Background and objectives: In order to address the current opioid crisis, research on treatment outcomes for persons with opioid use disorder (OUD) should account for biological factors that could influence individual treatment response. Women and men might have clinically meaningful differences in their experience in OUD treatment and might also have unique challenges in achieving successful, long-term recovery. This review summarizes and synthesizes the current literature on sex-based differences in OUD treatment outcomes.
Methods: Relevant literature was identified via automated and manual searches using the terms "opioid treatment outcome sex [or gender] differences" and "opiate treatment outcome sex [or gender] differences." Search methodology was consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and were conducted within the PubMed electronic database during March and April of 2018.
Results: The initial PubMed search yielded 241 manuscripts and 31 original research articles that met inclusion/exclusion criteria were synthesized in this review. Several important trends emerged, including findings that women are more likely than men to present to treatment with co-occurring mental health conditions such as depression, and that women might respond particularly well to buprenorphine maintenance.
Discussion and conclusions: While much of the literature on this topic is subject to potential cohort effects, interventions that address co-occurring mental health conditions and psychosocial stress might improve treatment outcomes for women with OUD.
Scientific significance: Funding agencies and researchers should focus attention toward human laboratory studies and clinical trials that are prospectively designed to assess sex-based differences in OUD recovery. (Am J Addict 2019;28:246-261).
© 2019 American Academy of Addiction Psychiatry.
Conflict of interest statement
Evaluating Comparative Effectiveness of Psychosocial Interventions for Persons Receiving Opioid Agonist Therapy for Opioid Use Disorder: Protocol for a Systematic ReviewDB Rice et al. BMJ Open 8 (10), e023902. PMID 30341139.This will be the first systematic review to incorporate NMA to compare psychosocial treatments used as an adjunct to opioid agonist therapy for OUD. Results of this revie …
Screening and Interventions for Childhood Overweight [Internet]EP Whitlock et al. PMID 20722132. - ReviewBMI measurement to detect overweight in older adolescents could identify those at increased risk of developing adult obesity, and its consequent morbidities. Promising in …
Behavioral and Pharmacotherapy Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults: An Updated Systematic Review for the U.S. Preventive Services Task Force [Internet]EL LeBlanc et al. PMID 30354042. - ReviewWe found that behavior-based weight-loss interventions with or without weight loss medications resulted in more weight loss than usual care conditions. The degree of weig …
Effects of Medication Assisted Treatment (MAT) for Opioid Use Disorder on Functional Outcomes: A Systematic ReviewMA Maglione et al. J Subst Abuse Treat 89, 28-51. PMID 29706172.This systematic review synthesizes evidence on the effects of Medication-Assisted Treatment (MAT) for opioid use disorder (OUD) on functional outcomes, including cognitiv …
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 GuidanceSL Klaman et al. J Addict Med 11 (3), 178-190. PMID 28406856. - ReviewWomen with OUD can be treated with methadone or buprenorphine during pregnancy. NAS is an expected and manageable condition. Although research has substantially advanced, …
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The Impact of the Opioid Epidemic on Children and AdolescentsEL Winstanley et al. Clin Ther 41 (9), 1655-1662. PMID 31303278.Although an epidemic of opioid-related overdose deaths has continued to increase in the United States for 2 decades, the impact of opioid use disorders (OUDs) on children …