Men More Likely Than Women to Face Substance Use Disorders and Mental Illness

June marks National Men’s Health Month, an opportunity to examine the prevalence of drug misuse and substance use disorders (SUDs) in men. Compared to women, men are more likely to engage in illicit drug use and to begin using alcohol or drugs at a younger age. These risk factors contribute to a rate of substance dependence in men that is twice that of women; men are also more likely to experience an opioid overdose. In fact, of the 47,600 opioid-related overdose deaths in 2017, two-thirds were among men.

This disparity is also true for alcohol and other drugs. For example, men are more likely to drink excessively, which is associated with higher rates of alcohol-related deaths, hospitalizations, and risky behavior, such as drinking and driving. For other drugs, such as marijuana, use in males is higher, as is the prevalence of cannabis use disorder.

Trauma is an important risk factor for the development of an SUD in both men and women, though the impact appears to be more significant in men. People who experience adverse childhood experiences—abuse, neglect, and other traumatic experiences before age 18—are at increased odds of developing an SUD, though the relationship between SUDs and previous physical or sexual abuse, and parental separation or divorce, is stronger in men. Post-traumatic stress disorder (PTSD) can also contribute to the progression of an SUD. Compared to women, men with PTSD are almost twice as likely to also have an SUD.

Nearly half (45.6 percent) of adults with an SUD also have a mental illness, such as depression. Additionally, rates of suicide are almost four times greater for men than for women, although substances are commonly found in both males and females who complete suicide. According to federal data from 2014, 40 percent of deaths by suicide involved alcohol intoxication, 30 percent involved opioids, and 21 percent involved marijuana.

Given the breadth of risk factors associated with substance use disorders and misuse in men, health care providers should focus on understanding and delivering appropriate treatment for the mental health issues that can affect individuals simultaneously. In particular, because the missed identification of co-occurring disorders can be a barrier to appropriate interventions, health care systems should focus on screening and referrals for an SUD and mental health treatment, including behavioral health therapies.

Getting access to effective care is the first step toward recovery, and medication-assisted treatment has proven to be the gold standard for helping people with an SUD achieve successful outcomes. With a focus on interventions, such as trauma-informed care, that address both mental health issues and substance use disorders, health professionals can better address the complex nature of drug misuse among men and reduce the risk of overdose.

Beth Connolly directs The Pew Charitable Trusts’ substance use prevention and treatment initiative.