Past clinical studies of people with drug use disorders have shown that women and men experience and respond to drug cues differently, raising the possibility that treatment approaches effective for men may not be as effective for women, and vice versa. To better understand differing responses in real life, researchers at NIDA’s Intramural Research Program used a method called ecological momentary assessment (EMA) to capture the drug behavior and transient mental states of a sample of cocaine and heroin abusers. For up to 25 weeks, 42 women and 72 men in a methadone maintenance program reported their current mood, drug-related cravings, and other information several times a day when randomly prompted via a personal digital assistant; they also recorded this information whenever they used or found themselves craving drugs, even if not prompted. Men and women in the study did not differ in the average amount of heroin or cocaine used per episode of drug taking, nor did they differ in how much they enjoyed it, but they did report divergent patterns of responding to drug cues. Women reported greater recent exposure to drug cues and more craving in response to those cues than men did. After using drugs, women were more likely than men to report using more than they had meant to, feeling guilty, and having used despite trying not to. Regarding triggers for drug use, women were more likely than men to say that they were testing their self-control; men were more likely than women to indicate that they took a drug because they felt uncomfortable or in pain, an interesting finding given men’s previously reported higher tolerance for pain. This research may be valuable in designing treatment strategies that are sex/gender-specific.
Kennedy AP, Epstein DH, Phillips KA, Preston KL (2013). Sex differences in cocaine/heroin users: Drug-use triggers and craving in daily life. Drug Alcohol Depend [Epub ahead of print].