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Why are Men More Likely to Die from a Heroin Overdose?

According to the National Institutes of Health, men are about five times more likely than women to die of a heroin overdose. Deaths from heroin overdose have increased exponentially in recent years for both men and women, but the ratio has remained about the same. Why do so many more men die of heroin overdose?

Sarah Berman explores the issue in a 2017 VICE article. In British Columbia, about 80 percent of deaths by heroin overdose were men. Berman puts forth two main reasons for this. First, men are just more likely to use hard drugs. Broadly speaking, this appears to be true. According to the NIH, men are also about four times as likely to die from cocaine overdose. The numbers are slightly different, however, for prescription drugs. While men are still more likely than women to die from an overdose of benzos or opioid painkillers, men are only about 25 percent more likely to die from a benzo overdose and about 30 percent more likely to die from opioid painkillers. This suggests that men’s greater willingness to risk using hard street drugs may be part of the problem.

The second factor Berman identifies is the difference in the way men and women use drugs. Specifically, men are more likely to use drugs alone. This means that if a man begins to overdose, there’s is less chance someone will notice and get help, or possibly administer Narcan. Women are, in fact more likely to use and abuse prescription opioids than men and more likely to end up in the emergency room because of overdose. Despite this, more men die of opioid painkiller overdose, lending credibility to the “men use alone” argument.

In addition to the factors Berman identifies, men are about twice as likely as women to become addicted–about 12 percent and six percent of the population, respectively. Heroin overdose is not very common among new users, as they are more likely to snort, smoke, or ingest opioids as pills, rather than inject heroin. Overdose is most common among addicts who have been using for two years or more. Therefore, the baseline for fatal overdose for men is already twice that of women.

A smaller but still significant factor may be suicide by overdose. The NIH estimates about 12 percent of fatal overdoses are intentional suicides. In the US, men are about three to five times more likely than women to commit suicide. Of the 12 percent of overdose suicides, that would mean only two or three percent are women.

A final possible factor is somewhat paradoxical. Men are more likely to be treated for addiction, either because men are less sensitive to the stigma of addiction, or because men are more likely to be court ordered to undergo treatment. While getting treatment is certainly a positive step, it does lower an addict’s tolerance, making him more vulnerable to overdose if he relapses. Some studies have shown that men are more likely than women to relapse, while other studies have shown the reverse is true. If men are more likely to relapse, it would help explain the massive disparity in fatal overdose.


If you or someone you love is struggling with heroin addiction, get help before it’s too late. Gardens Wellness Center can make detox as safe and as comfortable as possible and support you as you begin recovery. Call today at 844-325-9168 or email us at