A recent analysis article published by Psychology Today and authored by Dr. Smita Das examined why addiction is often overlooked in women. The article discussed how addiction in women often develops quietly and gradually during stressful life transitions, including postpartum and caregiving, and is often linked to hormonal changes, societal pressures, and having limited support.
“Women often develop substance use disorders differently from men, with a faster progression from initial use to dependence. This pattern, known as telescoping, has been observed across substances including alcohol, opioids, and cannabis,” wrote Dr. Das.
In addition, women often progress to more severe substance use more quickly than men due to delays in care and stigma that make recovery harder. There are also biological factors, including hormonal and metabolic differences, that intensify the effects of substances, with estrogen increasing dopamine activity and reinforcing addictive behaviours. These effects become more pronounced during periods of transition, including menstruation, pregnancy, postpartum, and menopause, when changing hormone levels can influence metabolism, cravings, and withdrawal.
According to Dr. Das, addiction in women often goes unnoticed because stigma makes disclosure feel more risky, especially for those in caregiving or demanding roles. As such, addiction can remain hidden behind routines and responsibilities, and support is often delayed until the situation escalates into a crisis rather than being addressed through early intervention. “I once worked with a patient who appeared to be doing it all with ease. Raising her kids, managing a household—seemingly holding it all together. What no one saw were the four bottles of wine tucked into her fashionable oversized bag each day,” she wrote.
Moreover, Dr. Das suggests that to prevent crises, times of transition should be treated as key opportunities for early intervention. In turn, this requires routine, stigma-free screening across healthcare visits, wider access to evidence-based treatments such as buprenorphine or naltrexone, and provider training to recognize subtle or high-functioning substance use. With existing science and tools, what’s needed is timely recognition and care that reflects women’s lived realities.
“The science is there. The tools are there. What’s needed now is earlier recognition, earlier action, and care that reflects the realities women are navigating—constantly, often invisibly, and with very little room to fall apart,” concluded Dr. Das.
