Barbosa-Leiker Celestina, Campbell Aimee N C, McHugh R Kathryn, Guille Constance, Greenfield Shelly F
College of Nursing, Washington State University, Spokane, (Barbosa-Leiker); Program of Excellence in Addictions Research, Washington State University, Spokane, (Barbosa-Leiker); Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, (Campbell); Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, Massachusetts (McHugh, Greenfield); Department of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, Medical University of South Carolina, Charleston, (Guille).
Psychiatr Res Clin Pract. 2021 Spring;3(1):3-11. doi: 10.1176/appi.prcp.20190051. Epub 2020 Oct 13.
The opioid epidemic continues to evolve and impact all groups of people. Moreover, there are concerning trends among women. The aim of this article is to provide a review of opioid use disorder in women and the implications for treatment.
A nonsystematic review of the literature as conducted to examine: (1) the epidemiology of opioid-related hospitalizations and deaths of women; (2) co-occurring pain, anxiety disorders, and trauma among women with opioid use disorder; (3) evidence for opioid agonist treatment of pregnant women with opioid use disorder; and (4) implications for treatment of women with opioid use disorder and next steps for research and practice.
The current opioid epidemic has produced important differences by sex and gender with increased rates of use and overdose deaths in women. Significant mental health concerns for women include co-occurring psychiatric disorders and suicide. Expanding medication treatment for perinatal opioid use disorder is crucial. While effective treatments exist for opioid use disorder, they are often not accessible, and a minority of patients are treated.
The end to the opioid epidemic will require innovative multi-systemic solutions. There are significant practice gaps in preventing rising death rates among women by opioid overdose, treating co-occurring psychiatric disorders and pain, and treating perinatal women with opioid use disorder and their infants. Research on sex and gender differences, and the intersection with race/ethnicity and US region, is critically needed and should include treatment implementation studies to achieve wider access for women to effective prevention, early intervention, and treatment.
阿片类药物流行仍在持续演变并影响着所有人群。此外，女性群体中还存在一些令人担忧的趋势。本文旨在综述女性阿片类药物使用障碍及其治疗意义。
对文献进行非系统性综述，以考察：（1）女性阿片类药物相关住院和死亡的流行病学情况；（2）患有阿片类药物使用障碍的女性中同时存在的疼痛、焦虑症和创伤情况；（3）阿片类激动剂治疗患有阿片类药物使用障碍的孕妇的证据；（4）对患有阿片类药物使用障碍的女性的治疗意义以及研究和实践的下一步方向。
当前的阿片类药物流行在性别方面产生了重要差异，女性的使用率和过量死亡发生率有所上升。女性面临的重大心理健康问题包括同时存在的精神疾病和自杀问题。扩大围产期阿片类药物使用障碍的药物治疗至关重要。虽然存在针对阿片类药物使用障碍的有效治疗方法，但往往难以获得，且只有少数患者得到治疗。
终结阿片类药物流行需要创新的多系统解决方案。在预防女性因阿片类药物过量导致的死亡率上升、治疗同时存在的精神疾病和疼痛以及治疗患有阿片类药物使用障碍的围产期女性及其婴儿方面，存在重大的实践差距。迫切需要开展关于性别差异以及与种族/族裔和美国地区交叉情况的研究，并且应包括治疗实施研究，以让更多女性能够获得有效的预防、早期干预和治疗。
