Gender, a biological determinant of mental health and illness, plays a critical role in determining susceptibility, exposure to mental health risks, and related outcomes of opioid addicted patients. Regarding sex differences in the epidemiology of opioid dependence, one third are women of childbearing age. Women have an earlier age of initiation of substance use and a more rapid progression to drug involvement and dependence than men. Generally few studies exist which focus on the special needs of women in opioid maintenance therapy.
The aim of this course is to provide an overview of treatment options for opioid-dependent women, with a special focus on buprenorphine, and to look at recent findings related to other factors that should be taken into consideration in optimizing the treatment of opioid-dependent women. Issues addressed include the role of gender in the choice of medication-assisted treatment, sex differences in pharmacodynamics, and the pharmacokinetics of buprenorphine drug interactions, cardiac interactions, induction of buprenorphine in pregnant patients, the neonatal abstinence syndrome and breastfeeding. This course aims to heighten the awareness of the need to take gender into consideration when making treatment decisions in an effort to optimize services and enhance the quality of life of women suffering from substance abuse.
This course is based upon material published as an author manuscript for the Journal of Addictive Diseases and is available as an open-access article from the National Institutes of Health. This course on gender-based differences in opioid addiction medications is designed for social workers, professional counselors, psychologists, nurses, and substance abuse counselors, who do clinical work. This course is appropriate for beginning, intermediate and advanced level practitioners who wish to develop their understanding of gender-based differences in medication-assisted withdrawal. The course material includes a review of pharmacodynamics and pharmacokinetics, especially concerning the use of buprenorphine in pregnant and postpartum women. It may also be useful for licensed clinicians who require clinical continuing education courses for license renewal.
Authors: Annemarie Unger, MD, Erika Jung, MD, Bernadette Winklbaur, PhD, and Gabriele Fischer, MD
Learning Objectives: This course will provide the practitioner with detailed information regarding medication-assisted opioid withdrawal, particularly in pregnant and postpartum women. Specifically, a professional will:
- Describe the role of gender in the choice of medication-assisted treatment for opioid addiction
- Identify sex differences in pharmacodynamics among the medications available for withdrawal assistance
- Recognize neonatal abstinence syndrome
Citation: Unger, Annmarie; Jung, Erika; Winklbaur, Bernadette; and Fischer, Garbriele. (2010). Gender Issues in the Pharmacotherapy of Opioid-Addicted Women: Buprenorphine. Author manuscript from the NIH, published in final edited form in Journal of Addictive Disorders 29(2): 217-230.