The gender gap in substance use disorders (SUDs), characterized by greater prevalence in men, is narrowing, highlighting the importance of understanding sex and gender differences in SUD etiology and maintenance. In this critical review, we provide an overview of sex/gender differences in the biology, epidemiology and treatment of SUDs. Biological sex differences are evident across an array of systems, including brain structure and function, endocrine function, and metabolic function. Gender (i.e., environmentally and socioculturally defined roles for men and women) also contributes to the initiation and course of substance use and SUDs. Adverse medical, psychiatric, and functional consequences associated with SUDs are often more severe in women. However, men and women do not substantively differ with respect to SUD treatment outcomes. Although several trends are beginning to emerge in the literature, findings on sex and gender differences in SUDs are complicated by the interacting contributions of biological and environmental factors. Future research is needed to further elucidate sex and gender differences, especially focusing on hormonal factors in SUD course and treatment outcomes; research translating findings between animal and human models; and gender differences in understudied populations, such as those with co-occurring psychiatric disorders and gender-specific populations, such as pregnant women.

Interventions designed to reduce heavy drinking among college students often contain suggestions for drinking control strategies. However, little is known about the relationship of the use of these strategies to alcohol consumption. This study developed a measure of drinking control strategies and investigated its psychometric properties in a sample of 250 college drinkers. Strategies clustered into three factors: selective avoidance of heavy drinking activities/situations, strategies used while drinking, and alternatives to drinking. These three types of strategies were independently associated with alcohol use; however, the first and last types were negatively associated with alcohol consumption, whereas the second type was positively associated with alcohol use. The findings from this study suggest that type of strategy recommended may be important when the goal is alcohol reduction. Keywordsdrinking control strategies; alcohol use; college students Surveys of drinking in national samples of college campuses revealed that between 34 to 44% of students met criteria for heavy drinking (Douglas et al., 1997;Wechsler et al., 2002). Heavy drinking can lead to health risks (e.g., blackouts, personal injuries, physical illnesses, and unprotected sexual activity), in addition to academic, interpersonal, and legal problems (Hingson, Heeren, Winter, & Wechsler, 2005;Perkins, 2002;Aertgeerts & Buntinx, 2002). Due to the substantial risks associated with heavy college drinking, innovative risk reduction strategies are needed. Effective intervention programs have combined information, normative feedback and values clarification within a context of teaching college students skills to moderate risky drinking behaviors (Larimer & Cronce, 2002).Skills-based interventions are designed to modify high risk drinking behaviors in two ways: (a) teaching how to cope with life stresses in ways other than alcohol use (e.g., building alternative stress management, relaxation, and social skills), and (b) teaching alcohol-specific harm reduction skills (e.g., drinking in ways to avoid extreme intoxication and negative consequences). These intervention components evolved from self-management approaches for controlled drinking. For example, Miller and Muñoz (2005) developed a manual titled Controlling Your Drinking which outlines self-control strategies in three domains: while you drink, before you drink, and instead of drinking. The 'while you drink' strategies focus on slowing down drinking. The 'before you drink' strategies focus on teaching ways to gain control over drinking by understanding and changing antecedents that lead to heavy drinking. Lastly, the 'instead of drinking' strategies focus on gaining understanding of the reinforcers of alcohol use and teaching alternate ways to achieve these reinforcing effects without alcohol use.Many skills-based interventions designed for college students offer a menu of strategies or tips to students to help them moderate their drinking. However, little is known about the relationship...

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