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WHRY Offers Roadmap to Address Sex Differences in Opioid Epidemic

January 11, 2021

The opioid epidemic continues in this country in the midst of the current COVID-19 pandemic in the United States.

To help halt the ongoing addiction and overdose deaths, Women’s Health Research at Yale (WHRY) is now proposing a data-driven way forward to uncover and more effectively negotiate differences among women and men in opioid use.

In a newly published paper, WHRY summarizes research demonstrating that the opioid epidemic was first fueled by the over-prescription of medications, particularly for alleviating pain. This trend has affected women more than men and resulted in prescription opioids becoming the primary route to opioid misuse and addiction by women in the country.

In the review and commentary published in The FASEB Journal, the official journal of the Federation of American Societies for Experimental Biology, WHRY Director Carolyn M. Mazure, Ph.D.; Jill Becker, Ph.D., Chair of Biopsychology at the University of Michigan; and Teddy G. Goetz, Yale ’17, a former WHRY fellow and now a fourth year medical student at Columbia University’s Vagelos College of Physicians and Surgeons, argue the case for studying sex-and-gender differences in opioid use to effect better outcomes for everyone.

To address the ongoing opioid public health crisis, the authors assert the necessity of research focusing on how women and men experience pain differently and the intersection of pain and addiction. Furthermore, current knowledge obtained from empirical research on sex-and-gender differences in opioid use and misuse must be deployed to inform clinical care, and public policy must incorporate the unique needs of women and men. For example, there is a dramatic need to adopt public health policies that protect the custody rights of mothers who seek treatment and recognize the unmet needs of women recovering from opioid use disorder.

We need to intentionally consider the health of all women and incorporate the spectrum of sex-and-gender differences in our population to best serve the public health.

Dr. Carolyn Mazure

The authors document that women suffer more acute and chronic pain than men, are more commonly prescribed opioid medications than men, and are given opioids at higher rates than men who report pain. Between 1999 and 2016, overdose deaths from opioid prescriptions increased by 583 percent for women — a rate 179 percent higher than for men. Initial efforts to address the opioid epidemic focused largely on reducing access to prescription opioids. However, without adequate treatment options, many with opioid use disorder sought illicit opioids — such as heroin and the high-potency opioid fentanyl — highlighting the need for more and better treatments of both pain and opioid use disorder.

“We have highlighted the importance of research dedicated to understanding opioid use in all persons and have provided data illustrating the need to recognize sex and gender differences in research, treatment planning and health policy,” Mazure said. “We need to intentionally consider the health of all women and incorporate the spectrum of sex-and-gender differences in our population to best serve the public health and derive better health outcomes.”

The paper is one in an ongoing series on the role of sex and gender on health led by Dr. Nina Stachenfeld, a fellow at the John B. Pierce Laboratory and Professor of Obstetrics, Gynecology, and Reproductive sciences. The series, “Sex as a Variable in Human Research: A Systems Approach,” will continue to appear over the next few months in The FASEB Journal.

Submitted by Rick Harrison on January 12, 2021