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Men and Substance Use

Addiction does not discriminate. It affects all genders. However, there are distinct differences in why and how men use and misuse drugs or alcohol.

man with substance abuse displaying issues

Many recognized gender differences are based on various culturally defined roles. Gender affects how we perceive ourselves and how others perceive us.1 Our societal perceptions of men play an important role in understanding drug use and misuse.

Drug abuse can take men through many different phases, from early use to addiction to relapse.2 Below is a list of some of the most abused drugs and their related issues for men.

  • Alcohol. Alcohol is a drug. Many people think that because it is legal, it is not as serious of a drug to use or abuse. This may also lead to the idea that a man should be able to easily handle or control his alcohol use. Often used to relax or escape from everyday stressors, alcohol can also have strong negative effects in your life. Men have higher rates of alcohol use, including binge drinking—so, not only do men drink more alcohol than women, they also have an increased risk of drinking excessively.1,3
  • Marijuana. In a 2019 National Survey on Drug Use and Health, 31.6 million people reportedly used marijuana in the month prior to the survey.12 More men than women use marijuana.4
  • Stimulants. Cocaine and methamphetamine are 2 stimulants commonly abused by men. Drugs in this class speed up several processes throughout the body, including functions that are normally regulated automatically by the body, such as heart rate, blood pressure, and pulse. Men are 2 times more likely to use cocaine compared to women.5
  • Pain relievers (opioids). Common opioids are heroin and oxycodone, and the CDC (Centers for Disease Control and Prevention) reports that more men die from opioid drug overdoses than women—though it notes that gap is closing.6
  • Nicotine. Nicotine is the primary addictive component of many tobacco products. About 1 in 6 men smoke cigarettes, and while smoking is more socially acceptable than using other drugs, nicotine is an addictive drug with long-term negative effects to your health and other aspects of life. Men who smoke have diminished overall health, increased risk of absenteeism at work, and an increase in health care needs and costs.7

Signs and Symptoms of Substance Misuse in Men

Society often expects men to be tough and independent—asking for help can be seen as weakness. So when men don’t know how to cope with stressors, they may turn to drugs or alcohol to escape the pain.

Trying to function as a spouse, father, son, and employee while under the influence of drugs is very difficult, though. Once caught in a pattern of using, men may not know how to ask for help to stop an emerging addiction. Some men do not easily open up about their feelings and emotions, so seeking help for addiction may cause them to feel weak, vulnerable, or even ashamed.8

Men with substance use disorders may also be more likely to experience anger, which may show in the form of violent behavior toward themselves or others.8 As substance abuse increases, you may notice a corresponding increase in aggressive behaviors.

Some general signs and symptoms you may recognize in yourself or your loved one if you suspect he is using a drug include:8,9

  • Sudden change in behavior. The drug may affect the chemicals in your brain, which could potentially result in unusual changes in behavior. These changes may also be compounded by a desire to hide the substance use or withdrawal symptoms associated with such use. Some men may exhibit violent outbursts or violent behavior.
  • Mood swings. Similar to changes in behavior, mood swings may be related to chemical changes in the brain due to drug use. You may notice that you feel happy one moment and, for no obvious reason, are angry or sad the next.
  • Withdrawal from family and activities. As problematic substance use worsens, you may withdraw from close friends and family and activities you once enjoyed. You may escape from them to use the drug alone or with a different group of friends, or you may try to hide the symptoms of dependence and withdrawal.
  • Carelessness about personal grooming. As addictions progress, interest in personal hygiene often decreases. The compulsion to seek out and use more drugs can overpower the desire to do even the simplest of daily tasks.
  • Changes in sleeping patterns. Changes in sleeping patterns may be related to the effect of the drug or could be a symptom of withdrawal when you are not actively using the drug.
  • Red or glassy eyes. Though a relatively non-specific sign, this physical symptom could be an indicator of drug use depending on the type of drug being used.
  • Running nose. A runny or sniffling nose could be a symptom of drug use in those who snort or inhale drugs often.

Consequences of Substance Misuse in Men

The use of any drug comes with consequences—the type, amount, and duration of drug use affects the severity of the consequences. Men experience specific physical effects as a result of substance abuse, including:3,10

  • A disruption of testosterone production and testicular function, which can result in impotence, infertility, and reduced chest or facial hair.
  • An increased risk of mouth, throat, esophagus, liver, and colon cancer compared with women.

Additional consequences that men tend to experience include:3

  • Men are hospitalized and die more frequently due to alcohol-related causes than women.
  • Men instigate more physical assaults due to alcohol-related aggression than do women.
  • Men initiate more sexual assaults than women, too, and often take greater risks such as unprotected sex or sex with more than one person.
  • Men are more likely to commit suicide after drinking than are women.
  • Men are nearly twice as likely to be involved in a fatal car accident than women as a result of being drunk.

Specialized Treatment Programs for Men

Many programs are designed specifically for men that consider both sex and gender when creating detox and treatment plans. These treatment programs provide for the physical, mental, and emotional health needs that affect you as a man.

As you face the uncertainty of starting treatment and dealing with the personal and professional consequences of your addiction being known by others, the need to feel masculine, independent, and invulnerable may come into play.8 Below are a few of the unique approaches to male-specific treatment that seek to address some of these fears and issues:8

two men talk closely in a addiction treatment setting

  • Maintaining privacy: Men may worry about who will be told that they are in treatment for addiction; counselors reassure them that treatment is confidential and will pose no threat to their image or standing.
  • Decreasing confrontation: Some men may do better in individual therapy versus group therapy, since this may decrease conflict with other men.
  • Acknowledging strength: Men may need to be acknowledged for the strength shown in making the decision to begin treatment. When counselors actively praise this, they may encourage engagement in treatment. Men may also be uncomfortable sharing their emotions and struggle with feelings of not fulfilling their role of husband, father, or worker while in treatment.
  • Emphasizing free choice: Men are usually goal-oriented and need to feel independent; they may feel uncomfortable accepting help, which may make them feel weak or even ashamed. Emphasizing choices often facilitates engagement.
  • Addressing violent behaviors: Men are more likely than women to be the perpetrators as well as the victims of violent crime because drug and/or alcohol use and misuse are often associated with violent behaviors and crime. The treatment center will have specific behavior expectations and consequences that must be followed to stay in treatment, and these may be stricter in a male-specific context.
  • Building positive support: Treatment will likely have an improved outcome if the man’s partner or family are involved. Counselors may suggest couples therapy or family therapy to help him and his loved ones through this difficult journey. If the man has close male friends who are not using drugs, including them in treatment may be beneficial.

As a man prepares for treatment, he may worry about the gender of the counselor since stereotypes are one of the most important issues to consider when choosing one.8 While one man may be comfortable speaking with a female counselor, another man will not. This may be related to their own gender biases, upbringing, or culture.8

Counselors are trained to help you through this difficult conversation about who you are most comfortable with assisting you along this journey of recovery. Being open and honest about your preferences, past counseling experiences, and your own gender biases can help in identifying and placing you in the best client-counselor relationship.

Types of Treatment

The main goals of any substance abuse treatment are to help you stop using the drug, develop strategies to remain drug-free, and become productive members of your family, work, and society again.11

  • Detox. When you first stop using a drug or quit drinking, your body may go through physical withdrawal, which may include uncomfortable physical and mental symptoms. Detox is the first step toward recovery.
  • Inpatient treatment. Inpatient treatment involves 24 hour a day rehabilitation. Access to medical and psychiatric care, when needed, is an important element of many inpatient or residential substance abuse treatment programs. Your length of stay depends on the severity of your addiction.
  • Outpatient treatment. Outpatient treatment is ideal if you do not have medical needs that require 24-hour supervision and you have a safe and supportive home environment. You go into the facility to see an addiction counselor and to participate in counseling sessions at set times.
  • Aftercare. Recovery from chronic conditions such as addiction often requires long-term attention, even after the initial treatment period. Substance abuse aftercare is often comprised of individual counseling, group counseling, or 12-step program participation—or a combination of these things. A large part of aftercare treatment is about relationships, so these programs are designed to help you establish relationships with others who can help you remain on the road to recovery.

If you or someone you love is a man struggling with addiction, seeking treatment may be a necessary step to leading a happier and healthier life.

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