Our understanding of the biology of addiction has expanded substantially in recent years. How the brain changes during addiction and withdrawal, the role of environment, genes, personality, and other factors have been explored with the hopes of developing new and effective treatments.
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One area that has not been explored to any great length is gender in addiction. The common perception was that most addicts were male and therefore most treatments were aimed at male physiology and psychology. This paper explores the sex differences in psychiatric comorbidity (one or more psychiatric conditions), how abuse-related disorders manifest, the causes of addiction, and the effects of addiction.
There are significant and important differences between male and female sensitivity to cannabis, thought to be the result of different sex hormones. Females appear to be more sensitive to the rewarding properties of cannabis and are more vulnerable to cannabis addiction than males. Other differences are discussed and evaluated and the conclusion of the author is that there need to be personalized treatments of cannabis addicts.
Cannabis addiction was not believed to be as severe as it is now known to be until relatively recently. Withdrawal symptoms are comparatively mild but they are severe enough to dissuade individuals from quitting. Although genes have been shown to play a major role in the likelihood of developing cannabis addiction, the role of sex differences have been less well explored.
Female rats self-administer more cannabinoids than males, demonstrating differences in their use of cannabinoids during their estrous cycle. This is seen in human females too, with premenstrual women reporting “significantly greater depression, anxiety, mood liability, anger, irritability and impaired social functioning”.
Differences in male and female brains are hard to pinpoint; there are more differences between individuals than between sexes. However, the differences between brains must play a role. The limbic system, the part of the brain that controls rewards, is different in males and females. While males use more marijuana, females appear to be more vulnerable to its effects.
Females generally respond better to drug treatment than men but respond differently. They often seek help more easily and justified their behaviors less than men. However, females were shown to be more affected by withdrawal symptoms and interpersonal problems, suggesting a different method of treating and maintaining withdrawal. The physical differences between men and women necessitate a different response if those treating them are to find the most successful methods.
Currently, the sex differences in withdrawal, relapse, and addiction are not well understood or widely known about. The trend of rolling out treatment programs to males and females, assuming they have a similar physiology and psychology, is demonstrably inaccurate and has probably led to wasted money, time, and suffering. With more data, more effective treatments will be developed.
There are significant differences between males and females in terms of cannabis addiction, withdrawal, and relapse. These are not currently addressed or accounted for in available treatment programs, and are therefore potentially ineffective. Taking into account sex differences will allow doctors to make more accurate and nuanced treatments available to their patients and raise the chances of successful treatment.