An FIU investigator received an $893,255 grant from the National Institute on Drug Abuse (NIDA) to lead a 5-year project to increase involvement in the care and access to services for women with opioid use disorder (OLD) to improve.
Melissa Ward, assistant professor of epidemiology at the Robert Stempel College of Public Health & Social
Work, will address the need for female-centric navigation systems that connect women with OLD to essential resources such as medicines, mental health, and social services.
The project includes the development of a pilot recovery navigation system that will meet the unique needs of women, raise awareness of services and resources, and destigmatize the search for treatment for OLD. The development will be led by the input of women in recovery, their families and leaders in the recovery community to ensure it meets the needs of the community it will serve.
“Patient navigation programs have been very successful in helping some populations — people with cancer and HIV, for example — figure out how to navigate the health system to get the treatment and care they need,” Ward says. “However, these programs have not been fully implemented or evaluated for women with OLD.”
In the United States, the opioid epidemic has escalated dramatically. This month, the Centers for Disease Control and Prevention (CDC) reported that nearly 81,000 people died from opioid-related overdoses in 2021. The number of opioid-related overdoses in women has also risen – from 1999 to 2020; it rose from 1.4 to 12.3 per 100,000 people.
FIU News spoke with Ward to learn more about her work and the unique challenges women face when seeking care for OLD.
What sparked your interest in opioid use disorder research?
I’ve spent time reading and learning about the challenges we see, especially for women. The incidence of neonatal opioid withdrawal syndrome, in which babies develop withdrawal symptoms due to mothers taking opioids during pregnancy, is increasing year on year. There are many interventions aimed at pregnancy in the literature. However, I did some test work with support from the FIU research center in minority institutions and one of the preliminary findings that came out was that women really do need support throughout the life course, not just pregnancy.
What does this finding suggest?
If we want to support women, we need to think about expanding the support available for OLD so that it’s not just related to pregnancy, and we need to remove the stigma that comes from seeking care. Obviously pregnancy is a very important time and women need all the support they can get. But we also need to provide care for women who use opioids before they become pregnant, after they become pregnant and if they decide they never want to become pregnant.
What challenges do women face in seeking treatment?
It is often a struggle for women to navigate treatment systems when they have children. Many treatment centers do not accept children. So if you need inpatient care for addiction, you sometimes have to forego that care because the facilities available do not allow you to take your children with you.
I think that women who use substances are judged in many different ways when it comes to care and motherhood. But when you talk to these women, they try to be the best moms they can be. And so it becomes a challenge. Sometimes they are afraid to report their substance use to providers because they are afraid that that provider will automatically appeal to child protection. True, if the child is really in danger, it is justified. But there are other times when that won’t happen, but moms are still concerned that it will, and that’s why they don’t tell their caregivers that they need help.
Another challenge is something called “telescoping,” which has to do with the trajectory of addiction. It is that period between when a person starts using a substance and when he becomes addicted to that substance. This period appears to be shorter in women than in men. Women are also more likely to have experienced serious trauma, such as sexual abuse, and often, if or when they go for treatment, they end up with other serious problems that they also need help with.
The recent scholarship you received will help identify ways to better support women with opioid use disorder. Tell us more about it.
The aim of the grant is to find out how we can use technology and virtual or phone-based navigation processes to help women get the care and support they need. In some cases, we know that virtual or telephone assistance may not be enough. So how can we best connect them with recovery groups in their area that meet in person or inpatient facilities that will treat them and also help them figure out their childcare needs? And how can we encourage women in need of assistance to participate in these services? By truly understanding the barriers that prevent women with opioid use disorder from accessing and participating in care, we can develop a program that will really help. That’s why it’s so important to build a community advisory board that includes women in recovery, their family members, and leaders in the recovery community to help lead this effort.
What do you think people should know about the opioid epidemic?
Often in the news, the opioid epidemic is reported as a problem that primarily affects white men. But many other groups are also affected. We need to use a health equity framework to ensure we serve everyone affected by the opioid epidemic. This project is really focused on using that health equity lens to help women with opioid use disorder.
In a sad way, the opioid epidemic has been dwarfed by COVID-19 of late, as the number of people who died from opioid-related overdoses last year is smaller than those who died as a result of the pandemic. But it’s important to remember that last year’s 81,000 deaths from opioids are still a huge, unacceptable number, especially when we have services and medicines that we know help people struggling with addiction. We have a lot of work ahead of us to ensure that women have equal access to those services and medicines.