Getting high to be a man: masculinity, health and the social meanings of substance use

Masculinity represents a multifaceted and socially constructed concept that reflects societal expectations and pressures regarding what constitutes appropriate male behavior. The connection between this complex concept and drug use is a topic that has garnered increasing attention within sociological debate. Various studies highlight the close relationship between adherence to gender expectations and personal health choices. Many men feel pressured to conform to images that suppress aspects of existence such as emotionality and vulnerability, with direct consequences on their health. Adherence to traditional models of masculinity is often associated with potentially harmful practices (such as episodes of binge drinking or the rejection of self-care, considered too “feminine”), which can play a key role in managing stress, replacing practices of self-care and emotional support (Marcos et al., 2013). This work aims to analyze how gender norms influence the consumption of psychoactive substances. A review of the literature will examine various theoretical contributions from different socio-cultural contexts, with specific attention to local constructions of masculinity and the contexts in which it is performed (Rinaldi, 2018). Preliminary findings suggest that gender expectations can influence substance use in various ways. For instance, some substances – such as alcohol and cocaine – more than others – such as benzodiazepines and barbiturates – may be perceived as “masculine,” with direct consequences on the legitimacy of their use (Measham, 2002). Moreover, men may be socially encouraged to demonstrate their masculinity through risk-taking behaviors, such as substance abuse or consumption in public and social settings. In fact, by referring to the concept of gender as situated action (West and Zimmerman, 1987), it becomes evident how consumption practices within (homo)social contexts intertwine with traditional gender norms, becoming an integral part of the process of constructing male identity. Within these spaces, drug use can serve a dual function: on one hand, as a social glue, strengthening relationships and the sense of belonging to the group, and on the other, as a means of competition for the reinforcement of male supremacy (Darcy, 2020). Drug use can thus become a means of exploration through which men challenge traditional norms of masculinity, accessing that “intermediate space” (ibid.) that allows them to maintain close social ties while simultaneously asserting their masculine identity. This analysis highlights how gender expectations and roles profoundly influence both, in general, behaviors and choices related to health, and more specifically, practices of substance use, underscoring the need for further research on this topic. The goal is to enhance substance use knowledge and develop targeted and culturally oriented prevention strategies.