December 2017
In This Issue
The Opioid Epidemic

Institute Happenings

Upcoming Events 
  Recent Blogs 

Dear Friends,
The opioid epidemic in the United States has recently been declared a public health emergency. According to the Centers for Disease Control, over 64,000 individuals died from a drug overdose in 2016 alone, with opioids such as heroin, fentanyl, and prescription pain killers the increasing cause. In this issue, we will examine the opioid epidemic through the lens of women’s health and explore the influences of sex and gender on opioid addiction. 

Nicole C. Woitowich, PhD
Director of Science Outreach and Education 
The Opioid Epidemic in the United States: A Women's Health Issue
Opioid-use disorders and opioid-related deaths have been rising at an alarming pace since the early 1990s. Now, the numbers have reached epidemic proportions. The Centers for Disease Control (CDC) estimates that 91 individuals die every day from an opioid overdose.
Opioids are a class of drugs which elicit pain-reducing, sedative, and euphoric effects. They include prescription drugs such as codeine, morphine, fentanyl, and oxycodone which are used clinically to provide pain relief. They also include illicit drugs such as heroin. When prescribed and used appropriately, prescription opioids can be useful for pain relief following an injury or surgery. Unfortunately, they also carry the risk of dependency or addiction.

Women have been uniquely affected by the opioid crisis. A report by the Agency for Healthcare Research and Quality found that between 2005 and 2014 hospitalizations involving prescription opioids and heroin increased by 75% for women, compared to a 55% increase among men [1]. Just as hospitalizations have increased, so too have opioid related deaths. The CDC estimates that between the years 1999 and 2010, fatal prescription drug overdoses rose by 400% in women, compared to 265% in men [2]. What makes women particularly vulnerable to this devastating epidemic? Below we take a closer look at the sex and gender influences on opioid-use disorders.
Sex and Gender Differences in Opioid Abuse

The Perfect Storm
Research suggests that women experience pain differently than men, due to both biological sex-based and gender-based factors [Reviewed in 3,4]. First, the prevalence of certain diseases and disorders which cause widespread or chronic pain is higher in women than men. These include migraine headaches, osteoarthritis, irritable bowel disease, and autoimmune disorders such as rheumatoid arthritis [4]. Women are more likely to report pain to their physicians and receive prescriptions for opioid pain killers, compared to men [5,6]. Thus, putting them at increased risk for misuse and dependency.  

Sex and gender differences also play a role in the course of substance use to substance addiction. The timespan between when a woman first uses a substance to dependence is accelerated compared to men – despite using less of the substance for a shorter amount of time [7].

Treatment options
For individuals with opioid-use disorders, medication assisted treatment (MAT) is the leading treatment approach. Medications such as buprenorphine, methadone, and naltrexone are  used to help people reduce or quit their use of opioids by minimizing physical dependence, suppressing withdrawal symptoms, and blocking the effect of other opioids [8]. Yet, a majority of research which guides MAT has been conducted primarily in men, and as such, treatment options are tailored towards the opioid-user of the past such as young inner-city, heroin-using males, rather than middle-aged females [9,10].

In the event of an opioid overdose, the drug naloxone can be administered as a life-saving agent to rapidly reverse the effects of opioids. Yet, women are three times less likely to receive naloxone from emergency medical services, compared to men [11]. This may reflect a gender-bias in identifying individuals suffering from an opioid overdose.

Together, this indicates an increased need for sex- and gender-specific research into opioid use and opioid-use disorders. For more information on opioid-use disorders and the opioid epidemic please consider visiting the following resources:
1. Weiss et al., Healthcare Cost and Utilization Project (HCUP) Statistical Briefs [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2006-.
2016 Dec.
3. Manson, JE. Metabolism. 2010 Oct;59 Suppl 1:S16-20.
4. Paller et al., Pain Med. 2009 Mar; 10(2): 289–299.
5. Simoni-Wastila L. J Womens Health Gend Based Med. 2000 Apr;9(3):289-97.
6. Hemsing et al., Pain Res Manag. 2016; 2016: 1754195.
7. Greenfield et al., Psychiatr Clin North Am. 2010 Jun; 33(2): 339–355.
9. Mattick et al., Cochrane Database Syst Rev. 2009 Jul 8;(3):CD002209.
10. Bawor et al., Biol Sex Differ. 2015 Nov 10;6:21.
Institute Happenings  
Grant Deadline Approaching
Last chance to submit your proposal for the Shaw Family Pioneer Awards!

Two awards of $12,000 in direct costs will be granted to research or tenure-line faculty members. Proposals must be directly relevant to sex-inclusive research, focusing on sex-based determinants of health and disease. The application deadline is December 12th . For more information and to access the application, please visit our website at click here.  
Abstract Submission for the 2nd Annual Symposium on Sex Inclusion

Do you conduct sex-inclusive or sex-based research? Hurry and submit your abstract for the 2nd Annual Symposium on Sex Inclusion in Biomedical Research before it is too late! Students, faculty, and staff from Northwestern University and neighboring institutions are encouraged to participate. Abstracts will be selected for both oral and poster presentations. The submission deadline is December 18th . Click here for more information!
Upcoming Events  

Tuesday, December 12th: Monthly Women's Health Research Forum & WHRI 10th Anniversary Celebration
Science to Care: A Decade of Transforming Women's Health Research at Northwestern and Beyond

Teresa K. Woodruff, PhD
Founder and Director, Women's Health Research Institute
The Watkins Professor of Obstetrics and Gynecology
Dean, The Graduate School and Associate Provost for Graduate Education

 12:00PM to 1:00PM
Prentice Women's Hospital
250 E. Superior Street
3rd Floor Conference Room L South

Continuing Nursing Education credits are not available at this forum.
Thursday, January 25th: 2nd Annual Symposium on Sex Inclusion in Biomedical Research
A Spotlight on Autoimmunity

Plenary Lectures 
Maureen Su, MD - Sex Bias in Autoimmune Disease
Associate Professor, Department of Pediatrics and Microbiology/Immunology
University of North Carolina, Chapel Hill
Sabra L. Klein, PhD - Sex is a Biological Variable that Affects the Outcome of Infection and Vaccination
Associate Professor, Department of Molecular Microbiology & Immunology
Johns Hopkins Bloomberg School of Public Health

Keynote Lecture 
Jayne Danska, PhD – Emerging Mechanisms in Immune-Mediated Diseases: Genes, Sex, and Microbes
Anne and Max Tanenbaum Chair in Molecular Medicine
Professor, Departments of Immunology and Medical Biophysics
University of Toronto
Senior Scientist, Genetics and Genome Biology
Hospital for Sick Children

9:00 AM to 3:00 PM
Prentice Women's Hospital
250 E. Superior Street
3rd Floor Conference Room L South
The Women's Health Research Institute at Northwestern University is leading the charge to eradicate sex bias in biomedical research. Help us accomplish this bold aspiration by supporting the Institute with a year-end gift.
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