McHugh · Clinical psychology review 2018 · narrative review · n=?

Sex and gender differences in substance use disorders.

Cited 1090 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative critical review synthesizing secondary literature without systematic methodology

PubMed 29174306 · doi:10.1016/j.cpr.2017.10.012 · record verified 2026-08-26

What was done

This critical narrative review synthesized literature on biological sex and sociocultural gender differences in the epidemiology, biological mechanisms (neural, endocrine, metabolic), and treatment of substance use disorders (SUDs).

What was found

No quantitative data or effect sizes are reported in the abstract. Qualitatively, the review notes a narrowing gender gap in SUD prevalence, more severe adverse medical, psychiatric, and functional consequences in women, but no substantive differences between men and women in SUD treatment outcomes.

Why it matters

Understanding distinct sex and gender pathways helps explain why women face disproportionately severe health consequences from substance use despite achieving comparable treatment outcomes to men.

Limits

The abstract contains no quantitative metrics or systematic search criteria, reflecting a narrative review design. Findings are constrained by the complex interplay of biological and environmental factors, limited translational data between animal and human models, and insufficient research on hormonal influences and understudied groups such as pregnant women.

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