BIOPSYCHOSOCIAL DIFFERENCES IN SUBSTANCE USE DISORDER BETWEEN WOMEN AND MEN AND CONSIDERATIONS ON THE THERAPEUTIC APPROACH

Abstract

Introduction. A search of scientific papers has been carried out in order to investigate sexual differences in drug abuse, and to underlying biological and psychosocial explanatory causes of these differences. Goals. Based on the anatomical and neurochemical differences of the male and female brain, the difference in skills and the possible importance of evolutionary factors, the reasons for the differential characteristics of addictions in men and women, as well as the sexual bias in the concurrent neuropsychiatric disorders are reviewed. The importance of sex hormones in these differences is also reviewed, as well as the influence of psychosocial conditioning factors associated with gender in addiction. Finally, the main features that differentiate the treatment of drug abuse in men and women are reviewed. Development and conclusions. The results obtained indicate that there is a close link between the differential biological characteristics of the male and female brain and sex hormones, which explain the specific characteristics of drug abuse according to sex. These differences exist both in the reward circuit, in metabolism and in the different phases of the addictive process: acquisition, escalation of consumption, abstinence and relapse, as well as in the associated neuropsychiatric disorders, all them modulated by psychosocial gender particularities. Finally, the need for separate sex treatments, especially indicated in the presence of coexisting psychological or psychiatric disorders, is assessed.