Skip to main content

Advertisement

SpringerLink
Log in

Challenges for Women Entering Treatment for Opioid Use Disorder

  • SEX AND GENDER ISSUES IN BEHAVIORAL HEALTH (CN EPPERSON AND L HANTSOO, SECTION EDITORS)
  • Published:
Current Psychiatry Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Women with opioid use disorder (OUD) face unique challenges the moment they enter treatment. This narrative review focused on recent literature regarding sex- and gender-based issues that could affect treatment outcomes in women with OUD.

Recent Findings

Women respond differently to opioids based on hormonal factors, are more likely to present to treatment with mental health conditions, especially depression, and are more likely to have experienced trauma via intimate partner violence compared with men. Women also face stigma when entering OUD treatment, particularly if they have children.

Summary

Future research to improve OUD treatment outcomes in women should account for sex as a biological variable and gender as a social construct. Women have a fundamentally different experience than men during the course of OUD and upon treatment entry. Programs that address childcare/family support, mental health, and trauma are warranted for women with OUD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Paller CJ, Campbell CM, Edwards RR, Dobs AS. Sex-based differences in pain perception and treatment. Pain Med. 2009;10(2):289–99.

    PubMed  PubMed Central  Google Scholar 

  2. Roberts AW, Fergestrom N, Neuner JM, Winn AN. New-onset persistent opioid use following breast cancer treatment in older adult women. Cancer. 2020;126(4):814–22.

    PubMed  Google Scholar 

  3. •• Springer SA, Biondi BE, Frank C, El-Bassel N. A call to action to combat the opioid epidemic among women. J Addict Med. 2020;14(5):364-6 This article provides actionable steps to improve opioid use disorder treatment in women.

  4. Huhn AS, Berry MS, Dunn KE. Sex-based differences in treatment outcomes for persons with opioid use disorder. Am J Addict. 2019;28(4):246–61.

    PubMed  PubMed Central  Google Scholar 

  5. Short VL, Goyal NK, Chung EK, Hand DJ, Abatemarco DJ. Perceptions of pediatric primary care among mothers in treatment for opioid use disorder. J Community Health. 2019;44(6):1127–34.

    PubMed  Google Scholar 

  6. Williams JR, Girdler S, Williams W, Cromeens MG. The effects of co-occurring interpersonal trauma and gender on opioid use and misuse. J Interpers Violence. 2020;13:886260519900309.

    Google Scholar 

  7. • Subodh NB, Grover S, Grewal M, Grewal S, Basu D, Mattoo SK. Interpersonal violence against wives by substance dependent men. Drug Alcohol Depend. 2014;138:124–9 This study quantifies the prevalence of intimate partner violence toward women living with men who have a substance use disorder.

    PubMed  Google Scholar 

  8. McCarthy M. Opioid overdose deaths rose fivefold among US women in 10 years. BMJ. 2013 July 08;347:f4415.

    PubMed  Google Scholar 

  9. VanHouten JP, Rudd RA, Ballesteros MF, Mack KA. Drug overdose deaths among women aged 30–64 years—United States, 1999–2017. Morb Mortal Weekly Rep. 2019;68(1):1–5.

    Google Scholar 

  10. Schiff DM, Nielsen T, Terplan M, Hood M, Bernson D, Diop H, et al. Fatal and nonfatal overdose among pregnant and postpartum women in Massachusetts. Obstet Gynecol. 2018;132(2):466–74.

    PubMed  PubMed Central  Google Scholar 

  11. Clayton JA, Tannenbaum C. Reporting sex, gender, or both in clinical research? JAMA. 2016;316(18):1863–4.

    PubMed  Google Scholar 

  12. Hyde JS, Bigler RS, Joel D, Tate CC, van Anders SM. The future of sex and gender in psychology: five challenges to the gender binary. Am Psychol. 2019;74(2):171–93.

    PubMed  Google Scholar 

  13. Becker JB, McClellan M, Reed BG. Sociocultural context for sex differences in addiction. Addict Biol. 2016;21(5):1052–9.

    PubMed  PubMed Central  Google Scholar 

  14. Becker JB, McClellan ML, Reed BG. Sex differences, gender and addiction. J Neurosci Res. 2017;95(1–2):136–47.

    CAS  PubMed  PubMed Central  Google Scholar 

  15. McHugh RK, Votaw VR, Sugarman DE, Greenfield SF. Sex and gender differences in substance use disorders. Clin Psychol Rev. 2018;66:12–23.

    PubMed  Google Scholar 

  16. Amaducci AM, Greenberg MR, Sheen AW, Warren HR, Parikh PM, Roth P, et al. Sex-specific outcomes in a substance use intervention program. Clin Ther. 2020;42(3):419–26.

    PubMed  Google Scholar 

  17. Huhn AS, Berry MS, Dunn KE. Systematic review of sex-based differences in opioid-based effects. Int Rev Psychiatr. 2018;30(5):107–16.

    Google Scholar 

  18. Klaman SL, Isaacs K, Leopold A, Perpich J, Hayashi S, Vender J, et al. Treating women who are pregnant and parenting for opioid use disorder and the concurrent care of their infants and children: literature review to support national guidance. J Addict Med. 2017;11(3):178–90.

    PubMed  PubMed Central  Google Scholar 

  19. Coyle MG, Brogly SB, Ahmed MS, Patrick SW, Jones HE. Neonatal abstinence syndrome. Nat Rev Dis Primers. 2018;4(1):1–17.

    Google Scholar 

  20. Koons AL, Greenberg MR, Cannon RD, Beauchamp GA. Women and the experience of pain and opioid use disorder: a literature-based commentary. Clin Ther. 2018;40(2):190–6.

    PubMed  Google Scholar 

  21. Pieretti S, Di Giannuario A, Di Giovannandrea R, Marzoli F, Piccaro G, Minosi P, et al. Gender differences in pain and its relief. Ann Ist Super Sanita. 2016;52(2):184–9.

    PubMed  Google Scholar 

  22. Huhn AS, Tompkins DA, Campbell CM, Dunn KE. Individuals with chronic pain who misuse prescription opioids report sex-based differences in pain and opioid withdrawal. Pain Med. 2019;20(10):1942–7.

    PubMed  PubMed Central  Google Scholar 

  23. • Dunn KE, Weerts EM, Huhn AS, Schroeder JR, Tompkins DA, Bigelow GE, et al. Preliminary evidence of different and clinically meaningful opioid withdrawal phenotypes. Addict Biol. 2020;25(1):e12680 Preliminary evidence that women experience a more severe withdrawal syndrome than men.

  24. Dunn KE, Huhn AS, Bergeria CL, Gipson CD, Weerts EM. Non-opioid neurotransmitter systems that contribute to the opioid withdrawal syndrome: a review of preclinical and human evidence. J Pharmacol Exp Ther. 2019;371(2):422–52.

    CAS  PubMed  PubMed Central  Google Scholar 

  25. Leone B, Di Nicola M, Moccia L, Pettorruso M, De Risio L, Nucara G, et al. Gender-related psychopathology in opioid use disorder: results from a representative sample of Italian addiction services. Addict Behav. 2017;71:107–10.

    PubMed  Google Scholar 

  26. Chiang Y, Wang R, Huang C, Chen S, Ho W, Lane H, et al. Reduced dosing and liability in methadone maintenance treatment by targeting oestrogen signal for morphine addiction. J Cell Mol Med. 2017;21(12):3552–64.

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Sartor CE, Kranzler HR, Gelernter J. Rate of progression from first use to dependence on cocaine or opioids: a cross-substance examination of associated demographic, psychiatric, and childhood risk factors. Addict Behav. 2014;39(2):473–9.

    PubMed  Google Scholar 

  28. Hernandez-Avila CA, Rounsaville BJ, Kranzler HR. Opioid-, cannabis-and alcohol-dependent women show more rapid progression to substance abuse treatment. Drug Alcohol Depend. 2004;74(3):265–72.

    CAS  PubMed  Google Scholar 

  29. Stoltman JJ, Woodcock EA, Lister JJ, Greenwald MK, Lundahl LH. Exploration of the telescoping effect among not-in-treatment, intensive heroin-using research volunteers. Drug Alcohol Depend. 2015;148:217–20.

    PubMed  PubMed Central  Google Scholar 

  30. Rouhani S, Park JN, Morales KB, Green TC, Sherman SG. Trends in opioid initiation among people who use opioids in three US cities. Drug Alcohol Rev. 2020;39(4):375–83.

    PubMed  Google Scholar 

  31. Qato DM, Zhang C, Gandhi AB, Simoni-Wastila L, Coleman-Cowger VH. Co-use of alcohol, tobacco, and licit and illicit controlled substances among pregnant and non-pregnant women in the United States: findings from 2006 to 2014 National Survey on Drug Use and Health (NSDUH) data. Drug Alcohol Depend. 2020;206:107729.

    CAS  PubMed  Google Scholar 

  32. Sanmartin MX, Ali MM, Novak P, Chen J. Polysubstance use among reproductive-aged parenting women who misused prescription opioids in the United States. J Addict Dis. 2018;37(3–4):142–5.

    PubMed  Google Scholar 

  33. • Ellis JD, Pittman BP, McKee SA. Co-occurring opioid and sedative use disorder: gender differences in use patterns and psychiatric co-morbidities in the United States. J Subst Abuse Treat. 2020;14:e108012 This study demonstrates that women have unique substance use and mental health profiles, and that depressive and schizotypal personality disorders are associated with sedative use in women with opioid use disorder.

  34. Gannon M, Short V, LaNoue M, Abatemarco D. Prevalence of adverse childhood experiences of parenting women in drug treatment for opioid use disorder. Community Ment Health J. 2020. https://doi.org/10.1007/s10597-020-00661-0.

  35. Schieber LZ. Variation in adult outpatient opioid prescription dispensing by age and sex—United States, 2008–2018. MMWR.Morbidity and Mortality Weekly Report. 2020;69(11):298-302.

  36. Hwang CS, Kang EM, Kornegay CJ, Staffa JA, Jones CM, McAninch JK. Trends in the concomitant prescribing of opioids and benzodiazepines, 2002–2014. Am J Prev Med. 2016;51(2):151–60.

    PubMed  Google Scholar 

  37. Goldman-Mellor S, Olfson M, Lidon-Moyano C, Schoenbaum M. Mortality following nonfatal opioid and sedative/hypnotic drug overdose. Am J Prev Med. 2020;59:59–67.

    PubMed  Google Scholar 

  38. Osmundson SS, Min JY, Grijalva CG. Opioid prescribing after childbirth: over-prescribing and chronic use. Curr Opin Obstet Gynecol. 2019;31(2):83–9.

    PubMed  PubMed Central  Google Scholar 

  39. Eeckhaut MC, Wagner J, Neitzke-Spruill L, Walker R, Anderson TL. Is the gender gap in overdose deaths (still) decreasing? An examination of opioid deaths in Delaware, 2013–2017. J Stud Alcohol Drugs. 2020;81(1):68–73.

    PubMed  Google Scholar 

  40. Khodneva Y, Richman J, Kertesz S, Safford MM. Gender differences in association of prescription opioid use and mortality: a propensity-matched analysis from the REasons for Geographic And Racial Differences in Stroke (REGARDS) prospective cohort. Subst Abuse. 2019. https://doi.org/10.1080/08897077.2019.1702609.

  41. •• Ataiants J, Mazzella S, Roth AM, Robinson LF, Sell RL, Lankenau SE. Multiple victimizations and overdose among women with a history of illicit drug use. J Interpers Violence. 2020. https://doi.org/10.1177/0886260520927501 This study demonstrates that women have a high rate of polyvictimization, and that polyvictimization is associated with overdose in women with opioid use disorder.

  42. Cleveland LM, McGlothen-Bell K, Scott LA, Recto P. A life-course theory exploration of opioid-related maternal mortality in the United States. Addiction. 2020;115:2079–88. https://doi.org/10.1111/add.15054.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Sumner SA, Mercado-Crespo MC, Spelke MB, Paulozzi L, Sugerman DE, Hillis SD, et al. Use of naloxone by emergency medical services during opioid drug overdose resuscitation efforts. Prehospital Emergency Care. 2016;20(2):220–5.

    PubMed  Google Scholar 

  44. Rhee TG, Peltier MR, Sofuoglu M, Rosenheck RA. Do sex differences among adults with opioid use disorder reflect sex-specific vulnerabilities? A study of behavioral health comorbidities, pain, and quality of life. J Addict Med. 2020. https://doi.org/10.1097/ADM.0000000000000662.

  45. Vigna-Taglianti FD, Burroni P, Mathis F, Versino E, Beccaria F, Rotelli M, et al. Gender differences in heroin addiction and treatment: results from the VEdeTTE cohort. Subst Use Misuse. 2016;51(3):295–309.

    PubMed  Google Scholar 

  46. Campbell ANC, Barbosa-Leiker C, Hatch-Maillette M, Mennenga SE, Pavlicova M, Scodes J, et al. Gender differences in demographic and clinical characteristics of patients with opioid use disorder entering a comparative effectiveness medication trial. Am J Addict. 2018;27(6):465–70.

    PubMed  PubMed Central  Google Scholar 

  47. Barbosa-Leiker C, Campbell ANC, Pavlicova M, Scodes J, Burlew AK, Hatch-Maillette M, et al. Substance use and mental health in emerging adult vs older adult men and women with opioid use disorder. Am J Addict. 2020. https://doi.org/10.1111/ajad.13059.

  48. Lugoboni F, Zamboni L, Mantovani E, Cibin M, Tamburin S, Gruppo InterSERT di Collaborazione Scientifica. Association between adult attention deficit/hyperactivity disorder and intravenous misuse of opioid and benzodiazepine in patients under opioid maintenance treatment: a cross-sectional multicentre study. Eur Addict Res 2020;26:263–273.

  49. El-Bassel N, Gilbert L, Frye V, Wu E, Go H, Hill J, et al. Physical and sexual intimate partner violence among women in methadone maintenance treatment. Psychol Addict Behav. 2004;18(2):180–3.

    PubMed  Google Scholar 

  50. Smith PH, Homish GG, Leonard KE, Cornelius JR. Intimate partner violence and specific substance use disorders: findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychol Addict Behav. 2012;26(2):236–45.

    PubMed  Google Scholar 

  51. • El-Bassel N, Gilbert L, Wu E, Go H, Hill J. Relationship between drug abuse and intimate partner violence: a longitudinal study among women receiving methadone. Am J Public Health. 2005;95(3):465–70 Women in treatment for opioid use disorder are more likely to use other substances if they experience current intimate partner violence.

    PubMed  PubMed Central  Google Scholar 

  52. Frye V, El-Bassel N, Gilbert L, Rajah V, Christie N. Intimate partner sexual abuse among women on methadone. Violence Vict. 2001;16(5):553–64.

    CAS  PubMed  Google Scholar 

  53. El-Bassel N, Gilbert L, Wu E, Chang M, Fontdevila J. Perpetration of intimate partner violence among men in methadone treatment programs in New York City. Am J Public Health. 2007;97(7):1230–2.

    PubMed  PubMed Central  Google Scholar 

  54. Moore BC, Easton CJ, McMahon TJ. Drug abuse and intimate partner violence: a comparative study of opioid-dependent fathers. Am J Orthop. 2011;81(2):218.

    Google Scholar 

  55. Panchanadeswaran S, El-Bassel N, Gilbert L, Wu E, Chang M. An examination of the perceived social support levels of women in methadone maintenance treatment programs who experience various forms of intimate partner violence. Womens Health Issues. 2008;18(1):35–43.

    PubMed  Google Scholar 

  56. de Dios MA, Anderson BJ, Caviness CM, Stein M. Intimate partner violence among individuals in methadone maintenance treatment. Subst Abus. 2014;35(2):190–3.

    PubMed  PubMed Central  Google Scholar 

  57. Wuest J, Ford-Gilboe M, Merritt-Gray M, Wilk P, Campbell JC, Lent B, et al. Pathways of chronic pain in survivors of intimate partner violence. J Women’s Health (Larchmt). 2010;19(9):1665–74.

    Google Scholar 

  58. Pallatino C, Chang JC, Krans EE. The intersection of intimate partner violence and substance use among women with opioid use disorder. Subst Abus. 2019;22:1–8.

    Google Scholar 

  59. Williams JR, Cole V, Girdler S, Cromeens MG. Exploring stress, cognitive, and affective mechanisms of the relationship between interpersonal trauma and opioid misuse. PLoS One. 2020;15(5):e0233185.

    CAS  PubMed  PubMed Central  Google Scholar 

  60. Uebel H, Wright IM, Burns L, Hilder L, Bajuk B, Breen C, et al. Reasons for rehospitalization in children who had neonatal abstinence syndrome. Pediatrics. 2015;136(4):811.

    Google Scholar 

  61. Parolin M, Simonelli A, Mapelli D, Sacco M, Cristofalo P. Parental substance abuse as an early traumatic event. Preliminary findings on neuropsychological and personality functioning in young drug addicts exposed to drugs early. Front Psychol. 2016;7:887.

    PubMed  PubMed Central  Google Scholar 

  62. Chatterjee A, Yu EJ, Tishberg L. Exploring opioid use disorder, its impact, and treatment among individuals experiencing homelessness as part of a family. Drug Alcohol Depend. 2018;188:161–8.

    PubMed  Google Scholar 

  63. Hall MT, Wilfong J, Huebner RA, Posze L, Willauer T. Medication-assisted treatment improves child permanency outcomes for opioid-using families in the child welfare system. J Subst Abus Treat. 2016;71:63–7.

    Google Scholar 

  64. • Feder KA, Mojtabai R, Musci RJ, Letourneau EJ. US adults with opioid use disorder living with children: treatment use and barriers to care. J Subst Abuse Treat. 2018;93:31–7 Mothers with opioid use disorder struggle to find treatment programs that fit their needs. Stigma associated with opioid use disorder is a barrier to treatment.

    PubMed  Google Scholar 

  65. Fang S, Huang N, Tsay J, Chang S, Chen C. Excess mortality in children born to opioid-addicted parents: a national register study in Taiwan. Drug Alcohol Depend. 2018;183:118–26.

    PubMed  Google Scholar 

  66. Lipari RN, Van Horn SL. Children living with parents who have a substance use disorder. The CBHSQ Report Rockville (MD). 2017. Retreived from: https://www.samhsa.gov/data/sites/default/files/report_3223/ShortReport-3223.html. Accessed 30 May 2020.

  67. Clemans-Cope L, Lynch V, Epstein M, Kenney GM. Opioid and substance use disorder and receipt of treatment among parents living with children in the United States, 2015-2017. Ann Fam Med. 2019;17(3):207–11.

    PubMed  PubMed Central  Google Scholar 

  68. Hooker SA, Sherman MD, Lonergan-Cullum M, Sattler A, Liese BS, Justesen K, et al. Mental health and psychosocial needs of patients being treated for opioid use disorder in a primary care residency clinic. J Prim Care Community Health. 2020;11:2150132720932017.

    PubMed  PubMed Central  Google Scholar 

  69. Swain JE, Ho SS. Neuroendocrine mechanisms for parental sensitivity: overview, recent advances and future directions. Curr Opin Psychol. 2017;15:105–10.

    PubMed  PubMed Central  Google Scholar 

  70. Swain JE, Ho SS, Fox H, Garry D, Brummelte S. Effects of opioids on the parental brain in health and disease. Front Neuroendocrinol. 2019;54:100766.

    CAS  PubMed  Google Scholar 

  71. Maguire DJ, Taylor S, Armstrong K, Shaffer-Hudkins E, DeBate R, Germain AM, et al. Characteristics of maternal-infant interaction during treatment for opioid withdrawal. Neonatal Netw. 2016;35(5):297–304.

    PubMed  Google Scholar 

  72. Betcher HK, Vande Voort JL, Croarkin PE, Gandhi KD, Shekunov J, Larrabee BR, et al. Effects of parental opioid use: outcomes of children of parents in medication-assisted treatment compared to healthy controls. Prim Care Companion CNS Disord. 2019;21(4):19m02474. https://doi.org/10.4088/PCC.19m02474.

    Article  PubMed  Google Scholar 

  73. • Brent DA, Hur K, Gibbons RD. Association between parental medical claims for opioid prescriptions and risk of suicide attempt by their children. JAMA Psychiatry. 2019;76(9):941-7 This study reports that opioid use in mothers is associated with suicidal behaviors in children, suggesting that opioid use has negative consequences within family units.

  74. Finer LB, Zolna MR. Declines in unintended pregnancy in the United States, 2008-2011. N Engl J Med. 2016;374(9):843–52.

    CAS  PubMed  PubMed Central  Google Scholar 

  75. Heil SH, Jones HE, Arria A, Kaltenbach K, Coyle M, Fischer G, et al. Unintended pregnancy in opioid-abusing women. J Subst Abus Treat. 2011;40(2):199–202.

    Google Scholar 

  76. Leinaar E, Brooks B, Johnson L, Alamian A. Perceived barriers to contraceptive access and acceptance among reproductive-age women receiving opioid agonist therapy in Northeast Tennessee. South Med J. 2020;113(5):213–8.

    PubMed  Google Scholar 

  77. Smith C, Morse E, Busby S. Barriers to reproductive healthcare for women with opioid use disorder. J Perinat Neonatal Nurs. 2019;33(2):E3–E11.

    PubMed  Google Scholar 

  78. Barton K, Redshaw M, Quigley MA, Carson C. Unplanned pregnancy and subsequent psychological distress in partnered women: a cross-sectional study of the role of relationship quality and wider social support. BMC Pregnancy Childbirth. 2017;17(1):44.

    PubMed  PubMed Central  Google Scholar 

  79. Hall KS, Dalton VK, Zochowski M, Johnson TRB, Harris LH. Stressful life events around the time of unplanned pregnancy and women’s health: exploratory findings from a national sample. Matern Child Health J. 2017;21(6):1336–48.

    PubMed  PubMed Central  Google Scholar 

  80. Sullins DP. Affective and substance abuse disorders following abortion by pregnancy intention in the United States: a longitudinal cohort study. Medicina (Kaunas). 2019;55(11):741. https://doi.org/10.3390/medicina55110741.

    Article  Google Scholar 

  81. Ti A, Stone RH, Whiteman M, Curtis KM. Safety and effectiveness of hormonal contraception for women who use opioids: a systematic review. Contraception. 2019;100(6):480–3.

    CAS  PubMed  Google Scholar 

  82. Rey CN, Badger GJ, Melbostad HS, Wachtel D, Sigmon SC, MacAfee LK, et al. Perceptions of long-acting reversible contraception among women receiving medication for opioid use disorder in Vermont. Contraception. 2020;101(5):333–7.

    CAS  PubMed  Google Scholar 

  83. Klaman SL, Turner K, Lorvick J, Jones HE. Integrating reproductive and sexual health education and services into opioid use disorder treatment programs: a qualitative study. J Addict Med. 2020;14(5):e175-82.

  84. Griesler PC, Hu MC, Wall MM, Kandel DB. Nonmedical prescription opioid use by parents and adolescents in the US. Pediatrics. 2019;143(3):e20182354. https://doi.org/10.1542/peds.2018-2354.

  85. Pragst F, Krumbiegel F, Thurmann D, Westendorf L, Methling M, Niebel A, et al. Hair analysis of more than 140 families with drug consuming parents. Comparison between hair results from adults and their children. Forensic Sci Int. 2019;297:161–70.

    CAS  PubMed  Google Scholar 

  86. Elam KK, Sternberg A, Waddell JT, Blake AJ, Chassin L. Mother and father prescription opioid misuse, alcohol use disorder, and parent knowledge in pathways to adolescent alcohol use. J Youth Adolesc. 2020;49(8):1663–73.

    PubMed  Google Scholar 

  87. Finkelstein Y, Macdonald EM, Gonzalez A, Sivilotti MLA, Mamdani MM, Juurlink DN, et al. Overdose risk in young children of women prescribed opioids. Pediatrics. 2017;139(3):e20162887. https://doi.org/10.1542/peds.2016-2887.

  88. Cicek E, Demirel B, Ozturk HI, Kayhan F, Cicek IE, Eren I. Burden of care and quality of life in relatives of opioid dependent male subjects. Psychiatr Danub. 2015;27(3):273–7.

    PubMed  Google Scholar 

  89. Adam M, Kitt-Lewis E. Family members lived experience with an opioid addicted loved one. J Addict Dis. 2020;02:1–7.

    Google Scholar 

  90. Davis MT, Warfield ME, Boguslaw J, Roundtree-Swain D, Kellogg G. Parenting a 6-year old is not what I planned in retirement: trauma and stress among grandparents due to the opioid crisis. J Gerontol Soc Work. 2020;63(4):295–315.

    PubMed  Google Scholar 

  91. Olsen Y, Sharfstein JM. Confronting the stigma of opioid use disorder-and its treatment. JAMA. 2014;311(14):1393–4.

    PubMed  Google Scholar 

  92. Schiff DM, Wachman EM, Philipp B, Joseph K, Shrestha H, Taveras EM, et al. Examination of hospital, maternal, and infant characteristics associated with breastfeeding initiation and continuation among opioid-exposed mother-infant dyads. Breastfeed Med. 2018;13(4):266–74.

    PubMed  PubMed Central  Google Scholar 

  93. Howard MB, Wachman E, Levesque EM, Schiff DM, Kistin CJ, Parker MG. The joys and frustrations of breastfeeding and rooming-in among mothers with opioid use disorder: a qualitative study. Hosp Pediatr. 2018;8(12):761–8.

    PubMed  Google Scholar 

  94. Scott LF, Stone C, Duwve J. Policy perceptions of US state public health and child and family services regarding maternal opioid use and neonatal exposure. Arch Psychiatr Nurs. 2019;33(5):22–30.

    PubMed  Google Scholar 

  95. Sanmartin MX, Ali MM, Lynch S, Aktas A. Association between state-level criminal justice-focused prenatal substance use policies in the US and substance use-related foster care admissions and family reunification. JAMA Pediatr. 2020;174(8):782-788.

  96. Sanmartin M, Ali M, Lynch S. Foster care admissions and state-level criminal justice-focused prenatal substance use policies. Child Youth Serv Rev. 2019;102:102–7.

    Google Scholar 

  97. Welle-Strand GK, Skurtveit S, Abel KF, Chalabianloo F, Sarfi M. Living a normal life? Follow-up study of women who had been in opioid maintenance treatment during pregnancy. J Subst Abuse Treat. 2020;113:108004.

    PubMed  Google Scholar 

  98. McGlothen KS, Cleveland LM. The right to mother’s milk: a call for social justice that encourages breastfeeding for women receiving medication-assisted treatment for opioid use disorder. J Hum Lact. 2018;34(4):799–803.

    PubMed  Google Scholar 

  99. Stephen JM, Shrestha S. Substance Use Research and Education (SURE) Center, University of New Mexico College of Pharmacy, Yakes Jimenez E, Williams SM, Ortega A, Cano S, et al. Disparities in breastfeeding outcomes among women with opioid use disorder. Acta Paediatr. 2020;109(5):1064–6.

    PubMed  Google Scholar 

  100. Yonke N, Jimenez EY, Leeman L, Leyva Y, Ortega A, Bakhireva LN. Breastfeeding motivators and barriers in women receiving medications for opioid use disorder. Breastfeed Med. 2020;15(1):17–23.

    PubMed  Google Scholar 

  101. Jansson LM, Choo R, Velez ML, Harrow C, Schroeder JR, Shakleya DM, et al. Methadone maintenance and breastfeeding in the neonatal period. Pediatrics. 2008;121(1):106–14.

    PubMed  Google Scholar 

  102. Ling S, Mangaoil R, Cleverley K, Sproule B, Puts M. A systematic review of sex differences in treatment outcomes among people with opioid use disorder receiving buprenorphine maintenance versus other treatment conditions. Drug Alcohol Depend. 2019;197:168–82.

    CAS  PubMed  Google Scholar 

  103. Dunn KE, Huhn AS, Strain EC. Differential adoption of opioid agonist treatments in detoxification and outpatient settings. J Subst Abus Treat. 2019;107:24–8.

    Google Scholar 

  104. Huhn AS, Hobelmann JG, Strickland JC, Oyler GA, Bergeria CL, Umbricht A, et al. Differences in availability and use of medications for opioid use disorder in residential treatment settings in the United States. JAMA Netw Open. 2020;3(2):e1920843.

    PubMed  Google Scholar 

  105. Pro G, Utter J, Cram J, Baldwin J. Racial/ethnic and gender differences in associations of medication-assisted therapy and reduced opioid use between outpatient treatment admission and discharge. J Psychoactive Drugs. 2020;52(2):186–94.

    PubMed  Google Scholar 

  106. Finan PH, Mun CJ, Epstein DH, Kowalczyk WJ, Phillips KA, Agage D, et al. Multimodal assessment of sleep in men and women during treatment for opioid use disorder. Drug Alcohol Depend. 2020;207:107698.

    CAS  PubMed  Google Scholar 

  107. Adams JW, Marshall BDL, Mohd Salleh NA, Barrios R, Nolan S, Milloy MJ. Receipt of opioid agonist treatment halves the risk of HIV-1 RNA viral load rebound through improved ART adherence for HIV-infected women who use illicit drugs. Drug Alcohol Depend. 2020;206:107670.

    CAS  PubMed  Google Scholar 

  108. van Reekum EA, Rosic T, Hudson J, Sanger N, Marsh DC, Worster A, et al. Social functioning outcomes in men and women receiving medication-assisted treatment for opioid use disorder. Biol Sex Differ. 2020;11(1):20–4.

    PubMed  PubMed Central  Google Scholar 

  109. Saraiya TC, Swarbrick M, Franklin L, Kass S, Campbell ANC, Hien DA. Perspectives on trauma and the design of a technology-based trauma-informed intervention for women receiving medications for addiction treatment in community-based settings. J Subst Abus Treat. 2020;112:92–101.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD, 21224, USA

    Andrew S. Huhn & Kelly E. Dunn

Authors
  1. Andrew S. Huhn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kelly E. Dunn
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrew S. Huhn.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Sex and Gender Issues in Behavioral Health

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Huhn, A.S., Dunn, K.E. Challenges for Women Entering Treatment for Opioid Use Disorder. Curr Psychiatry Rep 22, 76 (2020). https://doi.org/10.1007/s11920-020-01201-z

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11920-020-01201-z

Keywords

Search

Navigation