The United States is experiencing a devastating drug epidemic. In 2015, 52,404 Americans died of drug overdoses, more than any other year on record, causing more deaths than car crashes or gun violence.
Nearly two-thirds of the overdose deaths (33,091) were caused by opioids, a class of drugs used to reduce pain. The most common opioids are oxycodone (OxyContin), hydrocodone (Vicodin), morphine, methadone, Fentanyl (a synthetic opioid), and heroin.
While opioid overdoses are more common in men than women, the rates among women are rising faster than the rates among men. According to a report produced by the U.S. Department of Health and Human Services Office on Women’s Health:
Between 1999 and 2010, overdose deaths from prescription painkillers increased more than 400% among women, compared to an increase of 237% among men; between 2002 and 2013, heroin use among women increased 100% compared to an increase of 50% among men.
The report, Opioid Use, Misuse, and Overdose in Women, also examines how women are affected differently than men by the opioid epidemic and points out the need for additional research on these differences. One national trial suggests that women who use opioids not only progress to dependence more quickly than men, but also experience more cravings than men.
Because most people first use opioids to manage either acute or chronic pain, we need to also understand the similarities and differences in how men and women experience pain. An article in Vox examines new research by medical sociologist Hanna Grol-Prokopczyk:
In a 2016 paper, Grol-Prokopczyk uncovered huge disparities in how Americans experience pain. Examining 12 years of data from the biennial Health and Retirement Study, she found that women were more likely to experience severe pain than men, and that pain doesn’t decrease as we age. In fact, it goes up with age, and those over the age of 80 reported experiencing the most pain.
A new study from the Centers for Disease Control and Prevention sheds light on how the number of days of a person’s first opioid prescription correlates with long-term use. Researchers found that when a person takes an opioid prescription for longer than five days, the likelihood of long-term use increases dramatically. And the demographics of long-term users who continued to use opioids for more than a year? The study found they were more likely to be older and female, and to have been diagnosed with a pain condition before taking opioids.
Women, in fact, are more likely to suffer from chronic pain conditions than men. According to The Society for Women’s Health Research (SWHR),
Approximately 50 million American women live with pain associated with chronic fatigue syndrome, endometriosis, fibromyalgia, chronic migraine headaches and other chronic pain conditions. Women are also more likely than men to suffer from more than one of these chronic pain conditions, leading to an estimated $91 billion in annual direct and indirect costs for the four aforementioned disorders alone.
In addition, women are more like to receive pain medications:
Women with chronic pain conditions are more likely to be treated with prescription pain relievers, like opioids, at higher doses and also use them for longer periods than men. This has led to more women becoming dependent on these prescription pain relievers more rapidly than men.
Efforts to mitigate the opioid crisis must include researching more and better ways to prevent and treat chronic pain. This will simply address one aspect of the opioid epidemic. The factors that lead to addiction are complex, as is addressing those factors. Yet we do know strategies that work. According to U.S. Surgeon General Vivek Murthy:
We know what strategies work and what we need to do to end this epidemic: we need to expand treatment.
We need to get naloxone in the hands of more first responders and family members.
We need to not only train health care providers on how to treat pain, but also ensure that alternatives to pain management are covered by insurance.
We need to make sure everyone understands that opioids are addictive.
Finally, we need to stop seeing addiction as a moral failing and start treating it as the chronic illness it is, one that demands our skill, urgency and compassion. Once we stop judging, we can start helping.