The Effects of Opioid Abuse on Women

Are Women More Likely to Use Opioids?

Men are more likely than women to use the illicit opioid heroin during the past 30 days, however, women are more likely than men to use other opioids, such as prescription pain relievers.²

Women are also more likely than men to experience chronic pain and be prescribed prescription pain relievers.³ Women use prescription opioid pain medications for longer periods and are prescribed higher doses than men.³

Women between the ages of 45 and 54 are more likely than women of other age groups to die from a prescription opioid overdose.⁴

Initial consumption of opioid drugs may be in accordance with prescribed guidance or, in the case of illicit use, as isolated experimentation. Regular use, and especially misuse, may sometimes promote eventual compulsive patterns of use and misuse that are further reinforced by the rewarding neurochemical effects of these drugs.⁵

Signs an individual may have an opioid use disorder include:⁶

• Failure to follow through on obligations at home, work, or school.
• Social problems.
• Struggle to control use of opioids.
• Unsuccessful efforts to decrease the use of opioids.

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Women & Opioid Use Statistics

Opioids are naturally found in the opium poppy plant and although some opioids are derived from the plant itself (these are called “opiates”), they can also be manufactured in a lab using the same chemical structure (i.e., “semi-synthetic opioids” or “synthetic opioids”).⁷ Opioid pain killers are generally prescribed to reduce pain.⁷ They include:^{5, 8}

• Prescription opiate and semi-synthetic opioid pain relievers like hydrocodone, morphine, and oxycodone.
• Synthetic opioids that are used medicinally, such as fentanyl and methadone.
• The illegal drug heroin and illicitly produced fentanyl-related synthetic opioids.

The prevalence of opioid abuse is unfortunately more common than one would think. In 2018, around 4.5 million American women (3.5%) aged 18 or older, misused opioids in the past year. A little over 300,000 women aged 18 or older used heroin.⁹

During 2015-2018, there has been significant decreases of prescription opioid misuse among female adolescents and young adults.⁹ There were no significant changes in heroin use and opioid use disorder among women of all age categories during this same time.⁹

American Addiction Centers offers premier treatment programs for substance use disorders. If you or a family member are battling an opioid use disorder, reach out to one of our admissions navigators at

Women & Opioids

Although abuse of opioid drugs has a harmful impact on both men and women alike, the opioid epidemic raises particular concerns with females.  Women are more inclined to develop an opioid dependency in a shorter timespan than their male counterparts.¹⁴

Potential factors for women’s dependency susceptibility include:^{14, 15}

• Smaller framed bodies, opioids have a greater biological impact on women.
• The connection between hormones, such as estrogen and a heightened sensitivity to pain and women’s propensity to have chronic pain. This may drive the use for prescription opioids to manage pain.
• Personal experiences of emotional and psychological grief and trauma, such as sexual assault or domestic violence with a partner, which have been discovered to be risk factors in the use of opioids in women, yet not in men.

Motherhood, Pregnancy, and Opioids

There have been significant increases of opioid abuse during pregnancy in recent years resulting in a 5-fold increase in opioid withdrawal being experienced by newborns (known as “neonatal abstinence syndrome”).¹⁷

Using prescription opioid painkillers or heroin during pregnancy can be dangerous for both the mother as well as the fetus. Continually using opioids may lead to addiction, dependence, and withdrawal syndrome due to the physiological changes that it creates within the central nervous system.¹⁸ As such, opioid use disorder can cause maternal death, and for the fetuses may result in impaired fetal growth, birth defects, preterm birth, and stillbirth, in addition to neonatal abstinence syndrome (NAS).¹⁹

NAS collectively represents conditions that a newborn experience when they withdraw from specific substances (such as opioids) that they were exposed to before being born. Signs of NAS usually present themselves within 72 hours after birth.¹⁹

The signs of neonatal abstinence syndrome that a newborn might experience, as well as their severity, depends on a number of factors. Signs may include:¹⁹

• High-pitched or excessive crying.
• Hyperactive reflexes.
• Increased sweating.
• Loose stools.
• Poor feeding and sucking.
• Seizures.
• Sleep problems.
• Stuffy nose, sneezing, and yawning.
• Tremors.
• Vomiting.

Not all newborns exposed to opioids during pregnancy experience signs of NAS, and there is limited information about longer-term outcomes of children exposed to opioids prenatally.²⁰

The postpartum period may present a number of emotions in the new mother, especially for a woman who may be at risk for a relapse with opioids. Increased stressors may lead to a relapse or overdose events.¹⁹

Pregnant women undergoing medication-assisted treatment for an opioid use disorder will likely be advised to continue with their medication-assisted treatment during pregnancy and during the postpartum period. Prescribers may change the dosage throughout the course of pregnancy. Abruptly stopping treatment directly after delivery should be avoided. As the mother begins to stabilize and connects with her newborn, it may then be safe for her to discontinue under the careful supervision of a physician.^{22, 23}

Withdrawing from Opioids

Withdrawing from opioids may be extremely uncomfortable and can make it seemingly impossible to quit. Tapering off opioids can help minimize withdrawal symptoms but it can be difficult to do without the proper support.²¹ Medically assisted treatment started during detox is often used to stabilize a patient and help minimize withdrawal symptoms and drug cravings. In addition to medications, this type of treatment also includes behavioral counseling in order to more effectively treat patients.^{22, 24, 25}

Withdrawal symptoms from opioids may include:²⁶

• Anxiety.
• Cold and hot flashes.
• Diarrhea.
• Insomnia.
• Muscle cramps and bone pain.
• Nausea and vomiting.
• Perspiration.
• Severe cravings.

Pregnant women who are addicted to heroin or prescription opioids can also benefit from medical detox and medically assisted treatment for opioid use disorder, which includes the use of buprenorphine or methadone. Tapering off opioids altogether during pregnancy is generally discouraged, as the risks may outweigh the benefits, according to recent guidelines published by the American Society for Addiction Medicine.²³ Use of buprenorphine or methadone is associated with improved outcomes for babies as well as reduced symptoms of neonatal abstinence syndrome and reduced length of hospital stay.²⁴

Finding Opioid Addiction Treatment

Seeking out a licensed treatment facility that offers medical detox and inpatient or outpatient treatment for opioid use disorder is an option many people choose in order to successfully manage their opioid addiction.

Often with the treatment of opioid use disorders, doctors use medication assisted treatment in order to alleviate uncomfortable withdrawal symptoms as well as reduce cravings for opioids.²² Medications used during an opioid detox and subsequent treatment may include:²⁴

• Buprenorphine. The name brands that tend to be used are Suboxone or Subutex.
• Methadone.

American Addiction Centers (AAC) is the nation’s leader in addiction treatment, providing treatment facilities across the country in such states like California, Texas, Florida, and others. Our facilities offer medical detox from opioids in a safe, comfortable environment and under the care of a licensed medical doctor. We also offer outpatient and inpatient residential treatment and ongoing aftercare services to help patients better achieve long-term sobriety.

River Oaks Treatment Center, in Tampa, FL, specializes in addiction treatment for pregnant women. In addition to our River Oaks Treatment Center, all of our facilities offer unique care and treatment plans to help every patient’s individual needs. AAC also accepts many healthcare insurance providers. You can verify your insurance to see if your treatment is covered by your insurance provider.

Opioid use disorders are a threat to many lives and the families of the loved ones who are battling opioid addiction. Regardless of whether the addicted is a man, woman, or a newborn, solutions point to treatment under proper medical care. The opioid crisis is ongoing, but help is only one phone call away.

Sources

1. National Women’s Health Network. (2018). Women & the Opioid Epidemic.
2. Back, S. E., Payne, R. L., Wahlquist, A. H., Carter, R. E., Stroud, Z., Haynes, L., Hillhouse, M., Brady, K. T., & Ling, W. (2011). Comparative profiles of men and women with opioid dependence: results from a national multisite effectiveness trial. The American journal of drug and alcohol abuse, 37(5), 313–323.
3. American Society of Addiction Medicine. (2016). Opioid Addiction 2016 Facts & Figures.
4. National Institute on Drug Abuse. (2020). Sex and Gender Differences in Substance Use.
5. U.S. Department of Health and Human Services. (2018). What are opioids?
6. Centers for Disease Control and Prevention. (2020). Opioid Basics.
7. National Institute on Drug Abuse. (2020). What are prescription opioids?
8. Drug Enforcement Administration. (2020). Synthetic Opioids.
9. Substance Abuse and Mental Health Services Administration. (2020). 2018 National Survey on Drug Use and Health: Women.
10. National Institute on Drug Abuse. (2020). Opioid Overdose Crisis.
11. Substance Abuse and Mental Health Services Administration. (2018). 2018 National Survey on Drug Use and Health: Women.
12. SAMHSA. (2019). 2019 NSDUH Detailed Table.
13. Substance Abuse and Mental Health Treatment Services Administration. (2019). Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health.
14. Office of Women’s Health. (2017). Final Report: Opioid Use, Misuse, and Overdose in Women.
15. Centers for Disease Control and Prevention. (2018). Prescriptions Painkiller Overdoses.
16. National Institute on Drug Abuse. (2020). Overdose Death Rates.
17. National Institute on Drug Abuse (2019). Dramatic Increases in Maternal Opioid Use and Neonatal Abstinence Syndrome.
18. Wallace M.S., Papp A. (2017) Opioid Withdrawal. Challenging Cases and Complication Management in Pain Medicine. Springer, Cham. (15-20).
19. Centers for Disease Control and Prevention. (2020). About Opioid Use During Pregnancy.
20. National Center for Biotechnology Information. (2009). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings.
21. Centers for Disease Control and Prevention. Pocket Guide: Tapering Opioids for Chronic Pain.
22. Substance Abuse and Mental Health Treatment Services Administration. (2020). TIP 63: Medications for Opioid Use Disorder.
23. American Society of Addiction Medicine. (2020). The ASAM National Practice Guidelines for the Treatment of Opioid Use Disorder.
24. National Institute on Drug Abuse. (2016). Effective Treatments for Opioid Addiction.
25. Substance Abuse and Mental Health Treatment Services Administration. (2015). TIP 45: Detoxification and Substance Abuse Treatment.
26. National Center for Biotechnology Information. (2009). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings