Yale Program on Sex Differences in Alcohol Use Disorder

The primary aim for our Center is to provide a focused, highly-integrated, mechanistic approach to expedite the development of novel therapeutics that target sex-dependent factors that differentially maintain drinking in women and men.

Rates of alcohol use disorders are increasing in women

• Historically, rates of alcohol use disorder have been greater in men when compared to women, however, this gap is closing.
• Over the past ten years, rates of alcohol use disorder have increased in women by 84%, relative to a 35% increase in men

Women who drink experience exacerbated health risks.

• While drinking is strongly associated with significant health risks in both sexes, females have exacerbated alcohol-related health consequences when compared to males including liver injury, cancer, and cardiovascular conditions.
• Women also face sex-specific health consequences from drinking including menstrual irregularity, and pregnancy- and perinatal-related consequences including fetal alcohol syndrome. Alcohol use is also associated with increased risk of physical and sexual assaults against women, with approximately one half of cases involving alcohol consumption by the either the victim, perpetrator, or both.

FDA-approved medications for alcohol use disorder were developed based on research in men

• FDA-approved therapeutics for alcohol use disorder were developed either exclusively, or primarily in men.
• To date, there has not been concerted effort to develop medications for alcohol use disorder that prospectively considers sex differences in alcohol use disorder.
  

A considerable body of data identifies that women are more likely to drink to regulate negative affect and stress, while men are more likely to drink for alcohol-related positive reinforcement.

Across our research we plan to target key brain structures, neurochemical systems, HPA-axis activity, neuroimmune function, alcohol metabolism, and sex steroid hormones, which are hypothesized to differentially motivate alcohol consumption in women.

To effectively treat women with alcohol use disorders, medication development strategies need to target factors which serve to maintain drinking behavior in women.

• Dr. George Koob's talk about alcohol and the female brain
  
• Review published on Sex, Stress, and Alcohol Use
  
• NIAAA's fact sheet on women and alcohol