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National Institute on Drug Abuse
Women and Sex/Gender Differences Research
Director's Report to Council
Research Findings Excerpts
February, 1997
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Basic Research |
Anabolic Steroids & Sexual Behavior
NIDA supported research reports that different anabolic-androgen steroid (AAS) compounds have quite distinct effects on male sexual behavior. For example, administration of the 17 alpha-methylated compounds had the most deleterious effects in intact male rats; while, the 19-nortestosterone esters had minimal effects on sexual behavior at any dose. The individual AAS effects in male rat copulatory behavior were closely related to their effects on serum testosterone levels. In castrated male rats, in general the alpha-methylated compounds were relatively ineffective in maintaining sexual behavior. These findings suggest that examination of individual compounds is necessary as it provides a strong foundation for analysis of the physiological and behavioral responses to AAS combinations typically administered by human users. Clark, A.S., Harrold, E.V. & Fast, A.S., Hormone & Behavior, In Press; Clark, A.S. & Fast, A.S.,Behavioral Neuroscience, 110, pp. 1-9, 1996.
Other recent findings in female rats also demonstrate disruption of estrous cyclicity and reproductive behavior when different AAS compounds are administered for a short-term at levels commonly used by humans. Blasberg, M.E. Langan, C.J. & Clark, A.S., Physiology & Behavior, In Press.
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Behavioral Research |
Smoking and Menstrual Cycle
Researchers at the University of Michigan have found in healthy women smokers that the effects of nicotine administered intranasally did not vary across menstrual cycle phase. This held true for both physiological and behavioral (subjective report) dependent measures. Marks et al., J Substance Abuse, In Press.
Evidence for a Sex-Specific Residual Effect of Cannabis on Visuospatial Memory
Pope and his colleagues at Harvard Medical School used a novel computerized battery of neuropsychological tests of attention to assess residual cognitive impairment in marijuana users. They compared 25 college students who were heavy marijuana smokers (who had smoked a median of 29 days in the last 30 days) with 30 students who were light smokers (who had smoked a median of 1 day in the last 30 days). All subjects were tested after a supervised period of abstinence from marijuana and other drugs lasting at least 19 hours. Although there were no significant differences between the overall heavy and light smokers on the four subtests of attention, marked and significant differences were found between heavy- and light-smoking women on the subtest examining visuospatial memory. On this test, subjects were required to examine a 6x6 "checkerboard" of squares in which certain squares were shaded. The shaded squares were then erased and the subject was required to indicate with the mouse which squares had formerly been shaded. Increasing numbers of shaded squares were presented at each trial. The heavy-smoking women remembered significantly fewer squares on this test, and they made significantly more errors than light-smoking women. These differences persisted despite different methods of analysis and consideration of possible confounding variables. The authors suggest that it may be important to study the residual effects of marijuana on men and women separately, particularly since women have been greatly under-represented in previous studies in this area. Pope, H.G. Jr., Jacobs, A., Mialet, J.P., Yurgelun-Todd, D., and Gruber, S. Psychotherapy and Psychosomatics, In Press.
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Clinical and Services Research |
Neuropsychological Functioning in Cocaine Abuse
NIDA-funded researcher Dr. Tony L. Strickland, Ph.D., of Charles R. Drew University of Medicine & Science and the University of California at Los Angeles (UCLA) School of Medicine, presented preliminary findings from his ongoing NIDA-funded research study on neurobehavioral functioning among cocaine abusers at the National Academy of Neuropsychology Sixteenth Annual Meeting on November 1, 1996. The focus of this paper was on neuropsychological effects of chronic cocaine use following sustained abstinence. Subjects included 37 males and 34 female freebase cocaine abusers with verifiable abstinence of between 5 and 18 months. The sample was 72% African-American and 28% Euro-American with similar representation by gender. Statistical analyses revealed significant impairment on measures of attention-concentration, memory, academic achievement, with visuospatial, motor, language and executive functioning measures less consistently impaired. Interestingly, despite a substantial gender disparity in cocaine exposure, women appeared no more impaired on neuropsychological measures than men. Curiously, greater cocaine exposure did not appear to result in greater neuropsychological impairment. An abstract of the paper will be published in the journal Archives of Clinical Neuropsychology.
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AIDS Research |
Reaching and Enrolling At-Risk Drug Users for Prevention Studies
The St. Louis EachOneTeachOne (EOTO) is a NIDA-funded Cooperative Agreement project aimed at examining rates of HIV risk behaviors and studying HIV risk reduction interventions among out-of-treatment IDUs and crack users. This paper describes findings related to the effect of street outreach on HIV risk behavior involvement, including (1) men reported more HIV risk behaviors than did women, but there were no racial/ethnic differences; (2) women street contacts were largely ineligible to enroll in EOTO, but the program was able to enroll women; and (3) actual EOTO enrollees, compared with street contacts and eligible street contacts, engaged in fewer HIV risk behaviors. These results imply that strategies in addition to street outreach may be needed to enlist more individuals, particularly whites and women who are engaging in the highest risk drug and sexual behaviors. Cunningham, R.M., Cottler, L.B., and Compton, W.M. Are We Reaching and Enrolling At-Risk Drug Users for Prevention Studies? Journal of Drug Issues, 26(3): pp. 541-560, 1996.
The Efficacy of Network-Based Risk Reduction Programs in Mid-Sized Towns
Three HIV and drug abuse intervention approaches were compared in two mid-sized towns: an intensive outreach program using indigenous outreach workers providing reinforcement of an HIV risk reduction program; a low intensity outreach program combined with a more intensive office-based HIV risk reduction program, and the NIDA standard intervention. A total of 579 drug users participated in the study. Each of the enhanced interventions were effective in reducing both drug-related and sexual risks for HIV transmission in active drug users. The intensive outreach combined with office intervention and the intensive office intervention without outreach reinforcement each produced significant reductions in sexual risk taking in active drug users, beyond the reductions found in the standard intervention. Gender differences were also found, with intensive outreach having a significant effect on the reduction of sexual risk behaviors of men but not of women, and the more intensive office-based risk reduction program significantly related to improvement in the sexual risk behavior of women but not of men. Trotter, R.T., Bowen, A.M., Baldwin, J.A., and Price, L. The Efficacy f Network-Based HIV/AIDS Risk Reduction Programs in Mid-Sized Towns in the U.S. Journal of Drug Issues, 26(3): pp. 591-605, 1996.
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Epidemiology, Etiology and Prevention Research |
Alcohol Sensitivity and Smoking History in Men and Women
Many studies have found genetic effects to contribute to alcoholism risk in both men and women. Based on preliminary evidence for shared genetic risk between smoking and drinking problems, a re-analysis of alcohol challenge data on 412 Australian twins was performed to explore the possibility that smoking may diminish or moderate the intoxicating effects of alcohol. The authors found history of smoking to be strongly associated with self-reported intoxication after alcohol challenge in women (women: r= -0.44 + 0.08; men: r= -0.21 + 0.08), comparable with self-reported average weekly consumption of alcohol, which was more strongly associated in men (women: r= -0.37 + 0.07; men: r= -0.54 + 0.06). Structural equation model fitting indicated a strong association between heavy drinking and smoking, but the association between smoking and post-alcohol intoxication remained even when the effects of heavy drinking were controlled for. These results prompt the question of whether smoking cigarettes directly influences the transition from moderate to excessive use of alcohol by diminishing feelings of alcohol intoxication. Madden, P.A.F., Heath, A.C., Starmer, G.A., Whitfield, J.B., and Martin, N.G. Alcoholism: Clinical and Experimental Research, 19(5), October, 1995.
Fatal Consequences of Cocaine and Opiate Use
Cocaine, often with opiates (predominantly heroin) and ethanol, caused almost three-fourths of accidental fatal drug overdoses in New York City in 1990 through 1992. This study assessed all 1986 cases in that period using data collected in the Office of Chief Medical Examiner. This study excluded intentional (suicidal) fatal drug overdoses. Cocaine with opiates caused 752 (37.9%) deaths. Cocaine without opiates caused 629 (31.7%) deaths while opiates without cocaine caused 503 (25.3%) deaths. Drugs other than cocaine or opiates, predominantly benzodiazepines and antidepressants, caused 102 (5.1%) deaths. The highest cocaine overdose rates were found among African-American and Latino males. Rates of opiate overdose without cocaine did not differ in regard to race/ethnicity except for low rates among Asians. Males had higher overdose rates than women for all classes of drugs. The highest rates for cocaine and/or opiates were found among victims 35-44 years of age. The rates of overdose from cocaine and opiates increased from 1990-1992. There was a less pronounced but steady increase of opiate overdoses over that period of time. There was a marked increase of cocaine overdoses in 1991 followed by a slight decrease in 1992. The rates of overdoses from drugs other than cocaine or opiates showed no increase over time. Cocaine is the leading cause of accidental drug overdoses, unlike in the early 1980's when opiates prevailed as a cause of death. African-American and Latino males may be particularly susceptible to cocaine overdoses because of their exposure to crack in poor neighborhoods. This points to the urgency of targeting drug treatment and police interventions to these high risk areas. Tardiff, K., Marzuk, P.M., Leon, A.C., Hirsch, C.S., Stajic, M., Portera, L., Hartwell, N., Accidental Fatal Drug Overdoses in New York City: 1990-1992. The American Journal of Drug and Alcohol Abuse, 22 (3), 1996.
Substance Abuse Disorders Among Runaway and Homeless Youth
This study used systematic sampling methods to recruit a sample of 432 homeless youth from both service and natural 'hang-out' sampling sites in Hollywood. The interview procedures relied on participants' self-reports. According to DSM-III criteria, 71% of the respondents were classified as having an alcohol and/or illicit drug abuse disorder. Age and gender were not significantly associated with risk of having an alcohol or drug abuse disorder. The cumulative length of time a youth spent without a consistent place to live was found to be positively associated with the risk for a diagnosis with either disorder. Kipke, M.D., Montgomery, S.B., Simon, T., Iverson, E.F. Substance Use & Misuse, 32, pp. 7-8, 1997.
Results indicated extremely high prevalences of mental health problems among homeless youth as compared with corresponding rates of mental health problems found among housed youth in previous studies. Prevalence of mental health problems differed by age and ethnicity. African-Americans were at lower risk of suicidal thoughts and self-injurious behavior than were youth of other ethnicities. Older youth and females were at increased risk of depressive symptoms and younger youth were at increased risk of self-injurious behavior. Risk factors for drug abuse disorder included ethnicity other than African-American, homelessness for one year or more, suicidality, self-injurious behavior, depressive symptoms, and low self-esteem. The study suggests the need for street-based and non-traditional mental health services targeted toward these youth. Unger, J.B., Kipke, M.D., Simon, T.R., Montgomery, S.B., and Johnson, C.J. Homeless Youth in Los Angeles: Prevalence of Mental Health Problems and the Relationships Between Mental Health and Substance Abuse Disorders. American Journal of Community Psychology, In Press.
The histories of the youths were examined in terms of violence, perpetration of violence and fear of violence in association with gender, ethnicity, age, and length of time homeless. Respondents reported having experienced a wide range of violent events and attacks. Levels of exposure to violence were similar for males and females. However, females were more likely to report having been sexually assaulted and less likely to have used a knife to attack or stab someone. There were differences between ethnic groups on some exposure measures. Exposure to violence was positively associated with cumulative length of time homeless, and inversely associated with age. Kipke, M.D., Montgomery, S., Simon T. and Iverson E. Homeless Youth and their Exposure to and Involvement in Violence while Living on the Streets. Journal of Adolescent Health, In Press.
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