The Centers for Disease Control and Prevention released a report today: Overdose deaths have increased steadily over the past decade. This report describes drug-related deaths and emergency department (ED) visits among women.
In 2010, enough opioid pain relievers (OPR) were sold to medicate every adult in the United States with the equivalent of a typical dose of 5 mg of hydrocodone every 4 hours for 1 month (1), a 300% increase in the sales rate over 11 years. This rise in distribution of OPR is concomitant with increasing rates of drug overdose death and chronic, nonmedical use of OPR (2,3).
Differences between men and women related to prescription drug use outcomes are complicated. The death rate for OPR overdose is higher among men than women, but since 1993, hospitalizations for OPR overdoses have been more frequent among women than men (4). During 2004–2008, women and men had similar emergency department (ED) visit rates related to nonmedical use of OPR and benzodiazepines (5). OPR prescribing and use patterns also differ by gender. Women are more likely than men to be prescribed OPR, to use them chronically, and to receive prescriptions for higher doses of OPR (6,7). This might be because the most common forms of pain are more prevalent among women, and pain is more intense and of longer duration in women than men (8,9). Women also might 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 OPR combined with sedatives (10,11). Sex-specific health risks associated with long-term OPR use among women include amenorrhea and infertility (12,13). Finally, the progression to dependence on OPR might be accelerated in women, and women with substance use disorders are more likely than men to face barriers in access to substance abuse treatment (14,15). Taken together, these health concerns indicate a need to examine drug overdose deaths and ED visits among women to guide development of targeted prevention strategies.
Conclusions: Although more men die from drug overdoses than women, the percentage increase in deaths since 1999 is greater among women. More women have died each year from drug overdoses than from motor vehicle–related injuries since 2007. Deaths and ED visits related to OPR continue to increase among women. The prominent involvement of psychotherapeutic drugs, such as benzodiazepines, among overdoses provides insight for prevention opportunities.
Implications for Public Health Practice: Health-care providers should follow guidelines for responsible prescribing, including screening and monitoring for substance abuse and mental health problems, when prescribing OPR. Health-care providers who treat women for pain should use their state’s prescription drug monitoring program and regularly screen patients for psychological disorders and use of psychotherapeutic drugs, with or without a prescription.