Developing a Women’s Health track within addiction medicine fellowship: reflections and inspirations

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Abstract

Background

Women who use drugs face sexism and intersectional stigma that influence their drug use experiences and treatment needs. There is a need to build the capacity of addiction medicine specialists who can deliver gender-responsive services and advance research and policy in women-focused addiction care. We describe the development of a Women’s Health track within an addiction medicine fellowship program and reflect on successes, challenges, and future directions.

Main body

The Women’s Health track was developed in collaboration between program leaders in Addiction Medicine and Obstetrics/Gynecology. Implementing the track led to the development of women-focused rotations and continuity clinics, as well as enrichment of women’s health didactic education for all fellows. The fellowship track spurred interdepartmental mentorship and collaboration on research and advocacy projects.

Conclusion

Addiction medicine fellowships can replicate this curriculum model to advance women-focused education, research, and policy. Future curricula should focus on structural sexism in drug use and addiction treatment throughout a woman’s life course.

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Most cited references 8

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Sex and gender differences in substance use disorders

R Kathryn McHugh, Victoria R Votaw, Dawn E Sugarman … (2018)

The gender gap in substance use disorders (SUDs), characterized by greater prevalence in men, is narrowing, highlighting the importance of understanding sex and gender differences in SUD etiology and maintenance. In this critical review, we provide an overview of sex/gender differences in the biology, epidemiology and treatment of SUDs. Biological sex differences are evident across an array of systems, including brain structure and function, endocrine function, and metabolic function. Gender (i.e., environmentally and socioculturally defined roles for men and women) also contributes to the initiation and course of substance use and SUDs. Adverse medical, psychiatric, and functional consequences associated with SUDs are often more severe in women. However, men and women do not substantively differ with respect to SUD treatment outcomes. Although several trends are beginning to emerge in the literature, findings on sex and gender differences in SUDs are complicated by the interacting contributions of biological and environmental factors. Future research is needed to further elucidate sex and gender differences, especially focusing on hormonal factors in SUD course and treatment outcomes; research translating findings between animal and human models; and gender differences in understudied populations, such as those with co-occurring psychiatric disorders and gender-specific populations, such as pregnant women.

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Vital Signs: Demographic and Substance Use Trends Among Heroin Users — United States, 2002–2013

Christopher M Jones, Joseph E Logan, R Matthew Gladden … (2015)

Background Heroin use and overdose deaths have increased significantly in the United States. Assessing trends in heroin use among demographic and particular substance-using groups can inform prevention efforts. Methods FDA and CDC analyzed data from the National Survey on Drug Use and Health and National Vital Statistics System reported during 2002–2013. Trends in heroin use among demographic and substance using groups were compared for 2002–2004, 2005–2007, 2008–2010, and 2011–2013. A multivariable logistic regression model was used to identify characteristics associated with heroin abuse or dependence. Results Annual average rates of past-year heroin use increased from 1.6 per 1,000 persons aged ≥12 years in 2002–2004 to 2.6 per 1,000 in 2011–2013. Rates of heroin abuse or dependence were strongly positively correlated with rates of heroin-related overdose deaths over time. For the combined data years 2011–2013, the odds of past-year heroin abuse or dependence were highest among those with past-year cocaine or opioid pain reliever abuse or dependence. Conclusions Heroin use has increased significantly across most demographic groups. The increase in heroin abuse or dependence parallels the increase in heroin-related overdose deaths. Heroin use is occurring in the context of broader poly-substance use. Implications for Public Health Practice Further implementation of a comprehensive response that targets the wider range of demographic groups using heroin and addresses the key risk factors for heroin abuse and dependence is needed. Specific response needs include reducing inappropriate prescribing and use of opioids through early identification of persons demonstrating problematic use, stronger prescription drug monitoring programs, and other clinical measures; improving access to, and insurance coverage for, evidence-based substance abuse treatment, including medication-assisted treatment for opioid use disorders; and expanding overdose recognition and response training and access to naloxone to treat opioid pain reliever and heroin overdoses.

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Gender and Use of Substance Abuse Treatment Services

Carla Green (2006)

Women are more likely than men to face multiple barriers to accessing substance abuse treatment and are less likely to seek treatment. Women also tend to seek care in mental health or primary care settings rather than in specialized treatment programs, which may contribute to poorer treatment outcomes. When gender differences in treatment outcomes are reported, however, women tend to fare better than men. Limited research suggests that gender-specific treatment is no more effective than mixed-gender treatment, though certain women may only seek treatment in women-only programs. Future health services research should consider or develop methods for (1) improving care for women who seek help in primary care or mental health settings, (2) increasing the referral of women to specialized addiction treatment, (3) identifying subgroups of women and men who would benefit from gender-specific interventions, and (4) addressing gender-specific risk factors for reduced treatment initiation, continuation, and treatment outcomes.

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Author and article information

Contributors

Jordana Laks:

ORCID: http://orcid.org/0000-0002-7419-7542

jordana.laks@bmc.org

Journal

Journal ID (nlm-ta): Addict Sci Clin Pract

Journal ID (iso-abbrev): Addict Sci Clin Pract

Title: Addiction Science & Clinical Practice

Publisher: BioMed Central (London )

ISSN (Print): 1940-0632

ISSN (Electronic): 1940-0640

Publication date (Electronic): 9 January 2023

Publication date PMC-release: 9 January 2023

Publication date (Print): 2023

Volume: 18

Electronic Location Identifier: 3

Affiliations

[1 ]Grayken Center for Addiction, Section of General Internal Medicine, Clinical Addiction Research and Education Unit, Boston Medical Center, Boston University School of Medicine, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118 USA

[2 ]GRID grid.427661.0, ISNI 0000 0000 9549 973X, Boston Health Care for the Homeless Program, ; Boston, MA USA

[3 ]GRID grid.189504.1, ISNI 0000 0004 1936 7558, Division of General Pediatrics, Department of Pediatrics, , Boston University School of Medicine, ; Boston, MA USA

[4 ]GRID grid.189504.1, ISNI 0000 0004 1936 7558, Department of Obstetrics and Gynecology, , Boston University School of Medicine, ; Boston, MA USA

Author information

Jordana Laks http://orcid.org/0000-0002-7419-7542

Article

Publisher ID: 357

DOI: 10.1186/s13722-022-00357-8

PMC ID: 9827632

PubMed ID: 36617557

SO-VID: c83d182a-c4b1-42b7-9723-1b7f33763832

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 3 June 2022

Date accepted : 8 December 2022

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100000026, National Institute on Drug Abuse;

Award ID: R25DA033211

Funded by: FundRef http://dx.doi.org/10.13039/100000102, Health Resources and Services Administration;

Award ID: T25HP37593

Award Recipient : Alexander Y. Walley

Funded by: The Landry Family Foundation

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ScienceOpen disciplines: Health & Social care

Keywords: addiction medicine fellowship,women’s health,medical education,curriculum development

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ScienceOpen disciplines: Health & Social care

Keywords: addiction medicine fellowship, women’s health, medical education, curriculum development

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Developing a Women’s Health track within addiction medicine fellowship: reflections and inspirations

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Abstract

Background

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Advocacy for Maternal and Women’s Health

Most cited references 8

Sex and gender differences in substance use disorders

Vital Signs: Demographic and Substance Use Trends Among Heroin Users — United States, 2002–2013

Gender and Use of Substance Abuse Treatment Services

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