Masculine and feminine in a melting pot – A gendered perspective on substance abuse
Authors: Trulsson Karin 
Published: January 2018

The purpose of this article is to describe similarities and differences between female and male substance abuse and to discuss what implications these may have or should have for treatment. The article mainly draws on qualitative social research. The material consists of a theoretic overview of Scandinavian empirical interdisciplinary research on male and female substance abuse. The focus is on marginalised abusers, who are the main targets of society's measures and interventions. The theoretical framework is built mainly on gender studies, but such terms as class and culture are also used. The analysis of the similarities and differences between male and female substance abuse is based on the concepts of gender contract, social ideal, gendered division of work, and socialisation (Hirdman 1988).

As far as drugs are concerned, the social ideal is zero tolerance for both genders. In contrast, controlled use of alcohol is tolerated, while the social norm is that male drinking is more acceptable than female drinking. The fact that female drinking is considered more condemnable than male drinking contributes to the worse self-esteem and the higher prevalence of depression and suicide attempts among women. The requirements of “respectability”, care duties and sexual control that are imposed on women from the working- class perspective (Skeggs 1997) increase the demands made of women, whose substance abuse also tends to be associated with a greater sexual availability.

The gendered division of work traditionally gives the main responsibility for home and children to the woman. In general, women to a greater extent than men make efforts to fulfil this ideal by stopping or controlling their substance abuse during pregnancy and the time they spend with children. However, there are also examples of both ‘oppositional’ men who shoulder the main responsibility for home and children and of ‘emancipated’ women who hand over the responsibility to the man and other close persons and in the case of which drug abuse can be seen as a part of the emancipation process.

It has been possible to compensate for inadequate socialisation, i.e. the teen-age years that many women have “lost” due to substance abuse, by residential treatment of addicted women. Research findings indicate that abusers with poor treatment outcomes in residential treatment that is mainly given to men call for the same kind of treatment as that given to women. It has also been shown that the treatment of women does not meet the needs of women who have rejected the traditional female role model.

Both new masculinities (Connell 1996) and new feminities emerge in a society in which masculine and feminine are in a melting pot. This involves a risk that men and women who do not adapt to the traditional role model become losers with regard to substance abuse services in the same way as the most marginalised abusers. Less attention is also being devoted to them in substance abuse research. Accordingly, research from both the gender and the class perspective could open up new perspectives and paths for the treatment of substance abusers.