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Research has shown that rural areas often lack options for specialty treatment programs designed for specific populations such as women. The National Institute on Drug Abuse discusses sex and gender differences in substance use disorders, especially for women.

Women frequently assume caregiving roles, often taking on the responsibility of caring for children, older parents, or other family members. Women seeking treatment may be unable to abandon their role as caregiver which presents a significant barrier to care. Mothers may perform better in treatment if they can continue to fulfill their role as a caregiver. Also, and women may have a better experience in treatment if they can continue treatment at the same facility or with the same providers.

The Substance Abuse and Mental Health Services Administration's Treatment Improvement Protocol identifies several factors that affect adherence to treatment for women, including:

  • Socio-demographics such as age, education, race/ethnicity, and relationships
  • Involvement of the criminal justice system or child protective services
  • Pregnancy
  • Treatment environment
  • Type of treatment services
  • Other considerations

These factors should be considered when implementing rural substance use disorder treatment programs.

The U.S. Department of Health and Human Services Office on Women's Health (OWH) has developed an initiative focusing on the prevention and treatment of opioid use disorder among women. The initiative began with a national kick-off meeting 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.

Resources to Learn More

A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders
Guide for service providers on best practices for treatment approaches among women living with substance use disorders.
Organization: Substance Abuse and Mental Health Services Administration
Date: 10/2016

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. Table 2 provides data by location of patient residence, for rural and urban locations.
Authors: Fingar, K., Stocks, C., Weiss, A., Owens, P.
Organization: Agency for Healthcare Research and Quality
Date: 7/2015

Rural and Urban Differences in Neonatal Abstinence Syndrome and Maternal Opioid Use, 2004 to 2013
Examines increasing rates of neonatal abstinence syndrome in rural counties of the United States.
Authors: Villapiano, N., Winkelman, T., Kozhimannil, K., Davis, M., and Patrick, S.
Citation: JAMA Pediatrics
Date: 12/2016

White Paper: Opioid Use, Misuse, and Overdose in Women
Explores issues related to opioid use disorder, prevention, and treatment among women.
Organization(s): U.S. Department of Health and Human Services Office on Women's Health
Date: 12/2016