Causes and consequences of drug abuse and dependence are different between males and females. Objective: To identify possible gender differences in the ways of first exposure to drugs, in their risks of abuse, and the pattern of drug dependence. Methods: Four hundred and fifty seven patients of drug abuse who attended outpatient clinic in Neuropsychiatry Department in Tanta University Hospital along the period from June 2006 to June 2009 were classified into two groups according to gender. The

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... groups were assessed using DSM IV semi-structured interview and compared together regarding; Age, age of beginning of drug use, duration of abuse, educational level in years, occupation, marital state, first drug used, number of abused drugs, route of use, possible risk factors, cause of asking help and comorbid psychiatric conditions. Results: Males started drug abuse earlier in age than females with longer duration of addiction. Single males are more vulnerable to abuse than females. Drug abuse is more common in female students and in male workers. Cannabis followed by opiates then alcohol and analgesics are common in males, while in females analgesics ranked first followed by anticholinergics then cannabis. Peer pressure was the most common motivating factor for drug abuse in males in contrary to family troubles and sexual abuse in females. Anxiety disorders are more common in males while depressive disorders in females. Conclusion: There are many gender differences in drug dependence should be considered while planning treatment and prevention strategies for achieving optimal outcome. [Egypt J Neurol Psychiat Neurosurg. 2010; 47(3): 413-418]