Women and the Overdose Crisis: A Look at Tampa Bay
During this month in which we honor mothers, we turn our attention to women in our communities impacted by substance use and the overdose crisis. In preparation for celebrating a day that is dedicated to love and care, the most loving and caring action this organization — as an examiner of data, teller of stories, and convener of leaders — can do is to turn our attention to women in the overdose epidemic.
What is the rate at which women are impacted by this epidemic? What is the proportion of fatalities to overdose? Are the number of women overdosing increasing or decreasing? What age cohort of woman die most frequently from overdose? What are the drivers of overdose and substance use and women? This article is will examine the status of women within the overdose crisis in the Tampa Bay region.
The Tampa Bay MSA is home to over 2.6 million women and girls, which is 51% of the region’s population. Of this population, an estimated 202,125 women and girls have drug use disorders according to a report by the National Survey on Drug Use and Health (2024), and 1.5% of this population — or 2,873 females of all ages — have died in the past 5 years from overdose.
During the worst two years of the epidemic in the Tampa Bay region, women in their thirties were dying at record levels and at much higher rates than those in their forties or fifties, which differs from patterns leading up to, and following, the peak of the crisis.
In seeking to better understand this fatality trend, we examined peer reviewed literature. Among the most reproducible research findings discussed in peer reviewed articles, the following are likely contributors to this trend:
• Increased prevalence of substance use in women in past 3-4 decades of alcohol and drug use with lower levels of abstaining and higher levels of dependence (Grucza et al, 2008; Compton et al, 2007)
• Heightened vulnerability of women to adverse medical and social consequences (Chatham et al., 1999; Gentilello et al., 2000; Henskens et al., 2005)
• Telescoping: Women advance more rapidly than men from regular use to first treatment episode (Randall et al., 1999; Piazza et al., 1989)
• At treatment entry, with fewer years of use, women have more medical, psychiatric, and adverse social consequences than males (Randall et al., 1999; Hernandez-Avila et al., 2004)
These characteristics of substance use disorder also demonstrate the severity and early progression of substance use in women. In the context of synthetic opioids and adulterated substances – this early onset of SUD begets fatality and the trend of deceased thirty-year-old women.
While death trends for specific age cohorts differ between women and men (and the decedent population, as a whole), the overall deathrate topline trends for women who fatally overdose in Florida and the Tampa Bay region does mirror that of the general population. Women’s rate of reduction in deaths from the 2021 heights of the epidemic has been slightly faster than the rate for the general population. At a reduction of 11.99%, the fatality rate decrease for female Floridians outpaced the 10.78% reduction in the opioid deathrate for Floridians as a whole, between 2021 and 2023 (FDLE fatality raw data file, accessed 5/2025).
To continue this trajectory, we should examine the barriers that may disproportionately impact women and girls and factors keeping them from seeking treatment in a timely fashion.
• Women are less likely to be screened in primary and mental health care.
• Many communities lack treatment services for pregnant women.
• Similarly, treatment services lack childcare services for parenting women.
• Economic barriers (e.g., lack of insurance; other resources) disproportionately impact women.
• Trauma histories act as internal barriers, especially when confronted with co-ed campuses, treatment services, etc.
• While community stigma impacts all with SUD, women – and especially mothers – are hit hardest by social stigma and discrimination.
• Finally, separation of mental health and substance use services impact women who are at a higher risk for certain co-occurring psychiatric disorders such as mood, eating, anxiety, and post-traumatic stress disorder. (Brady and Ashley, 2005; Pelissier and Jones, 2005; Gordon et al, 2008; Killeen et al, 2011)
By working to incorporate gender-responsive, evidence-based therapies into treatment of women and by integrating programs that provide services and other programming specific to women’s needs (e.g., co-occurring disorders, trauma, childcare), treatment outcomes can be enhanced. When treatment outcomes are improved, not only does the person heal, but so does the family, and the intergenerational hold that substance use has on many families may just be broken.
Join us Thursday, May 22, at noon for our Mother’s Day Webinar. We will hear from Dr. Stephen Patrick, a leading voice on addiction and maternal-infant health. Click here to register.
References
Covington S, Bloom BE. Gender-Responsive Treatment and Services in Correctional Settings. In Women and Therapy, Elaine Leeder, Ed (2006). 29:3/4,p.9-33.
Gordon, et al. 2008. Assessment and treatment of co-occurring eating disorders in publicly funded addiction treatment programs. Psychiatric Services Sep;59(9):1056-9.
Hien, et. al. 2012. Attendance and Substance Use Outcomes for the Seeking Safety Program: Sometimes Less is More. JCCP, 80:1,29-42.
Hien et al. 2009. Multisite Randomized Trial of Behavioral Interventions for Women with Co-occurring PTSD and Substance Use Disorders. JCCP, 77(4):607-619.
Killeen, et. al. 2011. Assessment and treatment of co-occurring eating disorders in privately funded addiction treatment programs. American Journal of Addiction. May-Jun;20(3):205-11.
Luthar and Suchman. 2000. Relational Psychotherapy Mothers’ Group: a developmentally informed intervention for at-risk mothers. Developmental Psychopathology. Spring 12:2:235-53.
McHugh, et al. 2017. Sex and gender differences in substance use disorders. Clinical Psychology Review.
Messina and Grella. 2010. A randomized experimental study of gender-responsive substance abuse treatment for women in prison. Journal of Substance Use and Addiction Treatment; 38:97-107.
Sugarman, et al. 2017. Treatment Outcomes for Women with Substance Use Disorders: A Critical Review of the Literature (2010-2016). Current Addiction Reports. 4:482-502.