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The genetic makeup of a woman could increase the risk of cocaine addiction.
August 28, 2017

Are Women More at Risk of Cocaine Addiction?

The genetic makeup of a woman could increase the risk of cocaine addiction.How do two X chromosomes make you more susceptible to cocaine? Explore the latest findings from scientific experts and what they may mean for the future of cocaine treatment and recovery.

The role of gender with respect to drug and alcohol addiction has been a source of ongoing research. Specifically, scientists have sought to learn whether men and women are equally prone to substance abuse, or whether there are gender differences related to the addictive potential of certain drugs, be they prescription or illicit drugs. And until only very recently, the evidence has been mixed in answer to that question, suggesting that, on the one hand, men and women are equally susceptible to drug and alcohol abuse, and on the other, that there are gender differences.

There is, however, an increasing body of evidence revealing that women may be more at risk of cocaine addiction. This article will explore these latest findings and their implications for women in particular.

Why Women May Be More Vulnerable to Cocaine Addiction

If men and women are equally likely to use stimulants like cocaine and methamphetamine, women may be more prone to stimulants’ addictive potential, according to preliminary research summarized by Harvard Health:

  • Women reportedly begin using cocaine at a younger age, on average, than their male counterparts.
  • While the rate of cocaine addiction is higher in males, women get addicted to cocaine more quickly than men.
  • And after they quit cocaine, women are more susceptible to relapse.

Now, new research at the Icahn School of Medicine at Mount Sinai, which appeared in the January 2017 issue of the journal, Nature Communications, has shed further light on why women may be more vulnerable to cocaine addiction. The explanation, in short, may be one of biology and hormones.

The Mount Sinai research team discovered that an increase in women’s estrogen levels during their menstrual cycle intensifies the brain’s dopamine reward pathway, and, in turn, the euphoric effects of cocaine. Using mice, which exhibit the same sex differences in drug use as humans, the researchers fixed tiny fiber-optic probes to specific areas of the brain, including the dopamine reward pathway. They found that estrogen affects how much dopamine is released in response to cocaine and how long dopamine remains in the synapse between brain cells—in other words, the level of cocaine-induced pleasure. That led the researchers to conclude that menstruation-related fluctuations in estrogen may put women at greater risk of cocaine addiction.

In an interview with the New York Post, the study’s lead author, Dr. Erin Calipari, explained the results this way: “Females are experiencing more of a [cocaine] high, and it’s causing problems later because it’s so intense that they get more addicted.” Calipari said her findings validated previous research that found that while men make up a larger proportion of total drug addicts, on the basis of men’s greater exposure to drugs, women are more likely to get and stay hooked to cocaine.

Cocaine Treatment Implications for Women

These still very fresh findings contain important implications for how we treat cocaine addiction, especially among the female substance abuse population.

First, “we need to have more specialized treatment for drug abusers, because the mechanisms that are driving the addiction are likely different,” Dr. Calipari told the New York Post. Second, it’s possible that birth control pills, because they regulate and minimize fluctuations in estrogen levels, will be one dimension of future treatments specialized for women. (Dr. Calipari reportedly is now exploring to what degree birth control pills, by cutting the intensity of spikes in estrogen, affect the euphoric effects of cocaine and cravings for the drug.)

The Link Between Women and Cocaine Addiction

The Mount Sinai findings may also help fill in the contours of previous research, which has found a strong link between women and cocaine and sought to explain it. For example, a 1997 study of inmates found that 74 percent of female inmates with a substance abuse problem said crack/cocaine was their drug of choice, in marked contrast to 49 percent of male inmates with a substance abuse problem who said crack/cocaine was their drug of choice.

Similarly, in a later 2007 study of inner-city drug users, women were “significantly more likely to evidence crack/cocaine dependence than their male counterparts.” Strikingly, when compared with alcohol, cannabis and hallucinogens, cocaine was the only drug of abuse to evidence any gender differences.

The researchers wanted to know whether personality or environmental factors might explain this link between women and cocaine. What they found was that female crack/cocaine users exhibited more impulsivity than their male counterparts, and that this higher impulsivity put women at greater risk of crack/cocaine dependence. Females also exhibited more negative emotions, and had experienced childhood abuse at higher rates—yet unlike impulsivity, these personality and environmental variables were not risk factors for female cocaine abuse.

Hope and Help for Cocaine Addiction

Understanding the biology of women’s greater susceptibility to cocaine addiction is one more step in the direction of hope and help for cocaine addiction, which remains a serious public health issue in this country and the object of ongoing research into potential new treatments for cocaine.

If you or a loved one is struggling with cocaine addiction, you may also benefit from reading the article, “Cocaine Detox: 7 Things You Need to Know.” Or, contact us for a free and confidential consultation at 1-855-982-0450.

The National Helpline (1-800-662-HELP) is another helpful source for information and treatment referrals, as a free, 24/7 service of the Substance Abuse and Mental Health Services Administration.