Women bear the brunt of illicit drug policiesBMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j731 (Published 07 March 2017) Cite this as: BMJ 2017;356:j731
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Neurology of Drug Abuse in Women
In women drug abuse may have issues related to their hormones, menstrual cycle, fertility, pregnancy, breastfeeding, and menopause. In addition, women themselves describe various reasons for using drugs, including controlling weight, fighting exhaustion, coping with pain, and self-treating mental health problems.
Women misuse drugs differently from men, such as using smaller amounts of certain drugs for less time before they become addicted.
Women can respond to drugs differently. For example, they may have more drug cravings and may be more likely to relapse after treatment. This could be affected by a woman’s menstrual cycle.
Sex hormones can make women more sensitive than men to the effects of certain drugs.
Women who use drugs may also experience more physical effects on their heart and blood vessels.
Brain changes in women who use drugs can be different from those in men.
Women may be more likely to go to the emergency room or die from overdose or other effects of certain substances.
Women who are victims of domestic violence are at increased risk of substance use.
Divorce, loss of child custody, or the death of a partner or child can trigger women's drug abuse or other mental health disorders.
Women who use certain substances may be more likely to have panic attacks, anxiety, or depression.
Drug abuse during pregnancy can be risky to the woman’s health and that of her children in both the short and long term. Usage of some drugs can increase the risk of miscarriage and can cause migraines, seizures, or high blood pressure in the mother, which may affect the baby. The risk of stillbirth is two to three times greater in women who smoke tobacco or marijuana, take prescription pain relievers, or use illegal drugs during pregnancy.
When a woman abuses drugs regularly during pregnancy, the baby may go through withdrawal after birth, a condition called neonatal abstinence syndrome (NAS). NAS can occur with a pregnant woman's use of opioids, alcohol, caffeine, and some prescription sedatives. The type and severity of a baby’s withdrawal symptoms depend on the drug(s) used, how long and how often the mother used, how her body breaks down the drug, and if the baby was born full term or prematurely.
Also, substance use by the pregnant mother can lead to long-term and even fatal effects, including
low birth weight birth defects
small head size premature birth
sudden infant death syndrome
problems with learning, memory, and emotional control.
Teens who use drugs while their brains are still developing could be damaging their brain’s learning abilities. Therefore, similar risks for brain problems could exist for drug-exposed babies. Given the potential of all drugs to affect a baby’s developing brain, women who are breastfeeding should talk with a health care provider about all of their substance use.
Competing interests: No competing interests