Betting on a Brighter Future

WHRY Examines Addiction and Gender to Improve Lives

In December, the Centers for Disease Control reported that in 2016, for the second straight year, life expectancy dropped for newborns in the United States. 

The goal from the beginning was to factor gender into our understanding. It’s exciting to see that the work is having a national and an international impact.

Dr. Marc Potenza

That’s the first time the country has seen a two-year decline since the influenza epidemic of 1962-63. Before 2016, the most recent one-year drop was in 1993, during the peak of the AIDS crisis.

The source of this new spike in deaths? Drug overdoses, which have jumped 21 percent. Opioid overdoses alone contributed to 42,000 American deaths in 2016.

Even as drug addiction has grown into a nationwide epidemic, the problem does not affect men and women equally. Men are twice as likely to die of a drug overdose than women. And yet, over the decade leading up to 2010, the rate of women dying from prescription pain relief overdoses increased by 400 percent, compared with a 265 percent increase for men.

“Historically, addiction research has focused primarily on men,” said Dr. Carolyn M. Mazure, Director of Women’s Health Research at Yale. “However, increasing addictive behaviors in women require that we identify and understand gender-specific risk factors for addictive behaviors and how addictions affect women and men differently so that we can improve prevention, treatment, and public health policies.”

This mission is not new to WHRY. In 2000, the center established its Women and Addictive Behaviors Core to investigate addictive behaviors with a focus on their effects in women. Led by Dr. Marc Potenza, the core’s researchers engage in collaborative, interdisciplinary studies across the lifespan, drawing on the latest genetic techniques, brain imaging technology, and cognitive and clinical assessments to develop gender-specific medical interventions addressing preventable causes of illness and death.

“The goal from the beginning was to factor gender into our understanding of addictive behaviors and disorders,” said Potenza, a Professor of Psychiatry with appointments in the Child Study Center and Neuroscience. “Men and women and boys and girls differ in many ways, but we can help them all by understanding how specific addictions affect them differently.”

The core has published findings on how gender differences exist in problem gambling and substance use disorders involving nicotine, prescription drugs, and alcohol. 

“When initiating studies, we meet as a group,” Potenza said. “We discuss potential projects to examine and explore gender-related differences.”

The core investigates addictions rooted in substances — both legal and illegal — and behaviors, including overeating, sexual behaviors, and internet use.

The work has included examining data collected through the Gambling Impact and Behavior Study, a survey of adults and adolescents begun in 1998 by researchers at the National Opinion Research Center at the University of Chicago. 

“A majority of adults gamble, but most do not develop a gambling disorder,” Potenza said, noting that gambling disorder is the only non-substance addictive disorder classified in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. “Those that do are more likely to be men, but there is evidence the gap might be narrowing as gambling becomes more socially accepted for both females and males.”

Potenza, who was honored in 2016 with a Lifetime Achievement Award in Gambling Research from the National Council on Problem Gambling and who also directs the Center of Excellence in Gambling Research, said men prefer strategic forms of gambling, such as betting on sports or card games such as blackjack and poker. Women show preferences for non-strategic forms, such as gambling on slot machines.

“The question we need to answer is how do we best prevent people from developing problems,” Potenza said. “Are there any public policies that can take these differences into account?”

In addition, the core has revealed that trauma and post-traumatic stress disorder (PTSD) were more strongly associated with binge drinking and hazardous drinking among women as compared with men, that girls and boys involved in extracurricular activities were less likely to smoke marijuana and that this protective effect was stronger in girls, and that women and men have different expectations related to alcohol consumption, with women reporting different social and sexual outcomes from drinking.

In October of 2017, Potenza was honored with a research award by the Society for the Advancement of Sexual Health (SASH) for his recent work on compulsive sexual behaviors and problematic pornography use.

“The viewing of pornography is predominantly male, but the behavior significantly impacts women, particularly as young men and boys are often learning about sex through online pornography,” Potenza said. “The content of pornography over time has become more violent. And there are data to suggest that children as young as 7 to 10 years old are viewing pornography more frequently than in prior years.”

WHRY’s Women and Addictive Behaviors Core has published findings on how gender differences exist in problem gambling and substance use disorders involving nicotine, prescription drugs, and alcohol.
WHRY’s Women and Addictive Behaviors Core has published findings on how gender differences exist in problem gambling and substance use disorders involving nicotine, prescription drugs, and alcohol.

Another recent project of the core involves a section of the online journal Current Addiction Reports, guest-edited by Dr. Mazure and Yasmin Zakiniaeiz, devoted to sex and gender differences in addiction. Potenza is the Editor-In-Chief of the journal, and Zakiniaeiz is a graduate student pursuing a Ph.D. in neuroscience while working with Dr. Potenza and in a lab run by Dr. Evan Morris and Dr. Kelly Cosgrove, recipients of a recent WHRY grant to explore how the impact of smoking cannabis affects the brains of men and women differently.

Mazure is also currently collaborating on a paper exploring the gender differences in opioid addiction, seeking to draw more attention to the still-unknown factors driving the current deadly epidemic.

“It’s exciting to see that the work is having a national and an international impact,” Potenza said about his active collaborations with colleagues in China, South Korea, Italy, Spain, and Israel, among other countries. He feels confident in the core’s body of work and hopeful for a future in which a better understanding of how sex and gender influence addiction leads to better outcomes for everyone.

“I am confident that the seeds we have been planting to understand how sex and gender impact illness and disease will bring about better prevention strategies and treatments,” he said.   


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For questions, please contact Rick Harrison, Communications Officer at rick.harrison@yale.edu  or 203-764-6610.

This article was submitted by Carissa Violante on April 23, 2018.

About the Investigator

Dr. Marc Potenza earned a combined B.S. and M.S. in Molecular Biochemistry and Biophysics and a Ph.D. in Cell Biology with a concurrent M.D. — all at Yale University. He is currently a Professor of Psychiatry at Yale School of Medicine in the Child Study Center and of Neuroscience and Director of WHRY’s Women and Addictive Behaviors Core, the Center of Excellence in Gambling Research, and the Yale Program for Research on Impulsivity and Impulse Control Disorders

Dr. Potenza is a board-certified psychiatrist with sub-specialty training and certification in addiction psychiatry. He has consulted to the Substance Abuse and Mental Health Services Administration, National Registry of Effective Programs, National Institutes of Health, American Psychiatric Association, and World Health Organization on matters of addiction.