity and libido, and the development of frigidity against this background. After the start of heroin use, in some cases, a feeling of disgust arises during sexual contacts. Particular attention should be paid to the sharp increase in gynecological disorders: after the start of drug use, the vast majority of addicted women experience irregular menstrual cycles. The duration of the absence of menstruation can range from 2 weeks to 3 years. In most patients, the menstrual cycle returns to normal within the first month after stopping heroin use.

The use of alcohol and drugs by a woman during pregnancy exposes children to prenatal risk (possible teratogenic effect) and postnatal risk (defects in upbringing in families of drug addicts). Women who use drugs during pregnancy often also use alcohol and tobacco, which negatively affects the reproductive function of the woman, pregnancy, fetus, and development of offspring. The role of mother or potential mother conflicts with the lifestyle of the drug addict.

Pregnant women who use heroin often experience premature births, growth retardation, and weight loss in children. There is a high probability of withdrawal syndrome in the newborn, accompanied by tonic and clonic seizures. The high level of neonatal mortality is also associated with the partial and full risk of life of drug addicts. A large number of drug addicts have never visited a doctor during pregnancy. Later, their children are often found to have neurological disorders, mental retardation of varying degrees of severity, and behavioral disorders.

Loss of maternal duty and neglect of children are very common in families of drug addicts. Such children are forced to experience completely "unchildish" situations. This is one of the main factors that provoke the further development of drug addiction. Most patients with children do not participate in their upbringing, but entrust their children to relatives. More than 1/3 of all children are raised separately from drug-addicted mothers. With a formally caring attitude towards children, such women use motherhood to manipulate relatives and doctors: they want to leave the hospital faster, reporting fictitious illnesses of children, talk about their neglect, in every possible way emphasize the need to be close to the child, etc.

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Treatment of drug addiction in women

Women who abuse drugs are reluctant to seek medical help because they do not want to be diagnosed with drug addiction, as this contradicts the stereotypes of the traditional female role in society. In the established socio-cultural conditions, such women, especially if they are of childbearing age, often become outcasts. This is true mainly in relation to women in a "favorable social position." This is why it is shameful for "decent" women to admit their drug addiction. When a woman who has fallen into drug addiction realizes the need for treatment, she faces obstacles related to her gender role. Historically, men were considered the standard of treatment, so women were considered less curable. This is probably where the widespread myth that "female drug addiction is incurable" comes from. However, this is far from true. One of the most important aspects of treating women-narcomania is overcoming dependence on a drug-addicted sexual partner. For successful treatment and retention of patients in the treatment program, it is necessary to completely separate them from their drug-addicted partners for the duration of treatment. In the case of joint treatment of drug-addicted couples, it is preferable to undergo therapy in different hospital departments or in different clinics, but if possible, with the exclusion of any contacts between the partners. Particular attention should be paid to the deceitfulness of all drug addicts and their tendency to manipulate relatives, others, including medical personnel. Often, such patients want to emphasize their "defenselessness", "weakness", etc. in conversations with the doctor. Drug-addicted mothers in every possible way defend the need to be near their children, in connection with which all information received from patients must be confirmed and double-checked. Given the above-described dependence on the environment, submissiveness, suggestibility, many patients willingly enter into psychotherapeutic work, but, unfortunately, a deceptive impression of the success of the therapy often arises. Women easily reject their own previously expressed and seemingly critical attitudes towards sobriety, especially when resuming communication with a drug-addicted partner,

The number of people affected by drug addiction, especially among women, is much greater than the number of people who actually abuse drugs. Given the special social role of women, on whom the health and well-being of future generations depends, female drug addiction can certainly be considered as an indicator of the growth of drug addiction in society as a whole.