title: Gender issues in the pharmacotherapy of opioid-addicted women: buprenorphine.
abstract: Gender, a biological determinant of mental health and illness, plays a critical role in determining patients' susceptibility, exposure to mental health risks, and related outcomes. Regarding sex differences in the epidemiology of opioid dependence, one third of the patients are women of childbearing age. Women have an earlier age of initiation of substance use and a more rapid progression to drug involvement and dependence than men. Generally few studies exist which focus on the special needs of women in opioid maintenance therapy. The aim of this paper is to provide an overview of treatment options for opioid-dependent women, with a special focus on buprenorphine, and to look at recent findings related to other factors that should be taken into consideration in optimizing the treatment of opioid-dependent women. Issues addressed include the role of gender in the choice of medication assisted treatment, sex differences in pharmacodynamics and pharmacokinetics of buprenorphine drug interactions, cardiac interactions, induction of buprenorphine in pregnant patients, the neonatal abstinence syndrome and breastfeeding. This paper aims to heighten the awareness for the need to take gender into consideration when making treatment decisions in an effort to optimize services and enhance the quality of life of women suffering from substance abuse.
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Annemarie
authors.initials: A
authors.lastname: Unger
authors.forename: Erika
authors.initials: E
authors.lastname: Jung
authors.forename: Bernadette
authors.initials: B
authors.lastname: Winklbaur
authors.forename: Gabriele
authors.initials: G
authors.lastname: Fischer
mesh_terms: D002047:Buprenorphine / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009292:Narcotic Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D009357:Neonatal Abstinence Syndrome / Q000209:etiology; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000534:rehabilitation; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000534:rehabilitation; D011256:Pregnancy Outcome; D016032:Randomized Controlled Trials as Topic; D012737:Sex Factors; D016896:Treatment Outcome; D014930:Women
chemical_list: D009292:Narcotic Antagonists; D002047:Buprenorphine
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