• Posted June 15, 2023

Drug Overdoses Are Killing Men at Much Higher Rates Than Women

American men die of drug overdoses at a higher rate than women, but new research shows that difference can't be completely explained by factors like misuse or greater use.

A study led by scientists from the Icahn School of Medicine at Mount Sinai in New York City and the U.S. National Institute on Drug Abuse (NIDA) found that men were two to three times more likely than women to die of a drug overdose between 2020 and 2021.

That included overdoses from opioids, such as fentanyl and heroin, and from stimulants, including methamphetamine and cocaine.

Men use drugs at higher rates than women, but this doesn't explain all of the difference, the study authors said.

“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 study co-author Dr. Nora Volkow, director of the NIDA.

“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,” Volkow added in an NIDA news release.

In the study, the researchers analyzed data on overdose deaths in people aged 15 to 74 from the U.S. Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) platform. They also used data from the annual National Surveys on Drug Use and Health to estimate and control for rates of drug misuse in men compared to women.

After controlling for a sex-specific rate of drug misuse, the researchers found that the overall rates of drug overdose deaths from synthetic opioids were 29 deaths per 100,000 people for men, compared to just over 11 for women.

For heroin, there were 5.5 deaths per 100,000 people for men and 2 per 100,000 for women. They found about 13 deaths per 100,000 people for men compared to 5.6 for women for stimulants. For cocaine in particular, there were 10.6 deaths per 100,000 for men and 4.2 for women.

This higher overdose death rate in men was observed across the life span and was consistent across states, the findings showed.

When the investigators analyzed the data by 10-year age groups, they found men had greater rates of death than women across each group for overdose deaths involving synthetic opioids, as well as for the other drug categories, with few exceptions.

The study authors suggested the findings are likely a combination of potentially greater biological vulnerability to drug toxicity, taking the drugs in a riskier way, and other social- and gender-related factors.

In all, nearly 107,000 people died of a drug overdose in 2021 in the United States, largely because of fentanyl.

“These data emphasize the importance of looking at the differences between men and women in a multilayered way,” said lead study author Eduardo Butelman, an assistant professor of psychiatry at the Icahn School of Medicine at Mount Sinai. “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.”

The study was published June 14 in the journal Neuropsychopharmacology.

More information

The Substance Abuse and Mental Health Services Administration offers help for those dealing with drug and mental health issues.

SOURCE: U.S. National Institute on Drug Abuse, news release, June 14, 2023