Review of Women and Drugs: A New Era for Research

No authorship indicated
1987 Contemporary Psychology  
The history of drug abuse research shares with other sciences a relative paucity of knowledge about females in particular and about gender effects in general. This bias in knowledge stems from the tradition of using male subjects for animal and human experiments and an unexamined assumption that gender is not an important experimental variable. The Public Health Service is now charged with correcting this cumulated imbalance in knowledge, and the PHS Women's Task Force has developed specific
more » ... veloped specific recommendations for achieving the goal, including targets for the future of drug-and alcohol-related research. The history and significance of the Task Force is here described by Dr. Chatham, and mechanisms and guidelines for correcting gaps in knowledge about new and marketed drugs are referenced in Dr. Danello's overview of the Food and Drug Administration and its role in drug-related research. Among the culturally embedded but inaccurate assumptions about gender is that reproductive functioning is somehow an entirely female matter. Consideration must now be given to the possible assault on both male and female gametes by drug and alcohol abuse. Not only can the female ovum possibly be damaged by substance abuse, but male sperm can likewise be damaged and subvert healthy fetal development. Another false assumption about gender is that sex differences are relevant only to reproductive processes. Dr. Hamilton provides an extensive and well-documented story of the many ways that gender affects health, including the gonadal steroid influences on brain neurochemical substrate. A host of new discoveries make it clear that differences in brain structure and physiology exist that are attributable to a masculine or feminine patterning of hormones occurring at critical periods during development. As the chapter by Dr. Baum makes quite clear, sex hormones are not male or female, but interact at critical stages to produce profound differences in anatomy and behavior. Dr. Baum leads us v through an intricate trail of detection to show that, in the ferret. It is ultimately estrogen that permits the formation of a male brain nucleus that then seems to permit sensitivity to testosterone, leading to characteristic male behavior. Although Dr. Baum describes brain dimorphism in the ferret, an extensive literature is emerging that strongly suggests that brain dimorphism exists between the human female and male. For the purposes of scientific research, studying just women is as meaningless as studying just men. Rather, gender as an experimental variable needs to become standard in studies of drug abuse and drug effects. Dr. Mendelson shows us that the picture for women and drug abuse changes markedly when nature and extent figures are broken out for men and women separately. Looking only at how many substance abusers are women, their problem seems small compared to the numbers of men abusing drugs and alcohol. But among women needing mental health support services, drug and alcohol abuse problems rank second only to depressive illness. From a female perspective, substance abuse appears as an important threat to health. Dr. Mello presents evidence indicating that women who suffer dysphoria associated with the menstrual cycle may self-medicate during the dysphoric period. That the menstrual cycle involves coordinated and repeated hormonal secretions in the central nervous system makes the female possibly a useful model for studying drugs of abuse, as abused drugs typically act on central neural events. Going back to reanalyze epidemiologic data by gender, Dr. Clayton uses NIDA's 1982 National Survey to show certain stable differences in drug use by gender as well as a trend toward convergence in age-of-first-use for females and males. Dr. Clayton directs our attention to the changing role of women in society and sees a need to track how this may affect substance abuse patterns in the future. For the purpose of preventing drug abuse, it is important to understand how societal, economic, and physiological pressures differ for subpopulations. Several contributors address this question. Dr. Gritz outlines the correlation between a post World War II decision by cigarette manufacturers to target the female consumer and a gradual increase in cigarette smoking by women, beginning in their teens, at a time when men were decreasing their smoking. Dr. Braude provides an overview of the many important changes in biology and life circumstances that confront the older woman, who composes approximately 60 percent of the elderly population. Dr. Braude also points out the especially high risk In this population of harmful effects resulting from the taking of multiple medications that may have unknown and possibly dangerous interactions. In a related chapter, Dr. Barry, drawing upon her geriatric expertise, gives details of the changing response to drugs that accompanies the aging process and how this differs for men and women. vi Gender research is in its infancy and promises to challenge accepted ideas as the accumulating data sort fact from fiction. The NIDA conference on women and drugs and this monograph are one step in the process of opening the scientific community to new ideas and knowledge about gender as it relates to substance abuse. vii
doi:10.1037/026949 fatcat:rapv4hodl5ao7pn4nbtcabhdzi