Women's Health: Substance Use Disorder in Women

In this episode, we talk with Dr. Chwen-Yuen Angie Chen, MD, Clinical Professor at Stanford Health Care, about how substance use disorders uniquely affect women. The conversation covers the definitions of substance use disorder, how to effectively engage patients on substance misuse and identify those at risk, and review current barriers to care and available treatment options. We'll explore recent studies on excessive alcohol consumption and its associated health risks in women.  We’ll also examine opioid use disorders, highlighting the line between proper use for chronic pain management and the potential for misuse, and evaluate the risks and benefits of various treatments for opioid use disorder. Lastly, we'll discuss the importance of empathy, patience, and compassion in treating patients and supporting families through recovery, alongside resources and treatment programs that can help guide them through the process.

Resources for patients:  
•https://womenforsobriety.org/
•https://smartrecovery.org/

Resources for physicians discussed in episode: 
•Risk Index for Overdose or Serious Opioid-Induced Respiratory Depression (RIOSORD) Score
•Ashton Method for benzodiazepine taper
•Guidance for Buprenorphine prescribing:  https://bridgetotreatment.org/addiction-treatment/ca-bridge/

1. Determine the risk factors for substance use disorders that are prominent in women.
2. Differentiate between appropriate use and misuse of opioids for chronic pain management.

In support of improving patient care, Stanford Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

Credit Designation 
American Medical Association (AMA) 
Stanford Medicine designates this Enduring Material for a maximum of 1.00 AMA PRA Category 1 Credits^TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.  

Accessibility Statement
 Stanford University School of Medicine is committed to ensuring that its programs, services, goods and facilities are accessible to individuals with disabilities as specified under Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Amendments Act of 2008.  If you have needs that require accommodations, please contact the CME Office.

Cultural and Linguistic Competency
The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area for the purpose of complying with California Assembly Bill 1195. Moreover, the Stanford University School of Medicine Multicultural Health Portal contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws.  You are encouraged to visit the Multicultural Health Portal: https://laneguides.stanford.edu/multicultural-health

References/Bibliography
1.National Institute on Drug Abuse. (2020). Research Report: Substance Use in Women Research Report Summary. National Institutes of Health, National Institute on Drug Abuse; Advancing Addiction Science. https://nida.nih.gov/publications/research-reports/substance-use-in-women/summary 
2.Sallaup, T. V., Vaaler, A. E., Iversen, V. C., & Guzey, I. C. (2016). Challenges in detecting and diagnosing substance use in women in the acute psychiatric department: a naturalistic cohort study. BMC psychiatry, 16(1), 406. https://doi.org/10.1186/s12888-016-1124-y 
3.Substance Abuse and Mental Health Services Administration. (2009). Substance Abuse Treatment for Women. In SAMHSA, Substance Abuse Treatment: Addressing the Specific Needs of Women (ch. 7). Treatment Improvement Protocol (TIP) Series, No. 51. HHS Publication No. (SMA) 13-4426. Rockville, MD. https://www.ncbi.nlm.nih.gov/books/NBK83257/ 
4.US Preventive Services Task Force. (2020). Screening for Unhealthy Drug Use: US Preventive Services Task Force Recommendation Statement. Journal of the American Medical Association, 323(22):2301-2309. https://doi.org/10.1001/jama.2020.8020  
5.Webb, L., Fox, S., Skårner, A., & Messas, G. (2022). Editorial: Women and substance use: Specific needs and experiences of use, others' use and transitions towards recovery. Frontiers in psychiatry, 13, 1078605. https://doi.org/10.3389/fpsyt.2022.1078605 

For activity related questions, please contact
     Name: Emily Manche
     Title: CME Compliance Coordinator
     Email: [email protected]

For CME general questions, please contact 
     Email: [email protected]

Mitigation of Relevant Financial Relationships

Stanford Medicine adheres to the Standards for Integrity and Independence in Accredited Continuing Education.

There are no relevant financial relationships with ACCME-defined ineligible companies for anyone who was in control of the content of this activity.

Member Information

Role in activity

Nature of Relationship(s) / Name of Ineligible Company(s)

Sharon Hung, MD
Director of Women’s Health
Clinical Assistant Professor, Medicine - Primary Care and Population Health
Stanford Health Care

Course Director

Nothing to disclose

Chwen-Yuen Angie Chen, MD
Clinical Associate Professor Medical Director, Primary Care Chemical Dependency Clinics
Stanford Health Care (SHC)

Faculty

Nothing to disclose

Ruth Adewuya, MD
Managing Director
Stanford University School of Medicine

Planner

Nothing to disclose

Lauren Taylor, BA
CME Intern
N/A

Planner

Nothing to disclose