Relevant characteristics of women with opioid use disorder (OUD) can guide new treatment plans or improve old ones. Despite known challenges, understanding why some women remain engaged in treatment while others do not is unclear. Continued treatment improves recovery and reduces relapse risks. Integrating characteristic parameters such as attributes, behaviors, and patterns into treatment can potentially prevent relapse and overdose risks. Therefore, the purpose of this study is to assess characteristic parameters such as demographics, health behavior, health status, utilization, and drug use patterns to inform the continued recovery of parenting women.
Method:
This is a descriptive cross-sectional study to assess the characteristics of parenting women with OUD (n = 39) recruited from residential facilities in an original study to explore capital factors for sustained recovery. Data were collected through interviews from 2021 to 2022.
Results:
Women in the sample had a mean age of 35 years, were single, white, and had completed high school. Most women were unemployed, received public assistance, including Medicaid, smoked, and were not ready to quit. Approximately 50% reported good to excellent physical/mental health; 67% utilized primary care services compared to emergency departments/hospitals. Women reported drug use for 13.7 years; prescription opioid misuse at about 19 years, and marijuana as the first drug used, before opioids. On average, more women were on methadone than on buprenorphine medication.
Conclusion:
This study highlights the influence of key characteristic parameters, including age, smoking, health status, utilization, and drug use patterns, to inform gender-based treatment planning for continued recovery.
LydenJBinswangerIA.The United States opioid epidemic. Semin Perinatol. 2019;43(3):123-131. doi:10.1053/j.semperi.2019.01.001
2.
HanBComptonWMBlancoCCraneELeeJJonesCM.Prescription opioid use, misuse, and use disorders in U.S. adults: 2015 National Survey on Drug Use and Health. Ann Intern Med. 2017;167(5):293. doi:10.7326/M17-0865
3.
MakaryMAOvertonHNWangP.Overprescribing is major contributor to opioid crisis. BMJ. 2017;359:j4792. doi:10.1136/bmj.j4792
4.
Centers for Disease Control and Prevention. 2018 Annual Surveillance Report of Drug-Related Risks and Outcomes—United States. Surveillance Special Report. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2018. Accessed April 30, 2025. https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR2-2015/NSDUH-FFR2-2015.pdf
5.
MattsonCLTanzLJQuinnKKariisaMPatelPDavisNL.Trends and geographic patterns in drug and synthetic opioid overdose deaths—United States, 2013-2019. Morb Mortal Wkly Rep. 2021;70(6):202-207. doi:10.15585/mmwr.mm7006a4
ChaconNCWaliaNAllenA, et al. Substance use during COVID-19 pandemic: impact on the underserved communities. Discoveries. 2021;9(4):e141. doi:10.15190/d.2021.20
8.
JuddDKingCRGalkeC.The opioid epidemic: a review of the contributing factors, negative consequences, and best practices. Cureus. 2023;15(7):e41621. doi:10.7759/cureus.41621
BackSEPayneRLWahlquistAH, et al. Comparative profiles of men and women with opioid dependence: results from a National Multisite Effectiveness Trial. Am J Drug Alcohol Abuse. 2011;37(5):313. doi:10.3109/00952990.2011.596982
11.
Substance Abuse and Mental Health Services Administration. Substance Use Disorders Recovery With a Focus on Employment and Education. National Mental Health and Substance Use Policy Laboratory. Substance Abuse and Mental Health Services Administration; 2021. Accessed April 30, 2025. https://library.samhsa.gov/sites/default/files/pep21-pl-guide-6.pdf
12.
GoetzTGBeckerJBMazureCM.Women, opioid use and addiction. FASEB J. 2021;35(2):e21303. doi:10.1096/fj.202002125R
DahlhamerJLucasJZelayaC, et al. Prevalence of chronic pain and high-impact chronic pain among adults—United States, 2016. Morb Mortal Wkly Rep. 2018;67(36):1001-1006. doi:10.15585/mmwr.mm6736a2
15.
OdaniSLinLCNelsonJRAgakuIT.Misuse of prescription pain relievers, stimulants, tranquilizers, and sedatives among U.S. older adults aged ≥50 years. Am J Prev Med. 2020;59(6):860-872. doi:10.1016/j.amepre.2020.04.028
16.
OsborneNRDavisKD.Sex and gender differences in pain. Int Rev Neurobiol. 2022;164:277-307. doi:10.1016/bs.irn.2022.06.013
17.
McHughRKVotawVRSugarmanDEGreenfieldSF.Sex and gender differences in substance use disorders. Clin Psychol Rev. 2018;66:12-23. doi:10.1016/j.cpr.2017.10.012
18.
BatemanBTColeNMMaedaA, et al. Patterns of opioid prescription and use after cesarean delivery. Obstet Gynecol. 2017;130(1):29-35. doi:10.1097/AOG.0000000000002093
19.
LandauRCavanaughPFDiGiorgiM.Persistent opioid use after cesarean delivery in the United States of America: a systematic review. Int J Obstet Anesth. 2023;54:103644. doi:10.1016/j.ijoa.2023.103644
20.
Substance Abuse and Mental Health Services Administration. Patterns of use: from initiation to treatment. In: Substance Abuse Treatment: Addressing the Specific Needs of Women (Internet). TEDS. Substance Abuse and Mental Health Services Administration (US); 2009. Accessed April 26, 2025. https://www.ncbi.nlm.nih.gov/books/NBK83243/
NielsenTBernsonDTerplanM, et al. Maternal and infant characteristics associated with maternal opioid overdose in the year following delivery. Addiction. 2020;115(2):291-301. doi:10.1111/add.14825
24.
MartinCELonginakerNTerplanM.Recent trends in treatment admissions for prescription opioid abuse during pregnancy. J Subst Abuse Treat. 2015;48(1):37-42. doi:10.1016/j.jsat.2014.07.007
25.
Titus-GloverDShayaFTWelshC, et al. Opioid use disorder in pregnancy: leveraging provider perceptions to inform comprehensive treatment. BMC Health Serv Res. 2021;21:215. doi:10.1186/s12913-021-06182-0
26.
Fiddian-GreenAGubriumAHarringtonCEvansEA.Women-reported barriers and facilitators of continued engagement with medications for opioid use disorder. Int J Environ Res Public Health. 2022;19(15):9346. doi:10.3390/ijerph19159346
27.
MartinCEAlmeidaTThakkarBKimbroughT.Postpartum and addiction recovery of women in opioid use disorder treatment: a qualitative study. Subst Abus. 2022;43(1):389-396. doi:10.1080/08897077.2021.1944954
28.
LivingstonJD. Structural stigma in health-care contexts for people with mental health and substance use issues. A literature review. Technical report. Mental Health Commission of Canada; 2020. Accessed April 30, 2025. doi:10:13140/RG.2.2.21168.17929
CampbellJMatoff-SteppSVelezMLCoxHHLaughonK.Pregnancy-associated deaths from homicide, suicide, and drug overdose: review of research and the intersection with intimate partner violence. J Womens Health. 2021;30(2):236-244. doi:10.1089/jwh.2020.8875
WitkiewitzKMontesKSSchwebelFJTuckerJA.What is recovery?. Alcohol Res Curr Rev. 2020;40(3):1. doi:10.35946/arcr.v40.3.01
33.
BartG.Maintenance medication for opiate addiction: the foundation of recovery. J Addict Dis. 2012;31(3):207-225. doi:10.1080/10550887.2012.694598
34.
ChouRKorthuisPTWeimerM, et al. Medication-Assisted Treatment Models of Care for Opioid Use Disorder in Primary Care Settings. Agency for Healthcare Research and Quality (US); 2016. Accessed April 30, 2025. http://www.ncbi.nlm.nih.gov/books/NBK402352/
35.
ComerSDSullivanMAYuE, et al. Injectable, sustained-release naltrexone for the treatment of opioid dependence: a randomized, placebo-controlled trial. Arch Gen Psychiatry. 2006;63(2):210-218. doi:10.1001/archpsyc.63.2.210
36.
Substance Abuse and Mental Health Services Administration. Treatment Improvement Protocol (TIP) 63: Medications for Opioid Use Disorder. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration; 2021. Accessed April 30, 2025. https://store.samhsa.gov/sites/default/files/pep21-02-01-002.pdf
37.
Substance Abuse and Mental Health Services Administration. Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants. HHS Publ No: SMA 18-5054. Substance Abuse and Mental Health Services Administration; 2018. Accessed April 30, 2025. https://library.samhsa.gov/sites/default/files/sma18-5054.pdf
38.
AmaducciAMGreenbergMRSheenAW, et al. Sex-specific outcomes in a substance use intervention program. Clin Ther. 2020;42(3):419-426. doi:10.1016/j.clinthera.2020.01.020
39.
MooreKESiebertSLKromashROwensMDAllenDC.Negative attitudes about medications for opioid use disorder among criminal legal staff. Drug Alcohol Depend Rep. 2022;3:100056. doi:10.1016/j.dadr.2022.100056
40.
StoneR.Pregnant women and substance use: fear, stigma, and barriers to care. Health Justice. 2015;3(1):2. doi:10.1186/s40352-015-0015-5
41.
HodgesJWaselewskiMHarringtonW, et al. Six-month outcomes of the HOPE smartphone application designed to support treatment with medications for opioid use disorder and piloted during an early statewide COVID-19 lockdown. Addict Sci Clin Pract. 2022;17:16. doi:10.1186/s13722-022-00296-4
42.
KhanAROlatunjiOQureshiDMetellusPNkemjikaS.Accessibility of treatment among women with opioid use disorder: a brief review. Cureus. 2022;14(7):e27509. doi:10.7759/cureus.27509
43.
TarasoffLAMilliganKLeTLUsherAMUrbanoskiK.Integrated treatment programs for pregnant and parenting women with problematic substance use: service descriptions and client perceptions of care. J Subst Abuse Treat. 2018;90:9-18. doi:10.1016/j.jsat.2018.04.008
44.
BrorsonHHAjo ArnevikERand-HendriksenKDuckertF.Drop-out from addiction treatment: a systematic review of risk factors. Clin Psychol Rev. 2013;33(8):1010-1024. doi:10.1016/j.cpr.2013.07.007
45.
StahlerGJMennisJDuCetteJP.Residential and outpatient treatment completion for substance use disorders in the U.S.: moderation analysis by demographics and drug of choice. Addict Behav. 2016;58:129-135. doi:10.1016/j.addbeh.2016.02.030
46.
KampmanKJarvisM.American Society of Addiction Medicine (ASAM) national practice guideline for the use of medications in the treatment of addiction involving opioid use. J Addict Med. 2015;9(5):358-367. doi:10.1097/ADM.0000000000000166
47.
ZhaoXZhangXRongJMaJ.Identifying method of drunk driving based on driving behavior. Int J Comput Intell Syst. 2012;2011:361-369. doi:10.1080/18756891.2011.9727794
KimSJMedinaMChangJ.Healthcare utilization of patients with opioid use disorder in US hospitals from 2016 to 2019: focusing on racial and regional variances. Clin Drug Investig. 2022;42:853-863. doi:10.1007/s40261-022-01192-0
50.
ZekeriAA.Smoking behavior, demographic factors and smoking cessation among rural and urban residents. J Healthc Sci Humanit. 2018;8(2):21-30. Accessed March 26, 2025. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6945978/
51.
StaceyTSamplesJLeadleyCAkesterLJenneyA.“I don’t need you to criticise me, I need you to support me”. A qualitative study of women’s experiences of and attitudes to smoking cessation during pregnancy. Womens Birth. 2022;35(6):e549-e555. doi:10.1016/j.wombi.2022.01.010
52.
HarrisPATaylorRThielkeRPayneJGonzalezNCondeJG.Research Electronic Data Capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2008;42(2):377. doi:10.1016/j.jbi.2008.08.010
53.
Substance Abuse and Mental Health Services Administration. Community Engagement: An Essential Component of an Effective and Equitable Substance Use Prevention System. SAMHSA. Publication no: PEP22-06. National Mental Health and Substance Use Policy Laboratory. Substance Abuse and Mental Health Services Administration. 2022. Accessed April 30, 2025. https://store.samhsa.gov/sites/default/files/pep22-06-01-005.pdf
54.
MintzCMPresnallNJSahrmannJM, et al. Age disparities in six-month treatment retention for opioid use disorder. Drug Alcohol Depend. 2020;213:108130. doi:10.1016/j.drugalcdep.2020.108130
55.
DaltonKBishopLDarcyS.Investigating interventions that lead to the highest treatment retention for emerging adults with substance use disorder: a systematic review. Addict Behav. 2021;122:107005. doi:10.1016/j.addbeh.2021.107005
Gondré-LewisMCAbijoTGondré-LewisTA.The opioid epidemic: a crisis disproportionately impacting Black Americans and urban communities. J Racial Ethn Health Disparities. 2022;2022:1-15. doi:10.1007/s40615-022-01384-6
58.
AcevedoAPanasLGarnickD, et al. Disparities in the treatment of substance use disorders: does where you live matter?. J Behav Health Serv Res. 2018;45(4):533-549. doi:10.1007/s11414-018-9586-y
59.
SalonerBCookBL.Blacks and Hispanics are less likely than whites to complete addiction treatment, largely due to socioeconomic factors. Health Aff. 2013;32(1):135-145. doi:10.1377/hlthaff.2011.0983
60.
GuerreroEGMarshJCDuanLOhCPerronBLeeB.Disparities in completion of substance abuse treatment between and within racial and ethnic groups. Health Serv Res. 2013;48(4):1450-1467. doi:10.1111/1475-6773.12031
61.
MennisJStahlerGJ.Racial and ethnic disparities in outpatient substance use disorder treatment episode completion for different substances. J Subst Abuse Treat. 2016;63:25-33. doi:10.1016/j.jsat.2015.12.007
62.
EllisMSKasperZACiceroTJ.The impact of opioid use disorder on levels of educational attainment: perceived benefits and consequences. Drug Alcohol Depend. 2020;206:107618. doi:10.1016/j.drugalcdep.2019.107618
63.
HoJY.The contribution of drug overdose to educational gradients in life expectancy in the United States, 1992-2011. Demography. 2017;54(3):1175-1202. doi:10.1007/s13524-017-0565-3
64.
FordJAPomykaczCOrtizKMcCabeSESchepisTS.Educational attainment and prescription drug misuse: the importance of push and pull factors for dropping out. J Crim Justice. 2020;66:101636. doi:10.1016/j.jcrimjus.2019.101636
CampbellANCBarbosa-LeikerCHatch-MailletteM, et al. Brief report: gender differences in demographic and clinical characteristics of patients with opioid use disorder entering a comparative effectiveness medication trial. Am J Addict. 2018;27(6):465-470. doi:10.1111/ajad.12784
67.
BöckermanPHaapanenMHakulinenCVainiomäkiJ.Prescription opioid use and employment: a nationwide Finnish register study. Drug Alcohol Depend. 2021;227:108967. doi:10.1016/j.drugalcdep.2021.108967
68.
MumbaMNDavisLSmithNLEvansTCastilloR.Effects of unemployment on opioid use treatment trajectories. J Addict Nurs. 2022;33(3):168-171. doi:10.1097/JAN.0000000000000480
69.
LaudetAB.Rate and predictors of employment among formerly polysubstance dependent urban individuals in recovery. J Addict Dis. 2012;31(3):288. doi:10.1080/10550887.2012.694604
70.
SilvermanKHoltynAFMorrisonR.The therapeutic utility of employment in treating drug addiction: science to application. Transl Issues Psychol Sci. 2016;2(2):203. doi:10.1037/tps0000061
71.
MartinsonKMcDonaldDBerningerAWassermanK. Building Evidence-Based Strategies to Improve Employment Outcomes for Individuals With Substance Use Disorders. Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services; 2021. Accessed April 30, 2025. https://acf.gov/sites/default/files/documents/opre/BEES_SUD_Paper_508.pdf
72.
ChristieNC.The role of social isolation in opioid addiction. Soc Cogn Affect Neurosci. 2021;16(7):645. doi:10.1093/scan/nsab029
KumarNOlesWHowellBA, et al. The role of social network support in treatment outcomes for medication for opioid use disorder: a systematic review. J Subst Abuse Treat. 2021;127:108367. doi:10.1016/j.jsat.2021.108367
75.
MarkatouMKennedyOBrachmannMMukhopadhyayRDhariaATalalAH.Social determinants of health derived from people with opioid use disorder: improving data collection, integration and use with cross-domain collaboration and reproducible, data-centric, notebook-style workflows. Front Med. 2023;10:1076794. doi:10.3389/fmed.2023.1076794
DoranKMRahaiNMcCormackRP, et al. Substance use and homelessness among emergency department patients. Drug Alcohol Depend. 2018;188:328-333. doi:10.1016/j.drugalcdep.2018.04.021
Substance Abuse and Mental Health Services Administration. Best Practices for Recovery Housing. Publ No: PEP23-10-00-002. Substance Abuse and Mental Health Services Administration; 2023. Accessed April 30, 2025. https://library.samhsa.gov/sites/default/files/pep23-10-00-002.pdf
80.
de AndradeDElphinstonRAQuinnCAllanJHidesL.The effectiveness of residential treatment services for individuals with substance use disorders: a systematic review. Drug Alcohol Depend. 2019;201:227-235. doi:10.1016/j.drugalcdep.2019.03.031
81.
MeyerJPIsaacsKEl-ShahawyOBurlewAKWechsbergW.Research on women with substance use disorders: reviewing progress and developing a research and implementation roadmap. Drug Alcohol Depend. 2019;197:158-163. doi:10.1016/j.drugalcdep.2019.01.017
82.
WanarAMorrisonTMStandishKR, et al. Understanding cigarette smoking among mothers with opioid use disorder. J Subst Use Addict Treat. 2023;150:209065. doi:10.1016/j.josat.2023.209065
83.
McHughRKJanesACGriffinML, et al. Clinical correlates of smoking status in men and women with opioid use disorder. Subst Use Misuse. 2020;55(7):1054-1058. doi:10.1080/10826084.2020.1725056
84.
RamATutenMChisolmMS.Cigarette smoking reduction in pregnant women with opioid use disorder. J Addict Med. 2016;10(1):53-59. doi:10.1097/ADM.0000000000000186
85.
ShortVLHandDJPyferL, et al. Health status and preventive health services among reproductive-aged women in treatment for opioid use disorder. Womens Health Rep. 2022;3(1):998-1005. doi:10.1089/whr.2022.0057
86.
JooJY.Fragmented care and chronic illness patient outcomes: a systematic review. Nurs Open. 2023;10(6):3460-3473. doi:10.1002/nop2.1607
87.
ParadisoC.Opioid use disorder in women: distinguishing features. Women’s Healthcare. 2023;11(5):13-18. doi:10.51256/WHC102313
88.
BreslauJSorberoMJKusukeD, et al. Primary and Behavioral Health Care Integration program: impacts on health care utilization, cost, and quality. Rand Health Q. 2021;9(2):3. Accessed October 24, 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC8383834/
89.
ShastrySCountsCShegogELooGCowanE.Emergency department utilization patterns in patients with opioid-related emergency department visits. Subst Use Misuse. 2022;57(6):995-998. doi:10.1080/10826084.2022.2046098
90.
GillespieNAKendlerKSPrescottCA, et al. Longitudinal modeling of genetic and environmental influences on self-reported availability of psychoactive substances: alcohol, cigarettes, marijuana, cocaine and stimulants. Psychol Med. 2007;37(7):947-959. doi:10.1017/S0033291707009920
91.
PoudelAGautamS.Age of onset of substance use and psychosocial problems among individuals with substance use disorders. BMC Psychiatry. 2017;17:10. doi:10.1186/s12888-016-1191-0
92.
American College of Obstetrics and Gynecology. Committee opinion no: 722: marijuana use during pregnancy and lactation. Obstet Gynecol. 2017;130(4):e205. doi:10.1097/AOG.0000000000002354
93.
RyanSAAmmermanSDO’ConnorME, Committee on Substance Use and Prevention, Section on Breastfeeding. Marijuana use during pregnancy and breastfeeding: implications for neonatal and childhood outcomes. Pediatrics. 2018;142(3):e20181889. doi:10.1542/peds.2018-1889
VolkowNDHanBComptonWMMcCance-KatzEF.Self-reported medical and non-medical cannabis use among pregnant women in the United States. JAMA. 2019;322(2):167. doi:10.1001/jama.2019.7982
96.
HughesAWilliamsMRLipariRNVan HornS. State estimates of past year cocaine use among young adults: 2014 and 2015. In: The CHSQ Report—National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration; 2016. Accessed April 28, 2025. https://www.samhsa.gov/data/sites/default/files/report_2736/ShortReport-2736.pdf
97.
ChenCYStorrCLAnthonyJC.Early-onset drug use and risk for drug dependence problems. Addict Behav. 2009;34(3):319-322. doi:10.1016/j.addbeh.2008.10.021
98.
PerrenoudLOOikawaKFWilliamsAV, et al. Factors associated with crack-cocaine early initiation: a Brazilian multicenter study. BMC Public Health. 2021;21(1):781. doi:10.1186/s12889-021-10769-x
99.
ZhangSLimYBoyasJFBurlakaV.Family structure and youth illicit drug use, use disorder, and treatment services utilization. Child Youth Serv Rev. 2020;111:104880. doi:10.1016/j.childyouth.2020.104880
100.
MattickRPBreenCKimberJDavoliM.Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database Syst Rev. 2009;2009(3):CD002209. doi:10.1002/14651858.CD002209.pub2
101.
WakemanSELarochelleMRAmeliO, et al. Comparative effectiveness of different treatment pathways for opioid use disorder. JAMA Netw Open. 2020;3(2):e1920622. doi:10.1001/jamanetworkopen.2019.20622
102.
MarschLAMooreSKBorodovskyJT, et al. A randomized controlled trial of buprenorphine taper duration among opioid-dependent adolescents and young adults. Addiction. 2016;111(8):1406. doi:10.1111/add.13363
