Today was another day as usual for Lakeisha. She looked at the bottle sitting in front of her, fully aware that taking one more pill could have irreversible effects. The children would be home soon. She couldn’t put work off one more day, and the unexpected news of a baby on the way was too much. “I really am in pain,“ she rationalized.
Although she and Michael had been together for over six years and they were childhood sweethearts, she knew he wouldn’t understand. Her loneliness compounded when she thought about her family. Lakeisha knew she needed help, but she remembered the way her mom looked at her when Lakeisha hinted she might have a problem. She wasn’t sure what made her feel more shameful — the look or the words.
Her doctor suggested medication and a program. “It didn’t work before, why would it work now?” Lakeisha thought. She thought about her responsibilities. “I’m a mom,” the words echoed in her head as if she had screamed it out loud. “Besides, one more screw up and I know Michael is gone.”
Lakeisha needed to silence the voices in her head, the pain in her … … heart. Not just the pain in her heart, but the pain that started her relationship with opioids. “Maybe tomorrow will be better,” Lakeisha said as she took one more pill.
Although this story is fictional, many women can relate to Lakeisha’s story. If you are misusing or addicted to opioids or know someone who is, know that opioid use disorder (OUD) is not a moral problem; it is a brain disease. With comprehensive treatment, supportive relationships, and sustainable tools to reduce the likelihood of relapse, you can overcome this disease.
Opioid Use and Its Impact on Women
Many types of treatment and recovery programs for OUD are male-based. Gender plays a key role in how pain is experienced, how opioids are prescribed, and how dependency develops—making gender-responsive treatment essential.
Research suggests women may be more vulnerable to opioid dependence due to biological, social, and prescribing factors. Because women are prescribed opioids at a higher rate than men and are at a greater risk of relapse, we must understand this opioid crisis and how it could affect you or someone you know. We’re breaking the silence with education, empathy, compassion, and solutions.
There are many reasons women are prescribed opioids and may be more vulnerable to misuse. Women experience pain differently from men, including reporting pain more often and being more pain-sensitive. Women visit doctors more often than men, and are more susceptible to painful illnesses, such as irritable bowel syndrome and fibromyalgia. Conditions like these are treated more frequently with opioids than other health issues.
Women treated for OUD report higher rates of intimate partner violence (IPV). In general, women experience more violence and sexual abuse, including the psychological aftermath of the trauma, such as depression, anxiety, and post-traumatic stress disorder. Experiencing trauma can have psychological effects that may increase the risk of opioid misuse. Opioid use can also impact sexual health by affecting decision-making, increasing vulnerability to sexually transmitted infections, and disrupting overall well-being.
Lesbian women may have an increased risk of sexual and physical abuse and the resulting mental and physical trauma, leading to increased substance use.
Stigma and Its Unique Impact
Opioid misuse and addiction are, unfortunately, perceived as a character flaw instead of an illness, especially for women. This not only affects how those misusing opioids are regarded and treated by family, friends, and co-workers, but also by medical professionals.
But there’s an even more ominous factor: the way women perceive themselves. Many feel ashamed.
According to an article in Sage Journals, a World Health Organization survey of 14 countries found that substance use disorder (SUD) is more stigmatized than other mental illnesses. It is probably no surprise that the same study found that participants reported that shame was a major reason they did not seek help.
You won’t get arrested for sneezing and coughing — possible signs of a cold or the flu. No one treats you as if you are flawed. No one would dare say you are a bad mother for having a runny nose or getting treatment for it.
Having street opioids or using them when not prescribed to you, on the other hand, is a crime. The stigma against women who misuse opioids is worse than that against men. While those with SUD are considered dangerous, women are often labeled “bad women.” Mothers are considered selfish and bad parents.
When women internalize stigma and feel too ashamed to seek help, it can worsen their OUD, causing further physical and mental health problems, and the loss of support systems as women isolate. Women can end up losing their children, which is a fear that may also keep women from seeking help.
Imagine the self-stigma and stigma from others, including physicians, when a pregnant mom is misusing opioids.
This may help explain the rise in neonatal abstinence syndrome (NAS). When pregnant mothers who use opioids give birth, the baby can go into withdrawal because they are abruptly no longer getting opioids. NAS rose by almost 300% from 2000 to 2009.
Breaking the Silence
Understanding that opioid misuse and dependency are not moral flaws is the first step in getting help. If you are misusing or addicted to opioids, know that you are valuable, needed, loved, and enough. You deserve relief, compassionate and empathetic interventions, support, and to live a happy, peaceful, fulfilling life. And, you still can!
Many women have mental health issues and trauma along with OUD, and use opioids to self-medicate. For some, like Lakeisha in the opening story, opioids serve as a physical and emotional pain reliever and coping skill.
Consequently, the best OUD treatment is comprehensive. Depression, anxiety, PTSD, and any other mental health issues must also be treated along with OUD. Old habits of turning to opioids or other substances to cope with life must be replaced with healthier stress management techniques, practices that promote high self-esteem, effective communication strategies, self-care routines, and spiritual practice. Supportive relationships are also important to recovery.
Medication-assisted treatment is an option. Some programs are abstinence-based, while others may focus on harm reduction.
The best prevention programs will address the intersectional determinants affecting OUD in women, like pregnancy, motherhood, and women-focused stigma.
We have empowered you with information and support to know that women challenged with OUD are not alone and are justified in getting assistance that addresses all of their needs. Here are some facilities you can check out and see if they work for you:
- DC Department of Behavioral Health: Confidential mental health and substance use support.
- DC Health Pregnancy & Family Support Line: Pregnancy and family support.
- Live.Long.DC.: Harm reduction (including free naloxone) and treatment services.
- Us Helping Us, People Into Living, Inc.: Culturally responsive care for Black communities, including HIV/STI services.
- MedMark Treatment Centers: Medication-assisted treatment, including care for pregnant women.
- Samaritan Inns: Holistic programs, including long-term residential recovery.
Your health, your body, and your healing journey matter—and you deserve support every step of the way.
LaShonda Tucker
LaShonda Tucker is a freelance writer, poet, and spoken word artist in Atlanta. When she isn't writing, she enjoys playing her violin. She earned her master's degrees from the University of Georgia and Kennesaw State University, and her bachelor's degree in English from the University of Michigan.
