Considerations for Women

The National Institute on Drug Abuse (NIDA) discusses some of the sex and gender differences in substance use disorders (SUDs). For example, substance use can have different physical effects on women compared to men, including effects of the heart, blood vessels, and brain. Because of these differences, women may benefit from different types of SUD treatment than men. However, research has shown that rural areas often lack options for specialty treatment programs designed for specific populations, such as women.

The Substance Abuse and Mental Health Services Administration's (SAMHSA) Treatment Improvement Protocol identifies several factors that affect adherence to treatment for women. These include:

Socio-demographics such as age, education, race/ethnicity, and relationships
Involvement of the criminal justice system or child protective services
Pregnancy
Treatment environment
Type of treatment services
Other considerations

These factors should be considered when implementing rural SUD treatment programs. For example, when developing the curriculum for a tobacco use cessation program, program planners may need to investigate differences in the effects of tobacco on women compared to men and know that nicotine replacement therapies are not as effective in women as they are in men.

The U.S. Department of Health and Human Services Office on Women's Health has developed an initiative focusing on the prevention and treatment of opioid use disorder among women. The initiative began with a national kick-off meeting in September 2016 and is funding programs addressing the prevention of prescription and non-prescription opioid use disorder among women, particularly among underserved populations of adolescent girls (ages 10 to 17) and women age 50 and older. Efforts focus on using Screening, Brief Intervention, and Referral to Treatment (SBIRT), integrating opioid use disorder prevention services with primary care, and developing and/or enhancing partnerships within communities. As part of this initiative, OWH published a white paper, which outlines promising practices for treating women with SUD. For example, programs that serve women may need to consider that women often act as caregivers for their child(ren). Offering a family-centered treatment approach may help ensure women do not feel like they need to choose between caring for their family and enrolling in SUD treatment.

Resources to Learn More

A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders: Practice and Policy Considerations for Child Welfare, Collaborating Medical, and Service Providers
Document
Offers guidance to states, tribes, local communities, and service providers when developing interagency policies and practices supporting the treatment and recovery of pregnant women with substance use disorders and interventions to reduce the effect of prenatal substance exposure. Emphasizes the importance of a coordinated, multi-system approach to affect change, improve outcomes and promote program sustainability.
Organization: Substance Abuse and Mental Health Services Administration
Date: 10/2016

Neonatal and Maternal Hospital Stays Related to Substance Use, 2006-2012
Document
Examines newborn and maternal inpatient hospital stays associated with substance use based on data from 38 states. Hospital and patient characteristics, including the patient's residence by metropolitan and nonmetropolitan counties, are provided in Table 2.
Authors: Fingar, K., Stocks, C., Weiss, A., & Owens, P.
Organization: Agency for Healthcare Research and Quality
Date: 7/2015

Rural and Urban Differences in Neonatal Abstinence Syndrome and Maternal Opioid Use, 2004 to 2013
Document
Examines the characteristics of infants and mothers with opioid-related diagnoses in rural and urban counties of the U.S. using data from 2004 to 2013. Discusses the increases in neonatal abstinence syndrome (NAS) and the frequency of hospital deliveries complicated by maternal opioid use of patients during the same time period.
Authors: Villapiano, N., Winkelman, T., Kozhimannil, K., et al.
Citation: JAMA Pediatrics
Date: 12/2016

White Paper: Opioid Use, Misuse, and Overdose in Women
Document
Examines prevention, treatment, and recovery issues related to opioid use disorder and/or opioid overdoses among women.
Organization(s): U.S. Department of Health and Human Services, Office on Women's Health
Date: 12/2016

Sex Differences, Gender and Addiction
Document
Discusses sex and gender differences including social, environmental, biological, and developmental factors that influence drug and alcohol addiction.
Author(s) Becker, J., McClellan, M., & Glover Reed, B.
Date: 1/2017