Gender-related psychopathology in opioid use disorder: Results from a representative sample of Italian addiction services

Leone, Beniamino; Nicola, Marco Di; Moccia, Lorenzo; Pettorruso, Mauro; Risio, Luisa De; Nucara, Giuseppe; Zamboni, Lorenzo; Callea, Antonino; Janiri, Luigi; Cibin, Mauro; Lugoboni, Fabio

doi:10.1016/j.addbeh.2017.03.010

Cited by 11 publications

(14 citation statements)

References 22 publications

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“…Proactive business continuity plans for PWSUDs are important for all governments as part of COVID-19 remobilization plans and possible future responses to similar pandemics to support and avert delays and inequities in responses. Overall, PWSUDs are at risk for a negative impact of COVID-19 ( 6 ); it is also essential to mention that gender differences play a substantial role in the vulnerabilities of PWSUDs ( 40 ). Our findings showed that 88% of respondents reported continuity of other necessary medical and psychiatric care compared to <60% who reported the existence of business continuity/contingency plans and enough availability and accessibility of treatment and harm reduction services for PWSUDs.…”

Section: Discussionmentioning

confidence: 99%

Reorganization of Substance Use Treatment and Harm Reduction Services During the COVID-19 Pandemic: A Global Survey

et al. 2021

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Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted people with substance use disorders (SUDs) worldwide, and healthcare systems have reorganized their services in response to the pandemic.Methods: One week after the announcement of the COVID-19 as a pandemic, in a global survey, 177 addiction medicine professionals described COVID-19-related health responses in their own 77 countries in terms of SUD treatment and harm reduction services. The health responses were categorized around (1) managerial measures and systems, (2) logistics, (3) service providers, and (4) vulnerable groups.Results: Respondents from over 88% of countries reported that core medical and psychiatric care for SUDs had continued; however, only 56% of countries reported having had any business continuity plan, and 37.5% of countries reported shortages of methadone or buprenorphine supplies. Participants of 41% of countries reported partial discontinuation of harm-reduction services such as needle and syringe programs and condom distribution. Fifty-seven percent of overdose prevention interventions and 81% of outreach services were also negatively impacted.Conclusions: Participants reported that SUD treatment and harm-reduction services had been significantly impacted globally early during the COVID-19 pandemic. Based on our findings, we highlight several issues and complications resulting from the pandemic concerning people with SUDs that should be tackled more efficiently during the future waves or similar pandemics. The issues and potential strategies comprise the following: (1) helping policymakers to generate business continuity plans, (2) maintaining the use of evidence-based interventions for people with SUDs, (3) being prepared for adequate medication supplies, (4) integrating harm reduction programs with other treatment modalities, and (5) having specific considerations for vulnerable groups such as immigrants and refugees.

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Section: Discussionmentioning

confidence: 99%

Reorganization of Substance Use Treatment and Harm Reduction Services During the COVID-19 Pandemic: A Global Survey

et al. 2021

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“…Likewise, a large Italian cohort study (N=10,454) of OUD patients reported that women entered treatment with a higher prevalence of HIV, unemployment, use of sedatives, and depression than men, but had lower concurrent use of alcohol 19 . Another Italian cohort study (N=1,052) found that women were more likely than men to enter treatment with co-occurring depression, anxiety disorders, and also more likely to be prescribed psychopharmacotherapies 20 .…”

Section: Sex-based Differences In Presentation To Treatmentmentioning

confidence: 99%

Review: Sex‐Based Differences in Treatment Outcomes for Persons With Opioid Use Disorder

2019

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Background and Objectives: In order to address the current opioid crisis, research on treatment outcomes for persons with OUD should account for biological factors that could influence individual treatment response. Women and men might have clinically meaningful differences in their experience in OUD treatment and might also have unique challenges in achieving successful, long-term recovery. This review summarizes and synthesizes the current literature on sex-based differences in OUD treatment outcomes. Methods: Relevant literature was identified via automated and manual searches using the terms "opioid treatment outcome sex [or gender] differences" and "opiate treatment outcome sex [or gender] differences". Search methodology was consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and were conducted within the PubMed electronic database during March and April of 2018. Results: The initial PubMed search yielded 241 manuscripts; 31 original research articles that met inclusion/exclusion criteria were synthesized in this review. Several important trends emerged, including findings that women are more likely than men to present to treatment with co-occurring mental health conditions such as depression, and that women might respond particularly well to buprenorphine maintenance. Discussion and Conclusions: While much of the literature on this topic is subject to potential cohort effects, interventions that address co-occurring mental health conditions and psychosocial stress might improve treatment outcomes for women with OUD. Scientific Significance: Funding agencies and researchers should focus attention toward human laboratory studies and clinical trials that are prospectively designed to assess sex-based differences in OUD recovery.

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“…By contrast, a study by Leone et al. ( 12 ) found that MMT was significantly associated with higher psychological symptom scores in men compared with women. Wang et al.…”

Section: Introductionmentioning

confidence: 76%

“…A sex disparity in the responses to MMT regimens has been reported, with women experiencing more psychological symptoms than men ( 12 ). In 2015, Bawor et al.…”

Section: Introductionmentioning

confidence: 99%

Add-On Selective Estrogen Receptor Modulators for Methadone Maintenance Treatment

et al. 2021

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Methadone maintenance treatment (MMT) remains the cornerstone for the management of opiate abuse. However, MMT can be associated with complex factors, including complications during the tolerance phase, the inability of some patients to maintain treatment effects during the tapering or abstinence phases, and the development of methadone dependence. Previous studies have revealed a sex disparity in MMT efficacy, showing that women undergoing MMT experiencing an increase in psychological symptoms compared with men and suggesting a link between disparate responses and the effects of estrogen signaling on methadone metabolism. More specifically, estradiol levels are positively associated with MMT dosing, and the expression of a single-nucleotide polymorphism (SNP) associated with estrogen receptor (ER) regulation is also associated with MMT dosing. In addition to performing mechanistic dissections of estrogen signaling in the presence of methadone, past studies have also proposed the targeting of estrogen signaling during MMT. The present report provides an overview of the relevant literature regarding sex effects, including differences in sex hormones and their potential impacts on MMT regimens. Moreover, this article provides a pharmacological perspective on the targeting of estrogen signals through the use of selective ER modulators (SERMs) during MMT. Preliminary preclinical experiments were also performed to evaluate the potential effects of targeting estrogen signaling with tamoxifen on methadone metabolism.

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Gender-related psychopathology in opioid use disorder: Results from a representative sample of Italian addiction services

Cited by 11 publications

References 22 publications

Reorganization of Substance Use Treatment and Harm Reduction Services During the COVID-19 Pandemic: A Global Survey

Reorganization of Substance Use Treatment and Harm Reduction Services During the COVID-19 Pandemic: A Global Survey

Review: Sex‐Based Differences in Treatment Outcomes for Persons With Opioid Use Disorder

Add-On Selective Estrogen Receptor Modulators for Methadone Maintenance Treatment

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