Gender Differences in Individuals with Opioid Use Disorder Receiving Inpatient Care

• When looking at profiles of men and women with opioid use disorder (OUD), a number of gender differences become evident.
• Women report more issues with drug, medical, psychological, family/social, and employment problems, while men report more problems with legal and alcohol-related issues.
• Additionally, while there was a 265% increase in prescription opioid overdoses for men between 1999 and 2010, women experienced a 400% increase. Building knowledge of gender differences in demographic and health-related characteristics could help improve outcomes for both men and women in treatment.

This analysis looked at baseline gender differences in individuals participating in the NIDA Clinical Trials Study CTN-0051 (X:BOT), a randomized, controlled trial in the NIDA Clinical Trials Network comparing extended-release naltrexone to buprenorphine (CTN-0051, the X:BOT study). Participants (N=570) provided demographic, substance use, and psychiatric history information.

Women in the study, compared to men, were:

 - significantly younger;
 - more likely to identify as bisexual, live with a sexual partner, and be financially dependent on someone else;
 - less likely to be employed;
 - more likely to report psychiatric history (anxiety/panic disorder, bipolar disorder, major depression);
 - more likely to engage in sexual and drug risk behaviors (exchanging sex for drugs, sharing injection equipment).

Women also reported shorter duration of opioid use, but similar age of onset.

Conclusions: Findings underscore economic, psychiatric, and infection vulnerability among women with OUD, which may complicate treatment initiation, retention, and recovery. Gender-specific interventions focused on these areas of disparity for women with OUD should be considered, including integration of OUD care with treatment for co-occurring psychiatric disorders and trauma, couples-based risk reduction interventions that address relationship dynamics, and interventions that address the unique needs of sexual minority women.

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