Opioid epidemic continues to kill men at higher rates

As fatal drug overdoses continue to steal the lives of thousands of vulnerable Americans each year, there’s growing evidence men everywhere in the United States are dying at higher rates not just from opioids, but from methamphetamine and cocaine too.

The highly lethal synthetic opioid fentanyl is largely to blame for the increase in drug overdose deaths, which killed nearly 107,000 people in 2021, according to the Centers for Disease Control and Prevention.

Fentanyl has also increasingly contaminated the illegal supply of cocaine in the United States because the drugs are made and stored together, experts say.

New data published this week in the journal Neuropsychopharmacology shows men are “reliably at greater risk” of fatal overdoses from both opioids and psychostimulants compared to women.

Researchers said they found a “regular” and “big” pattern across all 50 states and Washington, D.C., showing men were at least two times more likely to die from using drugs compared to women.

“The thing we were quite surprised by was, even though there are very different rates of overdoses in different states that can be associated with poverty and stressors, within each state there’s still a very clear sex difference,” said Eduardo Butelman, a professor at Mount Sinai School of Medicine in New York City and the report’s lead author.

How many people are dying from drug use?

Using CDC data on drug overdose deaths, researchers found the following mortality rates for different substances:

• Synthetic opioids (fentanyl, for example): 29.0 deaths per 100,000 people for men, compared to 11.1 for women• Heroin: 5.5 deaths per 100,000 people for men, compared to 2.0 for women• Psychostimulants (methamphetamine, for example): 13.0 deaths per 100,000 people for men, compared to 5.6 for women• Cocaine: 10.6 deaths per 100,000 people for men, compared to 4.2 for women

Why are men more likely to die from drug overdoses?

There are still many unanswered questions about why men die from drug use at higher rates than women, the authors of the report 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,” Nora Volkow, one of the study’s authors and the director of the National Institute on Drug Abuse, told News-Medical.Net.

In general, men are more likely than women to use drugs in the first place, so they are more likely to die from overdoses, said Alex Kral, an epidemiologist with North Carolina’s Research Triangle Institute who focuses on drug use.

“Men are more likely to be using these drugs than women,” Kral said. “That’s why they’re more likely to have the medical complications from drug use, which includes overdose.”

Figuring out why men are more likely to use drugs to begin with is “very complicated,” Kral said. But there’s evidence that:

• Men may be more likely to use drugs to relieve psychological pain and mental health problems, instead of seeking therapy or medical treatment, Kral said.
• Risky drug use is most common after someone gets out of prison, Kral said. Because more men, especially Black men, are incarcerated compared to women, men are more likely to use drugs after being released, he said.

More men aren’t dying from drug use simply because of biological differences between the sexes, Butelman said.

“The other side is extremely important too,” he said. “Women are still dying of this. So this is not to say we don’t need to take care of women. We absolutely do. It’s more about finding the best way to take care of everybody in different ways.”

Men more likely to die from using meth, cocaine

The study also looked at different age groups, ranging from 15 to 74, and found that young men and older men were all dying from using meth and cocaine at much higher rates than women. When broken down by age among men, younger men were less likely to suffer heart attacks and strokes from using cocaine or meth.

Differences between women and men are “important targets for investigation,” the report says, and more research can lead to better “prevention and intervention to mitigate risk” surrounding drug overdose deaths.