Alcohol use disorder meds are geared toward men

What you probably already know: Women drink alcohol — and react to it — differently than men, but modern treatments for alcohol use disorder are tailored to men because medication trials have largely excluded female participants. The Yale Program on Sex Differences in Alcohol Disorder is exploring the reasons why women turn to alcohol and the ways in which their brains, hormones, and immune systems respond to it in the hopes that these discoveries will lead to medications better designed for women.

Why? Men have historically engaged in harmful rates of alcohol use at higher rates than women, but that’s changing. Women in the U.S. are closing the gap in alcohol use disorder rates: between 2016 and 2021, alcohol-related deaths increased by 35% among women, compared to 27% among men, according to the Centers for Disease Control and Prevention. Researchers think there’s a link between these rising numbers and changes in social norms. Women are delaying marriage and childbirth, while also earning higher incomes, potentially leaving more time for drinking. Marketing trends suggest that married women with families are also drinking more, particularly wine. The COVID-19 pandemic years also saw a steeper rise in alcohol use among women than men. Stress likely plays a large role in shifts that aren’t reflected across both sexes; previous studies have found men are more likely to drink for enjoyment, while women are more likely to drink to help manage stress.

What it means: Drinking can obviously lead to problems for both men and women, but women are at higher risk of liver injury, cancer, and heart problems in part because they metabolize alcohol differently than men. They also stand to suffer from menstrual disorders or pregnancy/perinatal problems. Researchers at Yale are looking at how men and women differ in brain development during adolescence to understand the key drivers of alcohol use disorder in women. One example is the neuroimmune system, which keeps the brain healthy: Researchers have discovered that women with alcohol use disorder have a greater deficit of microglia — a type of immune cell in the brain — compared to men. Malfunctioning microglia are linked to various neurodegenerative diseases and inflammation, which could help explain why women are at a greater risk of certain conditions like alcohol-related liver disease. In lab tests, reducing inflammation made mice less likely to choose alcohol over water.

What happens now? There’s a clear and pressing need for effective therapies for alcohol use disorder, especially for women, and a need for more research and information. The research program at Yale hopes to help bridge this gap in time, and is currently enrolling for medication trials. Women in need of help can always visit the National Institute on Alcohol Abuse and Alcoholism’s Alcohol Treatment Navigator.