The number of women dying from overdoses of opioid painkillers increased 5-fold between 1999 and 2010, according to new data released today by the US Centers for Disease Control and Prevention (CDC).
The problem of prescription opioid drug overdoses in women is "getting worse and getting worse quickly," CDC director Tom Frieden, MD, MPH, said during a media briefing.
Deaths due to opioid drugs have "skyrocketed in women; mothers, wives, sisters, and daughters are dying from overdoses at rates we have never seen before," he noted.
"The increase in opioid overdoses and opioid overdose deaths is directly proportional to the increase in prescribing of painkillers." Opioid prescriptions are "increasing to an extent that we would not have anticipated and that could not possibly be clinically indicated," Dr. Frieden added.
"Stopping this epidemic in women — and men — is everyone's business," he said.
The CDC analyzed data from the National Vital Statistics System (1999-2010) and the Drug Abuse Warning Network public use file (2004-2010). The study includes emergency department visits and deaths related to drug misuse/abuse and overdose, as well as analyses specific to prescription painkillers.
Although men are more likely to die of a prescription opioid overdose, women are catching up, according to the new data, reported in the July 2 issue of the CDC's Vital Signs, an early release of Morbidity and Mortality Weekly Report.
Since 1999, the percentage increase in deaths was actually greater among women than men (400% in women vs 265% in men). Prescription painkiller overdoses killed nearly 48,000 women between 1999 and 2010. More than 6600 women, or 18 women every day, died from a prescription painkiller overdose in 2010, the CDC said.
Troubling Numbers, Dangerous Meds
There were 4 times more deaths among women from prescription painkiller overdose than for cocaine and heroin deaths combined in 2010. In 2010, there were more than 200,000 emergency department visits for opioid misuse or abuse among women — about 1 every 3 minutes.
"These are troubling numbers," Dr. Frieden said.
Previous research has shown that women are more likely to have chronic pain, be prescribed prescription painkillers, be given higher doses, and use them for longer periods than men. The higher doses in women are "something we don't really understand," Dr. Frieden said, "given that, on average, women weigh less than men, and at the same or higher dose, they are more likely to have adverse events than men."
Studies have also shown that women may become dependent on prescription painkillers more quickly than men and may be more likely than men to engage in "doctor shopping" (obtaining prescriptions from multiple prescribers).
"These are dangerous medications," Dr. Frieden said. "They should be reserved for situations like severe cancer pain, where they can provide extremely important and essential palliation, 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."
The CDC's Chris Jones, PharmD, MPH, noted that there has been "a lot of push to treat pain and not a lot of information around what are the best ways to do that. Opioids certainly have a place in the treatment of pain. Our goal in our work with our partners is to really make sure they are being used in the right patient, in the right quantity and the right dose."
Call to Action
The CDC encourages healthcare providers to take the following steps when treating women for pain:
Follow guidelines for responsible opioid prescribing, including screening and monitoring for substance abuse and mental health problems.
Use their states' prescription drug monitoring program; this can help identify patients who may be improperly using opioids and other drugs.
Discuss pain treatment options, including ones that do not involve prescription drugs.
Discuss the risks and benefits of taking prescription painkillers, including situations in which painkillers are taken for chronic conditions, and especially during pregnancy.
Avoid prescribing combinations of prescription painkillers and benzodiazepines unless there is a specific medical indication.
MMWR. Published online July 2, 2013. Full article
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Cite this: Women Dying of Opioid Overdose at Unprecedented Rates - Medscape - Jul 02, 2013.