Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

20. Addictive Disorders in Women 439reflects the higher prevalence of prescription drug dependence in women,whereas men have higher rates of dependence on illicit drugs.Among young people, ages 15–24, the male rate of 12-month drug dependence(4.5%) is about twice the female rate (2.1%). However, among youngpeople who have used a drug within the past 12 months, the rates are almostequal (males 13.6%, females 10.6%).Demographic risk factors for alcohol problems in women have been foundto be age-dependent in a large general population sample. Women ages 21–34years reported the highest problem rates. Among them, those who were nevermarried, childless, and not employed (“roleless”) were at highest risk. Forwomen ages 35–49, those who were divorced or separated, had children not livingwith them, and were unemployed (“lost role”), and for women ages 50–64,those who were married, had children not living with them, and were not workingoutside the home (“role entrapment”) had the highest problem rates. Thelast group is reminiscent of the so-called “empty nest” syndrome describedamong older women (Blume & Zilberman, 2004).A prominent risk factor for both alcohol and other drug abuse/dependencein women is a history of physical and/or sexual abuse (Center on Addiction andSubstance Abuse, 1996; Simpson & Miller, 2002). In data derived from theEpidemiologic Catchment Area (ECA) study in the early 1980s, it was foundthat the lifetime prevalence of alcohol abuse/dependence increased threefoldand that of other drug abuse/dependence increased fourfold in women whoreported a history of sexual assault (Blume & Zilberman, 2004).Several researchers documented the influence of male “significant others”on the substance use patterns of women (e.g., Amaro & Hardy-Fanta, 1995).Men are likely to introduce women to the use of drugs and to supply drugs totheir female partners.Rates of both alcohol and other drug abuse/dependence are thought to beparticularly high among lesbian women (McKirnan & Peterson, 1989) andwomen in the criminal justice system (Center on Addiction and SubstanceAbuse, 1996). Among women convicted of homicide, rates of alcohol abuse/dependence were increased nearly fiftyfold above rates in the general population(Eronen, 1995). Among Jewish Americans who voluntarily participated intwo studies, an overrepresentation of women compared to men was found (Vex& Blume, 2001).PharmacologyPHYSIOLOGICAL FACTORSEarly research on the pharmacology of alcohol and other drugs was performedon male subjects and thought to apply to both sexes. More recently, however, ithas been found that given equal doses of alcohol (even if corrected for body