Sex and Gender Effects in Recovery From Alcohol Use Disorder

Abstract

The current article provides a brief summary of biopsychosocial gender differences in alcohol use disorder (AUD), then reviews existing literature on gender differences in treatment access, retention, outcomes, and longer-term recovery. Among psychotherapies for AUD, there is support for the efficacy of providing female-specific treatment, and for female-only treatment settings but only when female-specific treatment is included. However, despite mandates from the National Institutes of Health to do so, there is little work thus far that directly compares genders on outcomes of specific psychotherapies or pharmacotherapies for AUD. Although existing research has mixed findings on sex and gender differences in overall outcomes, there are more consistent findings suggesting different mechanisms of behavior change among men and women in AUD treatment and long-term recovery. Thus, more work is needed that attends to gender and sex differences, including planning studies that are structured to examine not only gender-differentiated outcomes in treatment response, but equally important, differences in treatment access and attendance as well as differences in mechanisms of change in drinking behavior.

Peer‐elicited alcohol craving in adolescents and emerging adults: Bridging the laboratory and natural environment

“…Considering recent work demonstrating that in youth 18 to 20 years old, cue‐elicited craving was a stronger predictor of craving during postdrinking moments (compared to nondrinking moments; Kohen et al, 2022), future work may wish to examine potential age‐related differences in associations between social‐context cues and craving in postdrinking moments. Biological sex covariates in relation to craving were marginal within the current sample, which contrasts with some research suggesting that sex differences and psychosocial gender differences may be relevant for understanding alcohol craving (Holzhauer et al, 2020; Moeller, 2012). Thus, additional research on this seems warranted.…”

The sex disparity in liver transplantation

“…They also found that women were more likely to be de-listed for active drinking than men [7]. Women liver transplant candidates with alcohol use disorder are more likely to have psychiatric co-morbidities and more likely to be on pharmacotherapy for psychiatric disorders [7,29]. Concomitant depression treatment in women has been shown to be important to the success of alcohol use disorder treatment [30].…”

Barriers to Accessing Addiction Treatment for Women at Risk of Homelessness

“…Not only does the etiology vary (29,30), but research continues to confirm the differential experiences of AOD use generally and substance use disorder (SUD) specifically across the sexes (31,32). Experiences of treatment and recovery from SUD can also differ across gender (33,34). Pregnancy, childbirth, and motherhood are regularly reported as factors preventing women from accessing AOD treatment (35)(36)(37)(38).…”