Women and opioid dependence treatment: office-based versus opioid treatment program-based care?

Women are under-represented in opioid dependency treatment, yet national statistics indicate that, as the non-medical use of prescription pain relievers rises, more women will require this treatment. Important considerations for the treatment of opioid-dependency in women include high rates of psychiatric illness, concerns regarding substance abuse and treatment in pregnancy, high rates of history of trauma, relationship dynamics that put women at risk for sexually transmitted diseases, and social factors such as lower economic status and responsibilities as care givers. Traditional approaches to opioid-dependency treatment, such as methadone maintenance programs (MMPs), have not consistently addressed these needs and do not provide flexible care and anonymity. Recent data suggest that, in comparison to MMPs, a greater percentage of women are entering office-based treatment. Yet it is unclear whether physicians' offices will be equipped to adequately handle women's treatment needs. Nonetheless office-based treatment may provide a solution for women concerned about anonymity, stigma, and the requirement of daily visits to a MMP.