Considerations for Women
The National Institute on Drug Abuse (NIDA) discusses some of the sex and gender
differences in substance use disorders (SUDs). For example, substance use can have different physical
effects on women compared to men, including effects of the heart, blood vessels, and brain. Because of these
differences, women may benefit from different types of SUD treatment than men. However, research has
shown that rural areas often lack
options for specialty treatment programs designed for specific populations, such as women.
The Substance Abuse and Mental Health Services Administration's (SAMHSA) Treatment Improvement Protocol identifies several
factors that affect adherence to treatment for women. These include:
- Socio-demographics such as age, education, race/ethnicity, and relationships
- Involvement of the criminal justice system or child protective services
- Treatment environment
- Type of treatment services
- Other considerations
These factors should be considered when implementing rural SUD treatment programs. For example, when
developing the curriculum for a tobacco use cessation program, program planners may need to
in the effects of tobacco on women compared to men and know that nicotine replacement therapies
are not as effective in women as they are in men.
The U.S. Department of Health and Human Services Office on
Women's Health has developed an initiative focusing on the prevention and treatment of opioid use
disorder among women. The initiative began with a national
in September 2016 and is funding programs addressing the prevention of prescription and
non-prescription opioid use disorder among women, particularly among underserved populations of
adolescent girls (ages 10 to 17) and women age 50 and older. Efforts focus on using Screening,
Brief Intervention, and Referral to Treatment (SBIRT), integrating opioid use disorder prevention
services with primary care, and developing and/or enhancing partnerships within communities. As part
of this initiative, OWH published a white paper, which outlines promising
practices for treating women with SUD. For example, programs that serve women may need to
consider that women often act as caregivers for their child(ren). Offering a family-centered
treatment approach may help ensure women do not feel like they need to choose between caring for
their family and enrolling in SUD treatment.
Resources to Learn More
Approach to the Treatment of Pregnant Women with Opioid Use Disorders: Practice and Policy
Considerations for Child Welfare, Collaborating Medical, and Service Providers
Offers guidance to states, tribes, local communities, and service providers when developing
interagency policies and practices supporting the treatment and recovery of pregnant women with
substance use disorders and interventions to reduce the effect of prenatal substance exposure.
Emphasizes the importance of a coordinated, multi-system approach to affect change, improve outcomes
and promote program sustainability.
Organization: Substance Abuse and Mental Health Services Administration
Neonatal and Maternal Hospital Stays Related to Substance Use, 2006-2012
Examines newborn and maternal inpatient hospital stays associated with substance use based on data
from 38 states. Hospital and patient characteristics, including the patient's residence by
metropolitan and nonmetropolitan counties, are provided in Table 2.
Authors: Fingar, K., Stocks, C., Weiss, A., & Owens, P.
Organization: Agency for Healthcare Research and Quality
Rural and Urban
Differences in Neonatal Abstinence Syndrome and Maternal Opioid Use, 2004 to 2013
Examines the characteristics of infants and mothers with opioid-related diagnoses in rural and urban
counties of the U.S. using data from 2004 to 2013. Discusses the increases in neonatal abstinence
syndrome (NAS) and the frequency of hospital deliveries complicated by maternal opioid use of
patients during the same time period.
Authors: Villapiano, N., Winkelman, T., Kozhimannil, K., et al.
Citation: JAMA Pediatrics
White Paper: Opioid
Use, Misuse, and Overdose in Women
Examines prevention, treatment, and recovery issues related to opioid use disorder and/or
opioid overdoses among women.
Organization(s): U.S. Department of Health and Human Services, Office on Women's Health
Gender and Addiction
Discusses sex and gender differences including social, environmental, biological, and developmental
factors that influence drug and alcohol addiction.
Author(s) Becker, J., McClellan, M., & Glover Reed, B.