Men Die of Overdose 2-3 Times More Than Women

Higher rates of use do not entirely account for the increase in mortality risk for men

By Deborah Jeanne Sergeant

Men died of opioid and stimulant drugs at a rate two to three times higher than women between 2020 and 2021, according to a recent study. The data looked at fentanyl, heroin, methamphetamine and cocaine.

The study said that men’s higher rates of use do not entirely account for the increase in mortality risk.

The study was published by Neuropsychopharmacology and led by investigators at the Icahn School of Medicine at Mount Sinai in New York City and the National Institute on Drug Abuse, part of the National Institutes of Health.

“Though men and women are being exposed to the modern, fentanyl-contaminated drug supply, something is leading men to die at significantly higher rates,” said Nora Volkow, physician and director of NIDA and one of the co-authors on the study in a press release. “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.”

The study indicated that further research must be done to determine why more men die from stimulant and opioid overdoses than women.

The numbers ring true in Erie County. The Department of Health’s statistics related that men outnumber women for opioid related deaths at a ratio of 2:1.

Bridget Vaccaro, family nurse practitioner and clinical director at Neighborhood Health Center’s Northwest location in Buffalo, thinks that socially constructed beliefs about gender are driving behavioral differences that result in higher overdose rates, with men less likely to seek treatment.

“Men do not seek help as much as women,” she said. “Men do not admit they need help; it’s a pride thing. Women are more apt to admit they need help at a certain point.”

She added that women may be more motivated to seek help because they do not want to be separated from their children.

“Men statistically start substance use at an earlier age,” said Carolyn Grisko director of clinical services at Beacon Center in Buffalo. “They may have had a longer history of use and bigger tolerance.”

There’s also the factor of men eschewing healthy ways of dealing with trauma and stress and turning to drugs. Grisko said that women tend to deal with trauma issues without feeling that doing so exhibits weakness.

The causes of opioid dependency may shed some light. Joshua Lynch, doctor of osteopathic medicine and emergency medicine physician at UBMD Emergency Medicine, said that women have higher rates of prescription opioids for chronic pain than men, “and men have higher rates of illicit drug use,” he added. “That’s one piece.”

The lack of safety of illicit drugs would translate to higher death rates, along with men being more likely to combine alcohol or other substances and opioids. But Lynch said that other biological differences between men and women could be present.

“It’s an interesting and troubling statistic, but it leaves us with more work to do before we come up with a clear-cut answer,” he said.

Evan Frost, assistant director of communications and public information at the NYS Office of Addiction Services and Supports in Albany, said that more than 70% of treatment admissions are male.

“A higher prevalence of substance use disorder in men is not new and has been a steady trend in both New York state and the rest of the country for years,” he said.

As to why more men are dying — especially since they’re entering treatment programs at higher rates — is not entirely clear.

Most of the programs OASAS offers are oriented toward men or are men-only, including programs on parenting, relationships in early recovery, anger management and specialized services for those involved in the criminal justice system.

“In general, we are also addressing opioid overdoses by increasing access to care through low-threshold access to medications for opioid use disorder, providing overdose prevention education and naloxone and providing fentanyl and xylazine test strips so people who use drugs can be informed about what is in their supply,” Frost added.

The Erie County Opiate Epidemic Task Force offers an extensive array of services.

“Our department has peers, support groups, an extensive distribution system for Narcan and other harm reduction supplies like fentanyl test strips, a Text for Narcan program (716-225-5473), outreach with education, and Narcan training for individuals, groups and businesses–virtual at www.erie.gov/opioidtrainings and in-person,” said Cheryll Moore, director of the Erie County Opiate Epidemic Task Force.