Cocaine Addiction in Women: Risk Factors & Warning Signs

Woman in fur hat struggling with cocaine addiction in women

Contributor: Megan Wilson, BS, CADC, of Timberline Knolls Residential Center

There is no question that gender plays a role in the development and experience of mental health issues, and cocaine addiction in women is no exception. Research indicates that women are more likely to use cocaine at an earlier age, take it in higher quantities, and have more difficulty maintaining abstinence [1]. What aspects lead to this gender difference?

Cocaine Addiction in Women Risk Factors:


Female bodily hormones alone present a risk factor for cocaine addiction in women, but the exact mechanism behind this gender difference is currently unknown.

A 2017 study theorizes that the menstrual hormone estrogen may stimulate increased dopamine release, resulting in women experiencing increased reward during certain parts of their cycle and found evidence to support this theory with lab mice [1].

The study also found that the reward effects of cocaine during certain parts of the menstrual cycle leading to strong and long-lasting associations that result in more compulsive drug-seeking over time [1].


Impulsivity involves the use of drugs in a rapid, but unplanned fashion and has been “linked to substance use vulnerability, frequency, severity…and dependence [2].

Researchers have not only found that cocaine users rate significantly higher in impulsivity than heroin users, but women were found to be more impulsive than their male counterparts in one study [2].

Emotional Trauma:

It is commonly known that early experiences of emotional or physical trauma put one at risk for substance abuse problems. Woman on the beach struggling with addictionWhile women are no more likely than men to experience potentially traumatic events such as accidents, disaster, fire, or combat, they are more likely to suffer sexual assault and childhood sexual abuse [3].

As such, women may engage in drug-seeking behaviors in order to cope with the negative memories and emotions left from these experiences thus leading to a higher rate of cocaine addiction in women.

Stress Reactivity:

Finally, studies show that exposure to personalized stressful imagery and cocaine-related imagery results in increased cocaine craving [4]. Numerous studies indicate that substance abusing females show more mood-related problems than males, particularly stress reactivity [2]. This suggests that “the mechanisms linking stress and substance use may be gender-specific [2].”

Warning Signs:

The warning signs of cocaine addiction in women are similar to those in men, and they are essential in which to be aware.


lady leaning on chair

One of the key indicators that someone is struggling with cocaine addiction is an inability to keep up with daily responsibilities in their work or home life. Individuals may appear more aggressive or withdrawn than usual [5].

Fiscally, the individual may report having less money despite no change in hours worked and day-to-day expenses. Furthermore, addiction is evident when the individual continues to use despite knowledge of the physical, emotional, and social consequences.


There are numerous physical warning signs that an individual may be using or abusing cocaine such as dilated pupils, runny nose, weight loss, nosebleeds, burn marks on hands or lips, and a deterioration in hygiene habits [6].


Cocaine is a central nervous system stimulant that floods the brain with dopamine which results in feelings of reward. More importantly, however, it results in significant cognitive impairments with prolonged use such as slow or rapid thought processes, excessive alertness, impaired judgment, and confusion [5].


[1] Calipari, E. S. et al. (2017). Dopaminergic dynamics underlying sex-specific cocaine reward. Nature Communications, Vol. 8.
[2] Lejuez, C. W. et al. (2007). Risk factors in the relationship between gender and crack/cocaine. Experimental and Clinical Psychopharmacology, 15:2, 165-175.
[3] Tolin, D. F. (2006). Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research. Psychological Bulletin, 132:6, 959-992.
[4] Sinha, R. (2003). Hypothalamic-pituitary-adrenal axis and sympathoadreno-medullary responses during stress-induced and drugcue-induced cocaine craving states. Psychopharmacology, 170, 62-72.
[5] Rose Rehab (2017). Women’s cocaine causes and effects. Rose Rehab, retrieved on 31 October 2017 from
[6] American Addiction Centers (2017). Signs of cocaine abuse. American Addiction Centers, retrieved on 31 October 2017 from

About the Author:

Megan Wilson photo

Megan Wilson, BS, CADC has been working at Timberline Knolls since 2013.  She facilitates psycho-educational group therapy, completes substance use assessments, and takes on the leadership role of the Addictions Specialist team.

She also individually meets with residents to support a better understanding and application of 12-step recovery.

Thank you to Timberline Knolls for providing this article.

Timberline Knolls is a leading residential treatment center for women and adolescent girls, ages 12 and older, with eating disorders, substance abuse, trauma, mood and co-occurring disorders. Located in suburban Chicago, residents receive excellent clinical care from a highly trained professional staff on a picturesque 43-acre wooded campus. An adult partial hospitalization program (PHP) is also available in nearby Orland Park, Ill., for women to step down or direct admit. For more information on Timberline Knolls Residential Treatment Center, call 630-755-5173. We are also on Facebook – Timberline Knolls, LinkedIn – Timberline Knolls and Twitter – @TimberlineToday.

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental, and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Published on December 3, 2017
Reviewed and Updated by Jacquelyn Ekern, MS, LPC on January 12, 2021
Published on

About Jacquelyn Ekern, MS, LPC

Jacquelyn Ekern founded Addiction Hope in January, 2013, after experiencing years of inquiries for addiction help by visitors to our well regarded sister site, Eating Disorder Hope. Many of the eating disorder sufferers that contact Eating Disorder Hope also had a co-occurring issue of addiction to alcohol, drugs, and process addictions.