Addicted to Masculinity: How Patriarchal Ideals Fuel Substance Use

A recently published qualitative study in the journal Healthcare investigates the complex relationship between hegemonic masculinity, heteronormative sexual expectations, and addiction in men undergoing substance use treatment.

The research, conducted by Camacho-Ruiz, Galvez-Sánchez, Galli, and Limiñana-Gras, draws on interviews with male participants at a residential addiction treatment facility in Spain. The researchers used a feminist and critical masculinity studies framework, combined with the biopsychosocial model of addiction, to examine how masculine social norms and internalized expectations influence both substance use and sexual behavior. As the authors write:

“It is important to emphasize the relationship between pornography consumption and substance addiction. Both activities are linked to behaviors associated with masculinity and are often learned within peer groups. Substance use reaffirms male courage through the risk involved in experimentation, while pornography reinforces the image of the virile, heterosexual man within the peer group.”

Rather than isolating addiction as a neurochemical malfunction or personal failing, the researchers trace its roots to social norms that reward emotional suppression, sexual performance, and dominance as markers of manhood. By foregrounding the lived experience of men who feel trapped by these expectations, the study challenges conventional assumptions about pathology and invites reflection on how treatment systems might be complicit in reinforcing the very ideals that cause harm. It suggests that meaningful change may require not just behavioral interventions but also a reevaluation of the cultural scripts that define what it means to be well.