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Drug Addiction Research

and the Health of Women

Editors:

Cora Lee Wetherington, Ph.D., Women’s Health Coordinator

Adele B. Roman, M.S.N., R.N., Deputy Women’s Health Coordinator

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

National Institutes of Health

National Institute on Drug Abuse

5600 Fishers Lane

Rockville, MD 20857
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ACKNOWLEDGMENTS

Two publications have been produced based on the September 1994

conference “Drug Addiction Research and the Health of Women,”

sponsored by the National Institute on Drug Abuse. This volume,

Drug Addiction Research and the Health of Women, builds on the conference presentations and provides greatly expanded reviews of research in

this field. A companion volume, Drug Addiction Research and the Health

of Women: Executive Summary, contains condensed versions of the

conference presentations as well as the ensuing discussion sessions.

To obtain copies of either publication contact the National

Clearinghouse for Alcohol and Drug Information (NCADI), P.O. Box

2345, Rockville, MD 20847-2345, 1-800-NCADI-64 (622-3464) or see

its World Wide Web site: http://www.health.org.

The following NIDA personnel are acknowledged for their assistance in providing a technical review of this publication: Rebecca S.

Ashery, Ph.D.; Lula Beatty, Ph.D.; J.C. Comolli, R.N., M.B.A.; Dorynne

J. Czechowicz, M.D.; Katherine Davenny, M.P.H.; Loretta P. Finnegan,

M.D.; Ronald I. Herning, Ph.D.; Coryl Jones, Ph.D.; Lisa Onken, Ph.D.;

and Pushpa V. Thadani, Ph.D.

COPYRIGHT STATUS

NIDA has obtained permission from the copyright holders to

reproduce certain previously published material as noted in the text.

Further reproduction of this copyrighted material is permitted only as

part of a reprinting of the entire publication or chapter. For any other

use, the copyright holder’s permission is required. All other material in

this volume except quoted passages from copyrighted sources is in the

public domain and may be used or reproduced without permission from

the Institute or the authors. Citation of the source is appreciated.

DISCLAIMER

Opinions expressed in this volume are those of the authors and do

not necessarily reflect the opinions or official policy of NIDA or any

other part of the U.S. Department of Health and Human Services.

The U.S. Government does not endorse or favor any specific

commercial product or company. Trade, proprietary, or company names

appearing in this publication are used only because they are considered

essential in the context of the studies reported herein.

National Institute on Drug Abuse

NIH Publication No. 98-4290

Printed 1998
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Foreword

Alan I. Leshner, Ph.D.

Drug abuse and addiction are among the most pressing health and

social issues facing our Nation, posing serious health risks and often

tragic consequences for those who are afflicted and for their families

and communities. Although extraordinary progress has been made in

understanding these disorders and in finding the best ways to prevent

and treat them, unfortunately, research on drug abuse and addiction

related to women has, until relatively recently, been sorely neglected.

Most drug abuse interventions developed to date, including prevention

and treatment programs, have largely been shaped by men’s characteristics and needs. Because women traditionally have been underrepresented in research studies and drug abuse treatment groups, the effects

of drug abuse are far less understood for women than for men. But the

scientific evidence generated thus far suggests that drug abuse and

addiction present different challenges to women’s health, progress

differently in females than in males, and may require different treatment

approaches and strategies. Moreover, the rapid increase in AIDS cases

among women in recent years makes it all the more critical to address

gender differences as they relate to drug problems.

In an effort to assess and begin to fill the gaps that exist in knowledge about drug abuse and women’s health, the National Institute on

Drug Abuse (NIDA), the Federal agency leading the Nation’s research

efforts on drug abuse and addiction, sponsored a national conference

in September 1994 titled “Drug Addiction Research and the Health

of Women.” This 2-day meeting brought together leading researchers

to present state-of-the-science findings, discuss research issues and

challenges confronting the field, and lay the framework for NIDA’s

research agenda in this important area. Condensed versions of the

presentations made at the 1994 conference, as well as the ensuing

discussion sessions, are contained in a companion volume, Drug

Addiction Research and the Health of Women: Executive Summary.

The chapters contained in this research volume build on the conference presentations and represent greatly expanded reviews of research

in the field. These indepth, state-of-the-science reviews emphasize that
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the causes, correlates, pharmacokinetics, mechanisms, and consequences

of drug abuse and addiction vary considerably between men and women.

The authors highlight much of what is known about the epidemiology,

the etiology, and the health, social, and behavioral consequences of drug

abuse and addiction. Biological mechanisms underlying these processes

and legal, prevention, and treatment issues surrounding drug abuse

and addiction also are discussed. Taken together, the material clearly

illustrates the breadth and complexity of drug abuse-related issues that

affect women’s health. This information also provides a foundation on

which NIDA can frame a scientifically diverse and vigorous research

agenda with the goal of ensuring that women’s needs related to drug

abuse and addiction are more successfully met.

Alan I. Leshner, Ph.D.

Director

National Institute on Drug Abuse

Parklawn Building, Room 10-05

5600 Fishers Lane

Rockville, MD 20857