This study focused on gender differences in childhood disorders and severity of adult psychosocial impairment among 106 females and 95 males seeking treatment for opiate addiction. Results indicated that as compared to males, female addicts reported significantly lower levels of conduct problems and higher levels of internalizing problems during childhood; these differences held even after controlling for comorbid adult psychiatric diagnosis. Findings also revealed that female addicts were at a disadvantage relative to males in terms of overall severity of psychiatric distress. Concomitantly, however, females showed less social deviance-on a range of illegal behaviors-as compared to men. Results were discussed in terms of implications for treatment planning: they underscore the need to consider gender differences in pathways to, and nature of, adult psychopathology among addicted individuals.