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Why sex and gender matter in substance use treatment

November 13, 2017

By Lindsay Jolivet

One size does not fit all when it comes to addressing the opioid crisis, according to experts at a sold-out Women’s Xchange fall event held on Oct. 27 at Women’s College Hospital (WCH).

The event, “Women & Substance Use: Tailoring Services to Meet Diverse Needs,” brought together researchers, front-line healthcare providers and community leaders from across the province to engage in a conversation about why sex and gender matter when treating substance use problems.

Women and substance use disorders

Women are prescribed opioids more often than men, according to Tara Gomes, a scientist at St. Michael’s Hospital and principal investigator of the Ontario Drug Policy Research Network, who presented the latest trends in opioid prescribing and outcomes in Ontario.

While women are less likely than men to die of an opioid overdose, they are also less likely to access and receive treatment for a substance use issue. A history of trauma is common among substance using women, said Dr. Jesleen Rana, a family physician at Women’s Health in Women’s Hands Community Health Centre. More than 90 per cent of women with a substance use disorder and a mental illness reported a history of physical abuse, according to one study, Dr. Rana said. She emphasized the importance of trauma-informed care that is free of judgment.

Reducing harm with tailored community services

Drug use tends to be riskier among women. They are more likely to use a needle after a partner, for example, or have someone else inject drugs for them. Women need non-judgmental spaces to ask questions about how to inject drugs safely, said presenters Ruth Cameron and Jenn Boyd from the AIDS Committee of Cambridge, Kitchener, Waterloo and Area (ACCKWA). ACCKWA provides such a space, taking an approach to harm reduction that considers gender, ethnicity, socioeconomic status and other factors.

In the LGBTQ community, substance use is much more prevalent than in the broader population — more than double by some estimates. Presenters Tim McConnell and Faith founded a program to support non-binary, trans and queer youth based on their own experiences accessing substance use support services. Called Pieces to Pathways (P2P), the program offers drop-in services, support groups and case management for LGBTTQQ2SIA youth.

Rapid access to addiction treatment for everyone

Patients with opioid use disorders who are treated in emergency departments for overdoses are discharged but usually without a referral to any ongoing addiction treatment. At WCH, patients can access lifesaving treatment, often the same day they request it, through our Rapid Access Addiction Medicine (RAAM) clinic. Dr. Meldon Kahan, medical director of the Substance Use Service at Women’s College Hospital, presented on the project known as META:PHI that led to the creation of RAAM clinics at WCH and across Ontario.

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