Evidence is accumulating that the etiology, epidemiology, consequences and mechanisms that underlie drug abuse are different in males and females. In this review, we present examples of sex differences in all phases of drug abuse, including acquisition, steady-state maintenance, escalation, dysregulation, withdrawal, relapse and treatment. Most reported findings are based on laboratory research in animals, but there are corroborating reports from human clinical and epidemiological studies. In all phases of drug abuse, females seem to be more sensitive to the rewarding effects of drugs than males, and estrogen is a major factor that underlies these sex differences.
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We are grateful to Maria Arrizi, Isadora Rosario-Gonzalez, Tina Gremmel, Kate Klammer, Erin Larson, Annemarie Loth, Lisa Normile and Craig Slapinski who contributed to the research into gender differences in drug abuse in our laboratory. Preparation of this manuscript was supported by National Institute on Drug Abuse grants KO5 DA15267, RO1 DA 03240 (MEC), F31 DA 11717 (WJL), F31 DA 14161 (MER), F31 DA 005575 (KPC) and T32 DA 07097 (ADM).