Steep increase in deaths from prescription painkillers among women

Although men are more likely to die of a prescription opioid overdose, the gap between men and women is narrowing.

A fivefold increase in the number of prescription painkiller overdose deaths occurred among women between 1999 and 2010, according to a Vital Signs report released by CDC.

"Prescription drug overdose deaths have skyrocketed in women," said Tom Frieden, MD, MPH, CDC Director, during a July 2 telebriefing. "We are also seeing not only deaths but a great increase in the number of emergency department visits for drug misuse or abuse, including opioid overdose or opioid misuse."

CDC reported that in 2010, there were 200,000 emergency department visits for opioid misuse or abuse among women, equaling about one visit every 3 minutes.

Frieden stated that compared with other health problems tracked by CDC, few are getting worse or affecting a wider variety of age groups in the U.S. population than prescription painkiller misuse and abuse.

He noted that the increase in opioid overdoses and opioid overdose deaths was directly proportional to the increase in prescribing of painkillers. Frieden said that use of opioids or narcotic pain relievers is increasing to an extent that "we would not have anticipated and that could not possibly be clinically indicated."

"These are dangerous medications; they should be reserved for situations like severe cancer pain where they can provide extremely important and essential palliation," stated Frieden. "But in many other situations, the risks far outweigh the benefits. Prescribing an opioid may be condemning a patient to lifelong addiction and life-threatening complications."

Although men are more likely to die of a prescription opioid overdose, the gap between men and women has been narrowing. Since 1999, the percentage increase in deaths among women has been greater (400%) than that in men (265%).

Compared with men, CDC has found that women are more likely to have chronic pain, to be prescribed painkillers and other medications, to be given higher doses, and to use prescribed drugs for longer periods of time. A potential reason could be that the most common forms of pain, such as abdominal pain, migraine, and musculoskeletal pain, are more prevalent in women.

Because on average women weigh less than men, they are more likely to experience adverse events from opioids at similar doses. Also, women who are taking opioids can give birth to opioid-addicted children, and these children are at higher risk of having heart malformations from the opioid medication.

Data from the Vital Signs report indicated that prescription painkillers have contributed substantially to increases in drug overdose deaths among women:

  • More than 6,600 women (equaling 18 women every day) died from a prescription painkiller overdose in 2010.
  • Deaths among women from prescription painkiller overdose occurred at a fourfold higher rate than deaths from cocaine and heroin combined in 2010.

Additional key findings from the Vital Signs report included the following:

  • Each day, about 42 women die from a drug overdose. Since 2007, more women have died from drug overdoses than from motor vehicle crashes.
  • In 2010, drug overdose suicide deaths accounted for 34% of all suicides among women compared with 8% among men.
  • More than 940,000 women were treated in emergency departments for drug misuse or abuse in 2010.

When treating women, CDC recommended that health care providers:

  • Follow guidelines for responsible opioid prescribing, including screening and monitoring for substance abuse and mental health problems.
  • Use prescription drug monitoring programs, which can help identify patients who may be using opioids and other drugs improperly.
  • Discuss pain treatment options, including those that do not involve prescription drugs.
  • Talk about the risks and benefits of taking prescription painkillers for chronic conditions and especially during pregnancy.
  • Avoid prescribing combinations of prescription painkillers and benzodiazepines unless a specific medical indication exists.

Steps that women can take to help protect themselves from prescription painkiller overdoses include:

  • Using prescription drugs only as directed by health professionals.
  • Discussing all medications they are taking with their health care provider, including OTC medications.
  • Discussing pregnancy plans with their health care provider before taking prescription painkillers.
  • Disposing of medications properly, as soon as the course of treatment is complete.
  • Helping prevent misuse and abuse by not selling or sharing prescription drugs.
  • Never using another person’s prescription drugs.
  • Getting help for substance abuse problems (800-662-HELP) and calling Poison Help (800-222-1222) with questions about medications.

Findings in the Vital Signs report were based on CDC analysis of data from the National Vital Statistics System (1999–2010) and Drug Abuse Warning Network public use file (2004–2010).

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