Many issues related to the use of psychoactives are gender-specific. Some of these issues pertain to the physical and psychological differences between genders, while others relate to the cultural construction of gender. Important differences exist between female and male role models. The archetypal and mythic dimensions of the psyche may differ between the genders in important ways.

As with most fields of study, men have historically received disproportionate attention and documentation in psychoactive literature and research. Most of the famous figures in the psychoactive-using subcultures over the last two centuries have been men. This may be due, in part, to the fact that, in the United States and Europe, a higher percentage of men have used recreational psychoactives than women.1 This imbalance of attention paid to men is reinforced by research biases in favor of using men as research subjects, as they are widely regarded as the putative norm for human behavior.2

Moral evaluations of the use of psychoactives frequently show bias against women. Many cultures are strongly disapproving of recreational psychoactive use by women, who may be judged more harshly than their male counterparts for becoming "out of control".3 Women are also commonly held to be disproportionately responsible for the wellbeing of children, which can influence how psychoactive use is judged.4

Contemporary political and media representations of female drug use often frame connections between psychoactives and sex in highly negative terms. For example, women who use psychoactives may be criticized for making themselves susceptible to substance-related sexual assault. Popular and news media frequently depict women losing control of their sexual urges while under the influence of psychoactives or prostituting themselves for access to substances. Gender-related fears may also be reinforced by sensationalist medical concerns related to pregnancy, as in the case of the long-debunked claims that LSD causes chromosome damage, or the "crack baby" scare of the late 1980s that was found to be largely baseless.5, 6


Historically in many cultures women and men have used psychoactives differently. In some cases this is due to explicit rules or taboos forbidding women (generally) from participating in particular rites or rituals, while in other cases it is simply the result of cultural differences between the genders.

For example, in some ayahuasca traditions, menstruating women are forbidden from participating in the ayahuasca ceremony. Among the Koryaks in Siberia, women gathered Amanita muscaria mushrooms for ritual use but were not permitted to ingest the sacrament.7 In other cultures women have held a privileged role with regard to psychoactives: in Oaxaca, only young women were traditionally allowed to gather hallucinogenic mushrooms or Salvia divinorum for use in religious healing ceremonies8. The cult of Apollo at Delphi used female priestesses as oracles in rites that may have involved a psychoactive gas or vapor.9

During the Victorian-era, cultural norms led to a split between male alcohol drinking and the widespread female use of "patent medicines". Today, psychoactive use continues to vary significantly by gender, though contemporary social and cultural norms shape behavior more often than strict taboo.


Female and male gender differences and the stages and cycles of the female reproductive cycle can accentuate discrepancies between female and male drug experiences. Women are often lighter than men (a factor with dose), may metabolize some drugs differently, and may need to consider menstruation, fertility, pregnancy, nursing or menopause when making choices about psychoactives use.


Special health questions arise when considering the maternal use of psychoactives during pregnancy. Many substances cross the placental barrier, and some are known to be teratogenic, or harmful to the developmental cycle of the fetus. Alcohol is particularly harmful, and heavy use by mothers during pregnancy can have serious life-long consequences for the child. The teratogenic effects of many psychoactive drugs is a matter of debate, and for some substances reliable data does not exist. [see Pregnancy Vault]


The use of psychoactives to intentionally increase the ease and pleasure of sex is a long-standing area of research and experimentation by herbalists and chemists, whether as individuals or large pharmaceutical corporations. While alcohol is probably the best known "sex drug" (reducing inhibitions and improving mood), virtually all stimulants, depressants and psychedelics have been experimented with for their potential to change or enhance the experience of erotic sexuality. Even birth control pills can have mood-altering effects.

Because of physical and cultural differences between genders, various aphrodisiacs may be differently suited to different genders. [see Psychoactives and Sex]


Alcohol and other psychoactives (usually depressants and sedatives) have been used to render people (most often women) semi-conscious or unconscious to facilitate sexual assault. The legal issues involved in these cases can be extremely complex because of the difficulty in determining consent or its absence.10 In cases where no physical injury is sustained, this determination may be difficult to make. The use of many recreational depressants is associated with memory impairment, adding an additional level of complexity. The attendant media frenzy surrounding this issue frequently distorts public perception of date rape, which is far more likely to occur in the context of alcohol inebriation than to involve so-called "date rape drugs" such as GHB, ketamine, or rohypnol. [see Psychoactives and Sexual Assault]


Women are often primary caregivers of children, disabled family members or elderly relatives, which can uniquely shape both their choices around the non-medical use of psychoactives and their opinions of psychoactive use. The roots of 20th century temperance movements, as well as the repeal of Prohibition, were grounded in women's concerns for their families' safety. Since the 1980s, the organization Mothers Against Drunk Driving (MADD) has launched high-profile campaigns advocating harsher penalties for driving while intoxicated, increasing the legal drinking age, as well as general anti-intoxication messages. [See Women & Prohibition]


Some states in the United States have passed laws or have used the police to enforce different rules for men and women relating to psychoactive drugs. In some states, pregnant women have been arrested for "child abuse" for violating controlled substance laws while pregnant. Primary caregivers of children may also face additional penalties for controlled substance legal violations.


Historically, male authors and their points of view have been disproportionately represented in the literature of psychoactive drugs. While there have been some well-known psychoactive-using female authors (Charlotte Brontë, Anaïs Nin, Billie Holiday, Margaret Meade, etc.), there have been far fewer than male authors. This issue is addressed in the 1982 book Shaman Woman, Mainline Lady:

Published feminine views of the drug experience generally have been limited to sociological studies and tabloid sensationalism. Media controlled by men have given us an enduring stereotype of a female drug abuser: a passive, exploited, degraded victim who becomes sexually promiscuous, ready to sell her body for the price of her next dose. Another common theme is the Hollywood actress, nightclub singer, or rock star who, unable to cope with the pressures of fame, overdoses on heroin or barbiturates--not unlike her Victorian sisters who met the same fate with laudanum and chloral hydrate.

[…] women's real experiences with drugs are far more varied and complex than the stereotypes suggest. The writers have a great variety of backgrounds and professions: housewife, schoolteacher, socialite, physician, parapsychologist, prostitute, professional writer, actress, social reformer, nutritionist, anthropologist, artist's model, shaman.

As the story of psychoactive research and culture continues to evolve, public perception and knowledge about relevant gender issues evolves as well. With the internet permitting greater access to diverse viewpoints and sources of information, hopefully more voices will continue to be heard, representing a broader spectrum of opinions and ideas, and encouraging a concordant evolution of attitudes and beliefs.