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Drug Overdoses Are 3 Times Deadlier for Men, Exposing Gender Disparity 

Over 100,000 lives were lost to drugs in 2021, with men facing an undeniably higher overdose mortality risk than women. Researchers say the gender disparity extends beyond greater drug use. 

In the United States, drug overdoses from opioids and psychostimulants have taken thousands of lives each year. Among these tragic losses, researchers gained sight of a clear trend; men throughout the nation face mortality rates two or three times higher than women.  

Since 1999, over 932,000 people have died from a drug overdose, but in recent years there has been a notable increase in the number of drug-related deaths, according to the Centers for Disease Control and Prevention (CDC).  

The surge in drug overdose deaths, claimed close to 107,000 lives in 2021, which can be largely attributed to the use of the synthetic opioid fentanyl. The COVID-19 pandemic amplified this increase, as it severely hindered patients’ access to substance abuse treatments.  

While men have long been identified as more likely to use drugs and consequently suffer from overdoses, researchers from the Icahn School of Medicine at Mount Sinai saw a critical need to further investigate this discrepancy.   

In the recently published study, researchers set to go beyond the existing research and explore the sex differences in overdose mortality across four specific drug categories: synthetic opioids, heroin, psychostimulants such as methamphetamine, and cocaine.  

Armed with this knowledge, investigators at the Icahn School of Medicine at Mount Sinai decided to dive deeper, launching a comprehensive study published in Neuropsychopharmacology.  

Was the heightened risk for men merely a reflection of their higher drug use, or were there other factors at play? To answer this, the team undertook a comprehensive, state-by-state analysis of overdose death data from 2020 to 2021 in the US, tapping into the resources of 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 looking at the differences between men and women in a multilayered way,” said Eduardo R. Butelman, PhD, assistant professor of psychiatry at Icahn Mount Sinai and a lead author on the study.  

Throughout all 50 states and Washington, DC, men were at least twice as likely to die from drug use as women.  

When breaking down the mortality rates for different substances, the gender disparity becomes more evident.  

Synthetic opioids, like fentanyl, were associated with 29.0 deaths per 100,000 people for men, versus 11.1 for women. Heroin was responsible for 5.5 deaths per 100,000 people for men, in contrast to 2.0 for women.  

For psychostimulants, such as methamphetamine, there were 13.0 deaths per 100,000 people for men, compared to 5.6 for women. Lastly, cocaine resulted in 10.6 deaths per 100,000 people for men, as opposed to 4.2 for women.  

The authors also analyzed the data by ten-year age groups. They found that, for overdose deaths involving synthetic opioids such as fentanyl, men had consistently higher rates than women across all age groups within the 15–74 range measured in the study.  

Additionally, the study found that men exhibited a cocaine overdose mortality rate that was 2.8 times higher than women. Men also showed a rate of cocaine misuse that was 1.9 times higher than women.  

Yet, higher drug use rates among men don't fully explain the gender disparity in overdose deaths, researchers pointed out.   

Researchers indicated that a complex mix of biological, behavioral, and social factors heightens mortality risk for men. This could potentially be explained by the fact that men might be more prone to using drugs to alleviate psychological distress and mental health issues, rather than seeking therapy or medical treatment.  

“Future research that investigates the interactive biological, behavioral and social mechanisms that underlie differential risks of overdose mortality in men versus women could eventually point to personalized strategies to mitigate the progression or severity of substance use disorders and thereby decrease the public health crisis caused by overdose mortality,” said Butelman.  

In the interim, while these overdose disparities are being investigated, it's clear that an increase in treatment accessibility could result in substantial improvement.  

 The US is currently grappling with a worsening overdose epidemic, yet access to potentially life-saving medication remains alarmingly low for most patients with opioid use disorder (OUD), as reported in the International Journal of Drug Policy. Therefore, bolstering healthcare support and treatment avenues is a crucial step toward mitigating this crisis.  

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