Overdose Epidemic: Steps to Reduce Opioid Deaths in Women
Between 1999 and 2010, there has been a five fold increase in the number of prescription painkiller overdose deaths among women. "Prescription painkillers" refer to opioid pain relievers, such as Vicodin (hydrocodone), OxyContin (oxycodone), Opana (oxymorphone), and methadone.
According to a recent Vital Signs report released by the CDC, there have been nearly 48,000 deaths since 1999–with 6,600 deaths occurring in 2010 alone. The percentage increase in deaths was far greater in women showing a >400% increase compared to 265% in men. This rise is related closely to the increased prescribing of these drugs during the past decade.
The CDC analyzed data from the National Vital Statistics System (1999–2010) and the Drug Abuse Warning Network public use file (2004–2010). Data included emergency department visits and deaths related to drug misuse/abuse and overdose, as well as analyses specific to prescription painkillers. Basic findings included:
- About 42 women die every day from a drug overdose
- There were four times more deaths among women from prescription painkiller overdose than for cocaine and heroin deaths combined in 2010
- Women ages 45–54 have the highest risk of dying from a prescription painkiller overdose
Studies have shown that women are more likely to suffer from chronic pain, be prescribed prescription painkillers, be given higher doses, and use them for longer periods than men. Women also may be more likely than men to engage in “doctor shopping” (receiving a prescription for a controlled substance from multiple providers), and more likely to be prescribed opioid pain relievers combined with sedatives.
"Our goal and work with partners is to make sure they are being used in the right patients and right quantities and right dose," stated Christopher Jones, PharmD, MPH, health scientist at the CDC.
Some steps that health care providers can take when treating women include:
- Recognizing that women can be at risk of prescription drug overdose — it's not just a problem among men.
- Screening and monitoring for substance abuse and mental health problems.
- Prescribing only the quantity needed based on appropriate pain diagnosis.
- Using patient-provider agreements combined with urine drug tests for people using long-term prescription painkillers.
- Teaching patients how to safely use, store, and dispose drugs.
- Using their states' prescription drug monitoring program (PDMP) to help identify patients who may be improperly using opioids and other drugs. PDMP is a statewide electronic database which collects designated data on controlled substances dispensed in the state.
- Discussing pain treatment options, including ones that do not involve prescription drugs.
- Discussing the risks and benefits of taking prescription painkillers including when painkillers are taken for chronic conditions.
- Discussing treatment options for pregnant women dependent on prescription painkillers (eg, opioid agonist therapy).
- Avoiding prescribing combinations of prescription painkillers and benzodiazepines (eg, Xanax (alprazolam) and Valium (diazepam) unless there is a specific medical indication. Benzodiazepines can potentiate CNS depression when combined with opioids – consider reducing opioid doses by at least one-half.
"Health care providers can help improve the way painkillers are prescribed while making sure women have access to safe and effective pain treatment," stated Linda C. Degutis, DrPH, MSN, director of CDC's National Center for Injury Prevention and Control.