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Drug abuse is generally considered to be the use of psychoactive or performance-enhancing drugs for nonmedical or therapeutic purposes. Drug abuse may occur with both legal (e.g., alcohol, cigarettes, prescription, and over-the-counter [OTC] medication) and illegal (e.g., cocaine, heroin, marijuana) substances. The abuse of drugs can lead to both psychological and physical addiction, with the degree of physical addiction depending upon the properties of the drug. Due to metabolic differences between the sexes, women are more susceptible to the effects of drugs, particularly alcohol, and are more likely to become addicted than men. A woman's entry into drug use may begin after experiencing a traumatic event, and women are more likely to use drugs to ease emotional pain from abuse, grief, and/or guilt than men. Since women are more likely to be prescribed mood-altering substances for emotional and psychological symptoms, they are more susceptible to addiction to prescribed medications.

Although overall rates of drug use are still higher among men than women, the gender gap has been decreasing, especially among younger age groups and with regard to specific drugs, such as tobacco and the nonmedical use of prescription drugs. Research has also begun to highlight health disparities in the consequences of drug use for women, with women demonstrating greater health consequences at the same level of behavior as men. Female alcoholics have a greater number of drinking problems and higher death rates than male alcoholics, and women are more susceptible than men to brain damage, cardiac problems, and liver disease as a result of their drinking. Women are also significantly more likely to develop dependence on nonmedical uses of psychotropic drugs, such as sedatives and tranquilizers, than men. Women may become addicted sooner than men but also seem to seek treatment sooner, causing womens' drug use experiences to be more compressed than men's.

Prenatal Drug Abuse

Women's drug use also has several unique costs to both the individual and to society, given their role in reproduction. The highest prevalence of use among women, regardless of substance, occurs during the childbearing years. In fact, alarming numbers of adult women and teens continue to use alcohol, tobacco, and other drugs during pregnancy. Substance abusers often have multiple addictions, and approximately half of all pregnant women who use illicit substances also smoke and drink. Since approximately half of all pregnancies are unintended, women may be using substances, especially cigarettes and alcohol, throughout the first trimester of pregnancy without knowing they are pregnant.

Drug abuse during pregnancy increases a woman's risk for a number of negative outcomes such as poor fetal growth, premature rupture of membranes, placental complications, premature delivery, and miscarriage. Likewise, the negative effects of smoking, alcohol, and other drug use on infants born to drug-using mothers are well established, and include low birthweight, preterm birth, fetal alcohol syndrome, a variety of birth defects, learning disabilities, and developmental delays. In addition, prenatal maternal smoking has been found to be associated with adolescent children's smoking, and this effect is stronger for daughters than for sons.

Risk factors associated with prenatal drug abuse include being single, unemployed, having less than a college education, relying upon public aid, being or having been a victim of physical or sexual abuse, and living with a substance abuser. Pregnant women who abuse drugs tend to be single mothers with limited access to support systems, including financial, social, and childcare. In addition, up to 20 percent of pregnant women have experienced abuse, which may begin or intensify with pregnancy.

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