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Gender Differences in a Clinical Trial for Prescription Opioid Dependence.

Journal of Substance Abuse Treatment 2013;45(1):38-43. [doi: 10.1016/j.jsat.2012.12.007]

R. Kathryn McHugh, PhD (McLean Hospical, NEC Node), Elise E. DeVito, PhD (Yale University School of Medicine, NEC Node), Dorian Dodd (McLean Hospical, NEC Node), Kathleen M. Carroll, PhD (Yale University School of Medicine, NEC Node), Jennifer Sharpe Potter, PhD, MPH (McLean Hospital, NEC Node), Shelly F. Greenfield, MD, MPH (McLean Hospital, NEC Node), Hilary Smith Connery, MD (McLean Hospical, NEC Node), Roger D. Weiss, MD (McLean Hospical, NEC Node).

Although gender differences in substance use disorders have been identified, few studies have examined gender differences in prescription drug dependence. This study aimed to examine gender differences in clinical characteristics and treatment outcomes in a large clinical trial for prescription opioid dependence, National Drug Abuse Treatment Clinical Trials Network protocol CTN-0030, "Prescription Opioid Addiction Treatment Study (POATS)." Despite no pre-treatment differences in opioid dependence severity, women reported significantly greater functional impairment, greater psychiatric severity, and high likelihood of using opioids to cope with negative affect and pain than men. Women were also more likely than men to have first obtained opioids via a legitimate prescription and to use opioids via the intended route of administration. Men reported significantly more alcohol problems than women. There were no significant gender differences in medication dose, treatment retention, or opioid outcomes. Thus, despite the presence of pre-treatment gender differences in this population, once the study treatment was initiated, women and men exhibited similar opioid use outcomes.

Conclusions: These findings underscore the importance of careful assessment of prescription opioid misuse in women, as traditional markers of opioid misuse and need for treatment (e.g. using the drug via a non-recommended route) were less common in women. Though the severity of prescription opioid dependence was similar among men and women in this sample, the functional impairment associated with this disorder appears to be more severe for women, and rates of treatment success were low regardless of gender. Efforts to improve overall outcome are needed. (Article (Peer-Reviewed), PDF, English, 2013)

Keywords: Buprenorphine/Naloxone | CTN platform/ancillary study | Gender differences | Heroin | Opioid dependence | Opioid detoxification | Pharmacological therapy | Prescription-type opiates | Suboxone | Women | Journal of Substance Abuse Treatment (journal)

Document No: 940, PMID: 23313145, PMCID: PMC3626739.

Submitted by CTN Dissemination Librarians, 1/22/2013.

Carroll, Kathleen M. search mail
Connery, Hilary Smith search mail
DeVito, Elise E. search
Dodd, Dorian search mail
Greenfield, Shelly F. search mail
McHugh, R. Kathryn search mail
Potter, Jennifer Sharpe search mail
Weiss, Roger D. search mail
NIDA-CTN-0030 search www
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