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Substance Use in Women

Other Sex and Gender Issues for Women Related to Substance Use

Co-Occuring Mental Health Disorders

Comorbidity Research Report coverMore information about comorbidity can be found in NIDA's Research Report.

Many women with substance use disorders are also diagnosed with other mental disorders. This is important because interactions between illnesses can worsen the course of both. Patients who have both a substance use disorder and another mental health condition often have symptoms that are more persistent, severe, and resistant to treatment compared with patients who have either disorder alone. Both disorders should be treated at the same time to improve the likelihood of success. Although men are more likely than women to report both a mental health and substance use disorder within the past year (SAMHSA, 2013), women are more likely to suffer from certain mental health conditions, such as depression (Depression: What Is Depression?, n.d.), anxiety, post-traumatic stress disorder—or PTSD (NIMH, 2009), and eating disorders (NIMH, 2014). Some women report using substances to relieve stress or negative emotions (Annis & Graham, 1995; Perkins et al., 2012; Shen et al., 2012). In addition, women are more vulnerable to developing substance use or other mental health disorders following divorce, loss of child custody, or the death of a partner or child (SAMHSA, 2011).

Women, Violence, and Substance Abuse

More than one in three women have experienced physical violence at the hands of an intimate partner, including a range of behaviors from slapping, pushing, or shoving to severe acts such as being beaten, burned, raped, or choked (de Boinville, 2013). Victims of violence are at increased risk of chronic health conditions, including obesity, chronic pain, depression, and substance use (2013 Trans-HHS Intimate Partner Violence Screening, 2014). In recognition of the severity of violence against women and the need for a national strategy to address this issue, in 1994 Congress enacted the Violence Against Women Act to hold offenders accountable and to provide services to victims (Factsheet: The Violence Against Women Act, n.d.). In 2013, the President reauthorized the Act to expand programs for reaching especially vulnerable populations (Reauthorizing the Violence Against Women Act, n.d.).

The Institute of Medicine and the U.S. Preventive Services Task Force (USPSTF) have recommended that clinicians screen and counsel for interpersonal violence. To help meet that need, the Affordable Care Act of 2010 (Section 2713) requires that health insurance providers cover all preventive services recommended by the USPSTF without co-pays or deductibles. However, improved prevention and screening guidelines are needed to help clinicians identify those who need help and link them to the care they need (Report: Intimate Partner Violence Screening, n.d.).


  • 2013 Trans-HHS Intimate Partner Violence Screening and Counseling: Research Symposium. Women's Health Resources. Office of Research on Women's Health. http://whr.nlm.nih.gov/ipv-symposium.html#b00. Updated July 17, 2014. Accessed July 7, 2015.
  • Annis HM, Graham JM. Profile types on the Inventory of Drinking Situations: implications for relapse prevention counseling. Psychol Addict Behav. 1995;9(3):176-182.
  • de Boinville M. Office of The Assistant Secretary for Planning and Evaluation. ASPE Policy Brief: Screening for Domestic Violence in Health Care Settings. Washington, DC: U.S. Department of Health and Human Services; 2013.
  • Depression: What Is Depression? National Institute of Mental Health. www.nimh.nih.gov/health/topics/depression/index.shtml. Accessed July 7, 2015.
  • Factsheet: The Violence Against Women Act. The White House. www.whitehouse.gov/sites/default/files/docs/vawa_factsheet.pdf. Accessed July 7, 2015.
  • National Institute of Mental Health (NIMH). Anxiety Disorders. Bethesda, MD: National Institutes of Health; 2009. NIH Publication No. 09-3879.
  • National Institute of Mental Health (NIMH). Eating Disorders: About More Than Food. Bethesda, MD: National Institutes of Health; 2014. NIH Publication No. TR 14-4901.
  • Perkins KA, Giedgowd GE, Karelitz JL, Conklin CA, Lerman C. Smoking in response to negative mood in men versus women as a function of distress tolerance. Nicotine Tob Res. 2012;14(12):1418-1425.
  • Reauthorizing the Violence Against Women Act: Key Provisions in S. 47. The White House. www.whitehouse.gov/sites/default/files/docs/vawa_improvements_1_pager.pdf. Accessed July 7, 2015.
  • Report: Intimate Partner Violence Screening and Counseling Research Symposium, December 9, 2013. Women's Health Resources. Office of Research on Women's Health. http://whr.nlm.nih.gov/Report_IPV_Symposium.pdf. Accessed July 7, 2015.
  • Shen W, Liu Y, Longhui L, Zhang Y, Zhou W. Negative moods correlate with craving in female methamphetamine users enrolled in compulsory detoxification. Subst Abuse Treat Prev Policy. 2012;7:44.
  • Substance Abuse and Mental Health Services Administration (SAMHSA). Addressing the Needs of Women and Girls: Developing Core Competencies for Mental Health and Substance Abuse Service Professionals. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2011. HHS Publication No. (SMA) 11-4657.
  • Substance Abuse and Mental Health Services Administration (SAMHSA). Results from the 2012 National Survey on Drug Use and Health: Mental Health Findings. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2013. HHS Publication No. (SMA) 13-4805. NSDUH Series H-47.

This page was last updated September 2016

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NIDA. (2016, September 20). Substance Use in Women. Retrieved from https://www.drugabuse.gov/publications/research-reports/substance-use-in-women

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