Women With Cannabis Use Disorder Used More Often to Cope With Negative Emotions Than Men | Research

The takeaway

Women with cannabis use disorder reported using cannabis significantly more than men in response to conflict, testing personal control, physical discomfort, and unpleasant emotions.

Addiction professionals, cannabis users concerned about their use patterns, and researchers studying gender differences in substance use.

Women scored higher on 4 of 8 negative-context use subscales

What the researchers found

Women scored higher on four of eight IDTS subscales related to negative affect: conflict with others, testing personal control, physical discomfort, and unpleasant emotions. Across both genders, cannabis use in negative contexts was associated with childhood stress history. Recent stress was differentially associated with use during unpleasant emotions by gender.

Why it matters

Understanding why men and women use cannabis differently is essential for developing gender-informed treatments for cannabis use disorder. The link between negative emotional contexts and women's cannabis use suggests that emotion regulation skills may be a particularly important treatment target for women.

The numbers in context

N = 148 non-treatment-seeking individuals with CUD. Women scored higher on 4 of 8 IDTS subscales. Past 90-day use sessions positively associated with negative affect and pleasant emotion subscales for both genders. Childhood stress associated with negative affect use for both genders.

How the study worked

Cross-sectional analysis of baseline data from 148 non-treatment-seeking individuals with cannabis use disorder. The Inventory of Drug Taking Situations (IDTS) assessed eight types of situations associated with cannabis use. Self-reported past 90-day substance use and measures of childhood and recent stress were included as covariates.

What this study cannot tell us

Cross-sectional design cannot determine causation. Non-treatment-seeking sample may not represent those in treatment. The IDTS measures self-perceived situations rather than objectively verified contexts. Sample size limits complex subgroup analyses.

How to read the evidence

Cross-sectional study with validated assessment tools but moderate sample size and non-treatment-seeking population.

When this study was published

Published in 2025.

The bigger picture

Gender-specific treatment approaches are becoming standard in addiction medicine for alcohol and opioids. This study provides evidence that cannabis use disorder also has important gender dimensions, particularly around the role of negative emotions and stress as triggers.

Questions still open

Would emotion regulation therapy be more effective than standard CUD treatment for women? Do these gender differences persist across racial and cultural groups?

Common questions

Does this mean women are more likely to develop cannabis problems?

Not necessarily. The study found that women with CUD use cannabis more often to cope with negative emotions, which may make their pattern of use harder to change. Prevalence of CUD itself is higher in men.

Why does childhood stress matter?

Both men and women who experienced childhood stress were more likely to use cannabis in negative emotional situations. Early adversity may shape coping patterns that make substance use more likely during distress.

Read the original research

Gender differences in circumstances associated with cannabis use.

The American journal on addictions, 34(3), 342-349

View on PubMed ↗Publisher’s paper ↗

Citation

Martin, Erin L; Baker, Nathaniel L; Ramakrishnan, Viswanathan; Neelon, Brian; Saladin, Michael E; McRae-Clark, Aimee L. (2025). Gender differences in circumstances associated with cannabis use.. The American journal on addictions, 34(3), 342-349. https://doi.org/10.1111/ajad.70000