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Opioid Use and Misuse: Special Concerns for Women

     

Misuse of opioids is a major concern affecting millions of Americans. Many aspects of the opioid use, misuse, and treatment are different for women than men.

Opioids are a class of drugs that includes prescription pain relievers (such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, fentanyl, and others) and the illegal street drug heroin. Opioid pain relievers are generally safe when taken for a short time and as prescribed by a doctor, according to the National Institute on Drug Abuse. However, they are frequently misused because they also produce euphoric feeling. Even as prescribed by a doctor, regular use of opioids can lead to dependence.

A research paper from the Department of Health and Human Services late last year highlights how women are affected by inappropriate use of prescription opioid medications.

For example:

  • The 2015 National Survey on Drug Use and Health found that 4 percent of females age 12 and older misused prescription pain relievers in the last year.
  • Women are more likely than men to have chronic pain, to be prescribed prescription pain relievers, to be given higher doses, and to use them for longer time periods.
  • Women may become dependent on prescription pain relievers more quickly than men and may experience more cravings than men.
  • Psychological and emotional distress are risk factors for opioid misuse among women, but not among men.
  • Women are more likely to be introduced to substances by a partner; men are more likely to be introduce by a peer.
  • Rates of childhood and adult sexual abuse, risk factors for substance misuse, are higher among women than men.
  • Women are more likely than men to have co-occurring mental health and substance use disorders.

Women may be less likely to receive needed emergency treatment. Naloxone is a potentially lifesaving medication used to reverse the physical effects of opioid overdose and it is becoming more widely available. However, women are much less likely to receive naloxone, according to a 2016 study of Emergency Medical Services opioid overdose resuscitation efforts.

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Among people needing treatment for opioid misuse, men are much more likely to get treatment than women.

Individual seeking treatment may face many barriers, such as lack of access or insurance and stigma associated with addiction. Women may face additional barriers, such as lack of childcare. Research has found that women are more likely to enter treatment, stay in treatment and maintain abstinence if they are can stay with their children in treatment. According to a 2014 survey of treatment programs, 44 percent provided special programs or groups for adult women and 20 percent offered programs or groups for pregnant or postpartum women.

Efforts to prevent opioid misuse are underway on a number of fronts. Guidelines from the Centers for Disease Control and Prevention for opioid use for chronic pain recommend nonpharmacologic therapies, such as physical therapy and exercise therapy. The guidelines suggest clinicians should consider opioid therapy “only if expected benefits for both pain and function are anticipated to outweigh risks to the patient” and that they should specifically discuss with patients known risks and realistic benefits of opioid therapy.

Prescription drug monitoring programs — statewide databases tracking the dispensing of opioids and other controlled substances — have shown to be effective in changing prescribing behavior and reducing the number of patients who visit multiple doctors to get controlled medications. Also, many health plans and state Medicaid programs use patient review and restriction programs which help prevent patients seeking pain relief medications from multiple doctors and pharmacies at the same time.

Resources/References

     

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