More men still die after overdosing on prescription painkillers in the U.S. each year, but women are catching up fast, according to a grim new report from government health researchers.
Opiate pain reliever deaths among women spiked five-fold in the decade from 1999 to 2010, climbing to 6,631, up from 1,287, according to an analysis by the Centers for Disease Control and Prevention. During that same period, prescription painkiller deaths among men jumped 3.6 times, to 10,020.
That means 17,000 people die each year from opiate overdoses, more than quadruple the number of a decade ago.
"Prescription painkiller deaths have skyrocketed in women," said CDC director Dr. Tom Frieden. "Stopping this epidemic in women -- and in men -- is everyone's business. Doctors need to be cautious about prescribing and patients about using these drugs."
About 42 women die each day in the U.S. from drug overdose, including 18 a day who die from prescription painkillers, the CDC found.
It's part of a worsening problem that saw some 943,365 women head to U.S. emergency departments in 2010 because of drug misuse or abuse, according to the study that analyzed data from the National Vital Statistics System and the Drug Abuse Warning Network, or DAWN. Top causes included heroin and cocaine, the psychoactive drugs called benzodiazepines – and opiate pain relievers.
Men used to be twice as likely as women to die from drug overdoses, most of which are unintended, researchers said. Now, the ratio is about 1.55 times. Overall, drug overdose deaths now claim more than 38,000 people in the U.S. each year.
Women are joining the boys' club of opiate overdoses for several reasons, experts say. Unlike illicit drugs like heroin and cocaine, prescription painkillers such as hydrocodone, oxycodone and fentanyl have a patina of legitimacy, said Dr. David Sack, an addiction psychiatrist with Promises Treatment Center in Malibu, Calif.
"People assume that because it's prescribed by a doctor, it's safe," Sack said.
There's less stigma surrounding prescription pills than drugs such as heroin or cocaine, said Daniel Raymond, public policy director for the Harm Reduction Coalition, an advocacy group.
"There doesn't seem to be the same level of punitive social attitudes," he said.
In addition, women are more likely than men to be prescribed prescription painkillers, to get higher doses of the drugs and to use them chronically. Some research has suggested that the most common forms of pain -- including back pain, abdominal pain, migraines and pain from cancer -- may be more prevalent in women, and that women may be more sensitive to pain.
Women also weigh less than men, so they may be more susceptible to the effects of prescription painkillers.
At the same time, women are more likely to have multiple prescriptions from different providers, including drugs to combat anxiety and depression.
"Most of the fatalities aren't on a single medicine. It's a mix of medicines," Sack noted. "And why you mix alcohol and opiate drugs, it's a deadly combination."
The unique stresses that women face may factor into the spike in prescription opiate use, said Dr. Leigh Vinocur, an emergency medical physician in Baltimore and Shreveport, La., and a spokeswoman for the American College of Emergency Physicians.
Many women who become addicted to prescription opiates have histories of sexual abuse or other trauma, experts said.
The bulk of the deaths from prescription opioids was in middle-aged women, with 1,515 deaths in 2010 in women aged 35 to 44 and 2,239 deaths in women from 45 to 54, the new study showed.
"Think of all the pressures on women to look good and to be perfect," Vinocur said. "I think that's why we're seeing it."
Opiate abuse is a special problem for pregnant women, who commonly give birth to children who are addicted to the same substances, said David Craig, a clinical pharmacist at the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Fla.
Incidences of neonatal abstinence syndrome, or NAS, tripled between 2000 and 2009, according to a study last year in the Journal of the American Medical Association.
Solving the problem may be difficult, despite efforts to crack down on so-called "pill mills" and to make doctors more aware of appropriate prescribing, said Raymond, of the Harm Reduction Coalition. It can be difficult for women to find treatment or to seek treatment, often because they worry about the effect on their children.
"I think it's a good wake-up call that we need to make sure we take gender-sensitive approaches, whether that's tailoring treatment access or recognizing some of the underlying causes of the histories of abuse," Raymond said. "Nobody's immune from this."
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