Gender differences in a clinical trial for prescription opioid dependence.

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.