Pharmacologic treatments for women with addictions Michael P. Bogenschutz, MD * , Cynthia M.A. Geppert, PhD, MD Department of Psychiatry, University of New Mexico School of Medicine, 2400 Tucker NE, Albuquerque, NM 87131, USA Pharmacotherapy plays an important and growing role in addiction treatment. For many years, opioid replacement therapy has been the primary treatment for opioid dependence, and recent advances, such as the availability of buprenorphine, promise to increase the utility and availability of this form of treatment. For other addictions, psychosocial treatments (eg, counseling, therapy, and mutual help) provide the core of most treatment programs, but effective pharmacotherapies are available and many more are in development. The development of medications to treat addictions is one of the most exciting and rapidly evolving areas in addiction treatment research. There have been few studies examining the efficacy of any of these pharma- cotherapies in women. In 1994, the National Institute on Drug Abuse convened a conference to address the wide gap in scientific knowledge regarding addiction in women. The conference, entitled ‘‘Drug Addiction Research and the Health of Women,’’ reviewed the historical obstacles to conducting addiction research in women, such as the following: pharmaceutical company hesitation to conduct trials with women who might become pregnant; difficulties in recruiting women, particularly from minority ethnic groups, because of concerns about criminal justice and stigma issues; and the widespread academic and industry practice of recruiting men almost exclusively in research trials [1]. One of the work products of the conference was an ambitious agenda to extend the research mandate for addictions in women outside the traditional reproductive sphere to explore questions of prevention and treatment, epidemiology, etiology, biologic and behavioral mechanisms, and consequences of substance use [2]. Men generally outnumber women in addiction treatment settings by approxi- mately 2 to 1. The overall imbalance is even greater in research samples because of 0889-8545/03/$ – see front matter D 2003 Elsevier Inc. All rights reserved. doi:10.1016/S0889-8545(03)00070-6 * Corresponding author. E-mail address: mbogenschutz@salud.unm.edu (M.P. Bogenschutz). Obstet Gynecol Clin N Am 30 (2003) 523 – 544