How Cocaine Affects the Female Brain Differently

Gender-Specific Treatment Strategies May Help

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Women make up about one-third of all cocaine users in the United States and they may differ from male cocaine abusers in several ways.

Research shows that cocaine-dependent women seek drug rehabilitation for different reasons than men, they respond to treatment differently and their brains react differently to a craving for cocaine.

Using PET (positron emission tomography) scan technology, Emory University School of Medicine scientists found that cocaine-dependent women experience reactions in the brain that are different from men.

Cerebral blood flow, which shows neural activity in the brain, changes differently for women addicted to cocaine than for cocaine-dependent men, the study found.

For these reasons, the researchers believe that gender-specific treatment strategies for cocaine abuse may be more effective.

Drug Craving and Brain Regions

Dr. Clinton Kilts and his colleagues examined blood flow related to drug craving in the brains of eight abstinent, cocaine-craving women and compared those results to samples from eight matched cocaine-craving men.

The researchers used a one-minute narration describing past cocaine use to provoke cocaine craving in the study's participants. The researchers made PET images of the participants' brains as they listened to the drug-using stories and when they heard drug-neutral stories.

Emotions and Cognition Affected Differently in Females

According to the National Institute on Drug Abuse, "The researchers found that cue-induced craving was associated with greater activation of the central sulcus and frontal cortex in women, and less activation of the amygdala, insula, orbitofrontal cortex, and ventral cingulated cortex.

Both men and women demonstrated activation of the right nucleus accumbens. Perhaps most notable was the neural activity measured in the amygdalas of study subjects; the women experienced a marked decrease in activity, in contrast to the increase observed in men," the report said.

  • Amygdalas:plays a role in your ability to control sexual behavior and feel certain emotions, including fear
  • Insula: plays a role in interoception (interpreting physical signals), decision-making, anxiety, pain perception, cognition, mood, threat recognition, and conscious urges
  • Orbitofrontal cortex:plays a role in choice and decision-making
  • Ventral cingulated cortex: plays a role in empathy, impulse control, emotion, and decision-making

Limitations of Study

The Emory researchers noted that their study had limitations which included small sample size and the inclusion of the participants of two female subjects who were not currently in drug treatment programs.

Although the investigators admitted that conclusions related to possible gender differences cue-induced drug craving associated with cocaine dependence should be considered as highly preliminary, they think the differences detected in the study may support the need to develop gender-specific strategies to treat drug abuse.

Metabolic and Absorption Differences

Other studies have found biological differences in how cocaine is absorbed and metabolized by men and women, and therefore affects men and women differently.

One study found that the gender differences in cocaine's effects were due to a combination of metabolic differences and the greater physical barrier to cocaine absorption created by increased mucus in the nasal passages caused by menstrual hormonal changes.

That study also suggested that treatment strategies for cocaine abuse should be different for women and men.

3 Sources
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  1. Kilts CD, Gross RE, Ely TD, Drexler KP. The neural correlates of cue-induced craving in cocaine-dependent women. Am J Psychiatry. 2004;161(2):233-41. doi:10.1176/appi.ajp.161.2.233

  2. “NewsScan for July 19, 2004 - Research News.” NIDA Archives, July 19, 2004.

  3. Lukas SE, Sholar M, Lundahl LH, et al. Sex differences in plasma cocaine levels and subjective effects after acute cocaine administration in human volunteers. Psychopharmacology (Berl). 1996;125(4):346-54. doie:10.1007/bf02246017

Additional Reading
  • National Institute on Drug Abuse. "Cocaine Affects Men and Women Differently." NIDA Notes January 1999

By Buddy T
Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism.