Women and Treatment for Opioid Use Disorder: Contributors to Treatment Success From the Perspectives of Women in Recovery, Women With Past Attempts in Drug Treatment, and Health and Criminal Justice Professionals

Abstract

Introduction: The disproportionate incidence of opioid use disorder (OUD) and the alarming increases in opioid-related overdose deaths among women highlight a clear need for the expansion of effective harm reduction and treatment practices. Research supports medications for opioid use disorders (MOUD) as an effective intervention; however, with low rates of utilization of such, there is a need to identify factors that facilitate MOUD treatment uptake and retention for women. Thus, the current study examines contributors to treatment success through the triangulation of perspectives from affected women as well as health and criminal justice professionals. Methods: Interviews (N = 42) were conducted from May to July 2022 with women in recovery who previously used or currently use MOUD (N = 10), women who currently use opioids who terminated a MOUD program previously (N = 10), SUD treatment professionals (N = 12), and criminal justice professionals who work with women who use opioids (N = 10). Interviews for all participants centered around their backgrounds, perceived barriers and facilitators to MOUD treatment, and issues specific to women in treatment for substance use disorder. We used a thematic qualitative data analysis process to analyze transcripts. Results: Participants highlighted contributors to treatment success from 3 domains: (1) internal processes (including promoting self-efficacy and setting realistic goals), (2) access to resources (including material resources, such as food and shelter, educational resources and social support), and (3) treatment structure (such as treatment type and protocol). Conclusion: Internal processes, access to resources, and treatment structure contribute to MOUD treatment success for women with OUD. Structured support where experiences are shared, and realistic goals are set, may promote feelings of acceptance and empowerment, thereby bolstering chances of treatment success. Additionally, the court system can promote evidence-based and trauma-informed substance use treatment and provide accessible educational resources related to substance use to extend these benefits to more women.

The impact of family systems and social networks on substance use initiation and recovery among women with substance use disorders.

“…One such driver is interpersonal relationships, including family, partner, and peer relationships, which substantially impact substance use initiation, treatment utilization, and overdose survival (Bowleg & Landers, 2023; Jones, Duncan, et al, 2023; Van Ryzin et al, 2012). Supportive family systems are known to promote substance use treatment and positive outcomes among those with substance use disorders (SUDs; Skogseth et al, 2024; Tambling et al, 2022). However, several studies have identified a positive relationship between parental substance use and adolescent substance use (Bowleg & Landers, 2023; Jones, Duncan, et al, 2023; O’Loughlin et al, 2017; Schuler et al, 2019; Tiberio et al, 2020; Windle et al, 2017).…”

“…Specifically, fluctuations in affect and hormones may increase substance use, particularly in the menstrual and premenstrual phases of the menstrual cycle (Joyce et al, 2021). Socially, initiating and retaining women in SUD treatment poses additional challenges as issues with childcare, transportation, and limited social support complicate treatment outcomes (Skogseth et al, 2024; NIDA, 2020). In addition, fears of losing custody or involving Child Protective Services can serve as a deterrent to women seeking treatment (NIDA, 2020).…”