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Substance use disorders (SUDs) are multifactorial, chronic medical conditions shaped by the interplay of genetic predispositions, environmental exposures, and sociocultural determinants. Women exhibit unique epidemiological patterns, disease trajectories, and therapeutic responses in the context of SUDs. According to the World Drug Report 2024 (UNODC, World Drug Report 2024. United Nations publication, Vienna, 2024), although the overall prevalence of SUDs remains lower among women compared to men, women with SUDs demonstrate heightened vulnerability. Notably, they exhibit increased rates of psychiatric comorbidities, heightened exposure to intimate partner violence, and greater risks to sexual and reproductive health. Furthermore, substance-dependent mothers are disproportionately at risk of child custody loss and the accumulation of adverse life experiences. Despite representing approximately one-third of the global population of individuals who use drugs, women comprise only one-fifth—or fewer—of those receiving treatment services for SUDs (UNODC, World Drug Report 2024. United Nations publication, Vienna, 2024). In general, women throughout their lifetime face more barriers to accessing services, and this issue is more prominent in addictive disorders; such barriers include the higher stigma attached to substance use among women, the lack of childcare, the absence of gender-sensitive protocols and treatments, and the lack of family support, among others. Sexual (e.g., bisexual, gay, lesbian, queer) and gender (e.g., transgender, nonbinary, gender-expansive) minority individuals (SGMI) exhibit disproportionately elevated rates of alcohol and other SUDs relative to their heterosexual and cisgender counterparts (Batchelder et al. LGBT Health 8(4):290–299, 2021. Schuler et al. Drug Alcohol Depend. 189:139–146, 2018). This chapter aims to present an overview of how sex and gender may influence the epidemiology, clinical manifestations, social determinants, and response to treatment in women with SUD and in sexual/gender minority populations.

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Substance Use Disorders

  • 章节

  • 发表日期：

    2026年

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  • Francina Fonseca,
  • Silvia Martinez,
  • Alba Llimona

摘要

Substance use disorders (SUDs) are multifactorial, chronic medical conditions shaped by the interplay of genetic predispositions, environmental exposures, and sociocultural determinants. Women exhibit unique epidemiological patterns, disease trajectories, and therapeutic responses in the context of SUDs. According to the World Drug Report 2024 (UNODC, World Drug Report 2024. United Nations publication, Vienna, 2024), although the overall prevalence of SUDs remains lower among women compared to men, women with SUDs demonstrate heightened vulnerability. Notably, they exhibit increased rates of psychiatric comorbidities, heightened exposure to intimate partner violence, and greater risks to sexual and reproductive health. Furthermore, substance-dependent mothers are disproportionately at risk of child custody loss and the accumulation of adverse life experiences. Despite representing approximately one-third of the global population of individuals who use drugs, women comprise only one-fifth—or fewer—of those receiving treatment services for SUDs (UNODC, World Drug Report 2024. United Nations publication, Vienna, 2024). In general, women throughout their lifetime face more barriers to accessing services, and this issue is more prominent in addictive disorders; such barriers include the higher stigma attached to substance use among women, the lack of childcare, the absence of gender-sensitive protocols and treatments, and the lack of family support, among others. Sexual (e.g., bisexual, gay, lesbian, queer) and gender (e.g., transgender, nonbinary, gender-expansive) minority individuals (SGMI) exhibit disproportionately elevated rates of alcohol and other SUDs relative to their heterosexual and cisgender counterparts (Batchelder et al. LGBT Health 8(4):290–299, 2021. Schuler et al. Drug Alcohol Depend. 189:139–146, 2018). This chapter aims to present an overview of how sex and gender may influence the epidemiology, clinical manifestations, social determinants, and response to treatment in women with SUD and in sexual/gender minority populations.