Featured News: Study Finds “Gender Paradox” in Opioid Overdose Rates Among Young Adults

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A study of young adults who misuse opioids finds that although women have a higher prevalence of potential risk factors for overdose such as mental health issues and sexual victimization, their lifetime prevalence of overdose is similar to that of men. This suggests women may have some protective factors that mitigate overdose risk, says lead author Kelly A. Quinn, MPH, PhD, Research Assistant Professor in the Department of Population Health at NYU Langone Health and researcher at National Development and Research Institutes (NDRI).

“Females in this sample have so many extra life stressors, yet they aren’t necessarily misusing drugs at higher rates than men or engaging in riskier practices,” she said. “We don’t yet know which protective factors might explain this ‘gender paradox’ in opioid overdose, but we think it could be social support, or increased resiliency, or greater knowledge of how to use drugs without harming themselves,” Dr. Quinn said. She presented findings at the recent annual meeting of the College on Problems of Drug Dependence with co-authors and NDRI Principal Investigators of the main study, Honoria Guarino and Pedro Mateu-Gelabert.

As documented by other researchers, gender disparities are emerging in opioid use, Dr. Quinn said. Women are prescribed opioids at higher rates and doses and for longer periods than men. The overdose death rate increased by 415 percent for women (compared with 265 percent for men) from 1999 to 2010.

The new study included 539 men and women ages 18 to 29 from New York City who used opioids non-medically in the previous month. The researchers found the overall rate of overdose was 47 percent for women and 42 percent for men. “The rate is alarmingly high for both males and females, but it did not differ significantly by gender,” Dr. Quinn said.

When the researchers examined risk factors for overdose by gender, they found females had statistically significant higher prevalence of many measures, including depression, anxiety and sexual victimization. For example, 77.5 percent of women and 56 percent of men had a history of depression; 84 percent of women and 62 percent of men had a history of anxiety; and 34 percent of women and 9.5 percent of men reported being sexually violated while using drugs.

There were very few significant differences between males and females in terms of drug use behaviors, such as the age at which they started using opioids non-medically, and the number of doctors they visited to get opioids.

The study found women with a history of depression and anxiety had 4.5 times the odds of overdose compared with women without a history of those mental health issues. The findings have implications for prevention of opioid overdoses, Dr. Quinn said. “We know mental health and sexual victimization issues are strongly associated with overdose, so we need to screen for them before a person overdoses,” she said. “The high rate of overdoses among young adults in this sample also point to the fact that like it or not, overdose is a reality, and we need to get serious about providing Narcan (naloxone) to treat overdoses.”

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