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Men in the US Are More Likely to Have a Fatal Overdose Than Women

NIH study finds US men 2–3 times more likely to have fatal overdose than women during 2020–2021.

As the opioid epidemic in the United States continues to progress, a recent study revealed that men are more likely to have a fatal overdose than women. Data from a study — led by researchers from the Icahn School of Medicine at Mount Sinai and the National Institute on Drug Abuse (NIDA) — published in Neuropsychopharmacology revealed that the rate of male overdose mortality is roughly 2–3 greater than overdose mortality in women.

The study analyzed data from the CDC WONDER platform on overdose deaths in individuals between 15 and 74 years old. The researchers classified overdoses using multiple ICD-10 codes, including X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), and Y10–Y14 (undetermined intents).

“Though men and women are being exposed to the modern, fentanyl-contaminated drug supply, something is leading men to die at significantly higher rates. It may be that men use drugs more frequently or in greater doses, which could increase their risk of death, or there may be protective factors among women that reduce their risk of death compared to men,” said Nora Volkow, MD, director of NIDA and one of the co-authors on the study, in the NIH press announcement.

“Understanding the biological, behavioral, and social factors that impact drug use and our bodies’ responses is critical to develop tailored tools to protect people from fatal overdose and other harms of drug use.”

Overdoses were divided into multiple categories: synthetic opioids, heroin, a psychostimulant with the potential for misuse, and cocaine. Male and female identifications were made based on the data from death certificates.

Overdose deaths from synthetic opioids were estimated to be 29.0 deaths per 100,000 people in men.  Comparatively, the rate among women was significantly lower, at 11.1 deaths per 100,000 individuals.

The rate of heroin overdose deaths in men was roughly 5.5 per 100,000 people, while the rate among women was more than 50% lower, at 2.0 deaths per 100,000 people. Additionally, the rate of psychostimulant overdose deaths in men was 13.0 per 100,000 people, compared to 5.6 per 100,000 women.

Finally, cocaine death rates in men were 10.6 per 100,000, while women’s rates were significantly lower at 4.2 deaths per 100,000 individuals.

“These data emphasize the importance of looking at the differences between men and women in a multilayered way,” concluded Eduardo R. Butelman, PhD, assistant professor of psychiatry at the Icahn School of Medicine at Mount Sinai and a lead author on the study, in the press statement. “Moving forward, it will be important for researchers to continue to investigate how biology, social factors, and behaviors intersect with sex and gender factors, and how all of these can impact addictive drug misuse and overdose deaths.”

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