Men face a significantly higher risk of mortality from drug overdoses compared to women, with rates two to three times higher. Beyond differences in drug use, a recently published study highlights the need to understand the complex mix of biological, behavioral, and social factors contributing to this gender disparity. Improving treatment accessibility and bolstering healthcare support are crucial steps in addressing the worsening overdose epidemic in the United States.
In 2021, the devastating toll of drug-related deaths exceeded 100,000 lives lost, revealing a stark gender disparity in overdose mortality. Beyond differences in drug use, men faced mortality rates two to three times higher than women, signaling a significant issue that extends throughout the United States.
Over the past two decades, the Centers for Disease Control and Prevention (CDC) has reported over 932,000 deaths from drug overdoses. In recent years, this already alarming figure has seen a notable increase. In 2021 alone, approximately 107,000 lives were claimed by drug overdoses, largely due to the rise in synthetic opioids like fentanyl. The COVID-19 pandemic worsened the situation by impeding patients’ access to substance abuse treatments.
While it has long been recognized that men are more likely to use drugs and consequently experience overdoses, researchers at the Icahn School of Medicine at Mount Sinai recognized the urgent need for a deeper understanding of this discrepancy. In a recently published study, they aimed to explore sex differences in overdose mortality across four specific drug categories: synthetic opioids, heroin, psychostimulants (such as methamphetamine), and cocaine.
Motivated by this objective, the investigators conducted a comprehensive study published in Neuropsychopharmacology. They sought to determine whether the heightened risk for men merely reflected their higher drug use or if other contributing factors were at play. To answer this question, the team analyzed overdose death data from 2020 to 2021 across all US states, utilizing resources like the CDC’s Wide-ranging Online Data for Epidemiologic Research platform and the National Surveys on Drug Use and Health.
“These data emphasize the importance of examining the differences between men and women from multiple perspectives,” stated Dr. Eduardo R. Butelman, a lead author on the study and assistant professor of psychiatry at Icahn Mount Sinai.
The findings revealed a consistent pattern of men being at least twice as likely to die from drug use compared to women across all 50 states and Washington, DC. When examining mortality rates for specific substances, the gender disparity became more pronounced. For instance, men faced 29.0 deaths per 100,000 people from synthetic opioids (e.g., fentanyl) compared to 11.1 for women. Heroin claimed 5.5 lives per 100,000 men, while the number for women was 2.0. Regarding psychostimulants like methamphetamine, the mortality rate for men was 13.0 per 100,000 people, compared to 5.6 for women. Similarly, cocaine resulted in 10.6 deaths per 100,000 men and 4.2 per 100,000 women.
The study also analyzed data by age groups spanning ten years. It consistently showed that for overdoses involving synthetic opioids such as fentanyl, men had higher rates of mortality than women across all age groups between 15 and 74 years.
Moreover, the study identified that men exhibited a cocaine overdose mortality rate 2.8 times higher than that of women. Men also demonstrated a cocaine misuse rate 1.9 times higher than women. However, researchers noted that higher drug use rates among men alone do not fully explain the gender disparity in overdose deaths.
The complex mix of biological, behavioral, and social factors plays a significant role in elevating mortality risk for men. One possible explanation is that men may be more inclined to use drugs as a coping mechanism for psychological distress and mental health issues, rather than seeking therapy or medical treatment.
Dr. Butelman emphasized the need for future research to explore the interactive biological, behavioral, and social mechanisms that contribute to differential risks of overdose mortality in men versus women. Such studies could eventually lead to personalized strategies aimed at reducing the progression or severity of substance use disorders and, consequently, decreasing the public health crisis caused by overdose mortality.
Meanwhile, as the investigation into overdose disparities continues, it is evident that improving access to treatment is crucial. The United States is grappling with a worsening overdose epidemic, yet most patients with opioid use disorder (OUD) face alarmingly low accessibility to potentially life-saving medication, as reported in the International Journal of Drug Policy. Therefore, enhancing healthcare support and treatment options becomes a vital step toward mitigating this crisis.
