Men were less likely than women to remit from dependence on all the substances assessed. Women tend to experience worse physical, mental, and social consequences of substance use than males [43], which may lead to an increased motivation to stop using drugs and help explain women’s higher rates of remission. Feelings of guilt and concerns regarding the effects of using substances during pregnancy and child-rearing can lead to decrease drug use among women [44]. Gender differences in the neural response to cue-induced craving and stress [45], as well as in the activity of the lateral and medial regions of the orbitofrontal cortex (OFC), which modulates impulsivity and decision making [46] can also help explain the different course of cocaine dependence among males and females.
