Gender and the Presentation of Harms Associated with AUD in Women

Gender may influence the context in which men and women present for treatment. Women presenting during pregnancy should be screened for alcohol use (see Chapter 14). They may also present in a crisis context, for example, with an injury associated with domestic violence (see Box 13.1), the prevalence of which is high in women with substance use histories. Men may present with injuries from alcohol-related violence, which is more common in men than women.

Box 13.1: Domestic Violence

The definition of domestic violence varies by jurisdiction. The term is often used interchangeably with “family violence” and “intimate partner violence”. For the purpose of this guide “domestic violence” refers to any physical violence; sexual abuse; emotional abuse; verbal abuse and intimidation; economic and social deprivation; damage of personal property and abuse of power between those in a domestic relationship, including intimate partners and/or family members.

Women are at increased vulnerability to disadvantage, victimisation, stigma and scrutiny around parenting and may experience greater barriers to treatment due to childcare responsibilities. Whilst both men and women may be parents, women are much more likely to be either the primary carer or a sole parent of young children and often both. In such cases, child protection needs should also be considered.