An Exploratory Study of Sex and Gender Differences in Demographic, Psychosocial, Clinical, and Substance Use Treatment Characteristics of Patients in Outpatient Opioid Use Disorder Treatment With Buprenorphine

As treatment expansion in the opioid epidemic continues, it is important to examine how the makeup of individuals with opioid use disorder (OUD) is evolving. Treatment programs are increasingly utilizing buprenorphine, an effective OUD medication. This exploratory study examines sex and gender differences in psychosocial, clinical, and substance use treatment characteristics of a clinical population in outpatient medication treatment for OUD with buprenorphine. This is a secondary data analysis from a cross-sectional survey study with retrospective medical record review conducted with patients recruited from an office-based opioid treatment clinic between July-September 2019. Participants on buprenorphine for at least 28 days at time of survey completion were included (n = 133). Differences between men and women were explored with Pearson χ2 and Fisher's exact tests for categorical variables and T-tests for continuous variables. The sample was 55.6% women and nearly three fourths Black (70.7%). Mean days in current treatment episode was 431.6 (SD = 244.82). Women were younger and more likely to be unemployed, identify as a sexual minority, and live alone with children than men. More women than men had a psychiatric comorbidity. Women reported more prescription opioid misuse while men had more heroin only opioid use. More men reported comorbid alcohol use and a history of drug overdose. One third of participants reported recent discrimination in a health care setting due to substance use. As buprenorphine-based outpatient treatment programs continue to expand, present study findings support evaluation of the unique needs of men and women in order to better tailor OUD-related services and improve treatment outcomes. What is the significance of this article for the general public? Focusing on the NIH mandate to consider sex and gender in research and clinical practice, we explored differences between men and women in the growing clinical population of patients in outpatient buprenorphine treatment for opioid use disorder (OUD). Findings complement prior research within alternative treatment settings illustrating important variations in clinical and psychosocial characteristics between men and women. Within the opioid crisis, incorporating sex and gender-informed, multidimensional services, such as integrated mental health treatment, is imperative to support recovery-based OUD treatment.