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Gillian A Beauchamp,1,2 Jennifer L Carey,3 Mikayla B Hurwitz,1 Briana N Tully,1 Matthew D Cook,1,2 Robert D Cannon,1,2 Kenneth D Katz,1,2 Andrew L Koons,1,2 Hope Kincaid,4 Marna Rayl Greenberg1 On Behalf of the Toxicology Investigators Consortium (ToxIC)1Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/University of South Florida (USF) Morsani College of Medicine, Allentown, PA 18103, USA; 2Section of Medical Toxicology, Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/USF Morsani College of Medicine, Allentown, PA 18103, USA; 3Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA; 4Network Office of Research and Innovation, Lehigh Valley Health Network/USF Morsani College of Medicine, Allentown, PA 18103, USACorrespondence: Marna Rayl Greenberg 1909 Earls Court, Allentown, PA 18103, USATel +1 610-967-3140Email mrgdo@ptd.netBackground: Variations between male and female populations are previously reported in classes of harmfully used/misused drugs, severity of substance use disorder and risk of relapse. The aim of this study was to provide a review of bedside medical toxicologist managed, sex-specific poisonings in adults that present with harmful drug use/misuse.Methods: ToxIC Registry cases ≥ 19 and ≤ 65 years old, with harmful drug use or misuse during the timeframe June 2010–December 2016, were studied. Demographics, primary agents of toxic exposure, administration route and complications were analyzed. Descriptive methods were used in the analysis.Results: The database included 51,440 cases. Of these, 3426 cases were analyzed in which the primary reason for the encounter was harmful substance use/misuse. Females were found to harmfully use/misuse pharmaceutical drugs (N=806, 65.6%) more than nonpharmaceutical drugs (N=423, 34.4%). Males more frequently used nonpharmaceutical drugs (N=1189, 54.1%) than pharmaceutical drugs (1008, 45.9%). Analgesics were used by females (N= 215, 18.2%) and males (N=137, 6.6%). Sedative hypnotics were used by females (N=165, 14%) and males (N=160, 7.8%). Psychoactive agents were used by males (N=325, 15.8%) and females (N=67, 5.7%). Sympathomimetics were used by males (N=381, 18.5%) and females (N=151, 12.8%). The majority of both male and female participants, 1712 (57.9%), utilized an oral route of administration. However, 312 (16.5%) of males utilized inhalation vs 73 (6.8%) of females inhaled their substance.Conclusion: There were sex-specific differences among patients evaluated for harmful substance use/misuse by toxicologists. Considering these differences in regards to management and preventive approaches may be indicated.Keywords: gender studies, substance use, toxicology, overdose, substance misuse