Are State Policymakers Aware of Sex and Gender Impacts on Opioid Use Disorder?


Are State Policymakers Aware of Sex and Gender Impacts on Opioid Use Disorder?


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Background: Sex and gender-based differences have been identified as risks for opioid use disorder (OUD) and treatment outcomes. In response to the “opioid crisis,” states have developed action plans to inform strategies of state agencies, impact legislative efforts, and help prioritize funding allocations for prevention initiatives, substance use disorder treatment, and law enforcement programs.

Objectives: This study aimed to provide the first analysis of state opioid action plans and their inclusion of gender-specific issues. The results of this study would be used to develop educational materials and programs for state policymakers to inform policy decisions and improve the care of women with OUD.

Methods: Forty-nine state action plans were identified from state websites and were analyzed for their inclusion of 15 variables covering provider education in gender differences, pregnancy-related topics, and discussion of gender-based differences in opioid addiction and treatment.

Results: Forty-one percent of states mentioned prenatal or postpartum care for women with OUD. Only 14% of states speciffcally mentioned pregnancy-related opioid use stigma, 12% mentioned contraceptive care/access, 8% mentioned family planning provider education, and 24% of states mentioned trauma-informed care. Three states mentioned gender differences in social risk factors, another three states mentioned treatment barriers specific to women, and only two states mentioned treatment stigma specific to women.

Conclusions: Few action plans contained gender-specific information; those that did focused almost exclusively on pregnancy and neonatal opioid withdrawal syndrome, showing a lack of understanding about the issues faced by women with OUD outside of reproductive health. Given the rising rate of opioid-related deaths among women and the impact of OUD on women of every age, state opioid policies need to be inclusive of the unique needs of women. This will require education of policymakers about gender-based differences in addiction physiology, medical and social risk factors, and barriers to treatment.

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Are State Policymakers Aware of Sex and Gender Impacts on Opioid Use Disorder?