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Opioid Use Disorder in Women and the Implications for Treatment
Celestina Barbosa-Leiker1, Aimee N C Campbell1, R Kathryn McHugh1
1College of Nursing, Washington State University, Spokane, (Barbosa-Leiker); Program of Excellence in Addictions Research, Washington State University, Spokane, (Barbosa-Leiker); Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, (Campbell); Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, Massachusetts (McHugh, Greenfield); Department of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, Medical University of South Carolina, Charleston, (Guille).
Objective:
The opioid epidemic continues to evolve and impact all groups of people. Moreover, there are concerning trends among women. The aim of this article is to provide a review of opioid use disorder in women and the implications for treatment.
Methods:
A nonsystematic review of the literature as conducted to examine: (1) the epidemiology of opioid-related hospitalizations and deaths of women; (2) co-occurring pain, anxiety disorders, and trauma among women with opioid use disorder; (3) evidence for opioid agonist treatment of pregnant women with opioid use disorder; and (4) implications for treatment of women with opioid use disorder and next steps for research and practice.
Results:
The current opioid epidemic has produced important differences by sex and gender with increased rates of use and overdose deaths in women. Significant mental health concerns for women include co-occurring psychiatric disorders and suicide. Expanding medication treatment for perinatal opioid use disorder is crucial. While effective treatments exist for opioid use disorder, they are often not accessible, and a minority of patients are treated.
Conclusions:
The end to the opioid epidemic will require innovative multi-systemic solutions. There are significant practice gaps in preventing rising death rates among women by opioid overdose, treating co-occurring psychiatric disorders and pain, and treating perinatal women with opioid use disorder and their infants. Research on sex and gender differences, and the intersection with race/ethnicity and US region, is critically needed and should include treatment implementation studies to achieve wider access for women to effective prevention, early intervention, and treatment.
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