While substance abuse disorders, including alcohol use disorder (AUD), have traditionally been diagnosed more frequently in men than women, the incidence of binge drinking and heavy alcohol use is increasing in women.

Research suggests that the mechanisms that drive alcohol consumption in men and women are different, highlighting the need for AUD treatments tailored by sex.

Sex differences in alcohol use

Nearly 15 million people aged 12 years and older have AUD, according to the 2019 National Survey on Drug Use and Health. This translates to approximately 6.8% of men and 3.9% of women in this age group.

Men are more likely to suffer alcohol-related consequences than women. For example, they are more likely to be arrested for driving under the influence and to die from alcohol-related incidents, as reported in the ARCR article. 

Health disparities

Even though studies have shown that women drink less frequently and are less likely to engage in heavy drinking than men, women are more likely to suffer alcohol-related health consequences, as per the ARCR article. For example, women with AUD have been shown to perform cognitive tasks worse than men with AUD.

This even holds true for women who have had AUD for less time than their male counterparts. Women are also at increased risk for certain cancers, cardiovascular diseases, liver inflammation, and alcohol-induced hangovers.

Alcohol cues

There is an established link between attentional bias—the tendency to pay attention to certain types of stimuli over others—and alcohol use and cravings.

Further research is needed to elucidate the relationship between attentional bias and alcohol cravings in men and women.

A study published in Alcoholism: Clinical & Experimental Research in 2022 found that mood shifts—as well as exposure to alcohol-related cues, such as beer cans and bars—led to alcohol cravings in opposite ways for men and women.

Investigators enrolled 69 college students, aged 18–29, who drank. The subjects didn’t have any diagnosed mental health conditions. Each participant was instructed to carry a tablet for approximately 2 weeks and answer questions about their mood and alcohol cravings.

Attentional bias was determined by a visual task that included alcohol-related as well as non-alcohol-related stimuli. To assess mood, the subjects were asked if they felt nervous, sad, or joyful. Study participants were also asked to assess how strongly they craved alcohol.

Researchers found that while both positive and negative moods were positively correlated with alcohol cravings, attentional bias operated differently in men and women.

For men, positive moods increased the link between attentional bias and alcohol cravings. For women, the attentional bias-alcohol craving association increased when positive mood decreased.

This study highlighted sex-specific disparities in attention and alcohol cravings, suggesting that interventions targeting AUD should use a tailored approach that takes these differences into consideration.

However, more research is needed to see if the findings from this study apply to diverse groups.

This story is contributed by Samar Mahmoud and is a part of our Global Content Initiative, where we feature selected stories from our Global network which we believe would be most useful and informative to our doctor members.