Prescription Drug Addiction Growing Among Women

Prescription drug abuse and addiction is becoming more prevalent among women across the country.

18 women die each day in the United States from drug overdoses.

Dr. Jim Mahanes said he had believed that drug overdoses were mostly a problem with men before researching the growing number of women who are abusing drugs.

He led a discussion of the issue with members of the Prescription Drug Abuse Alliance Thursday morning.

He said drug abuse and misuse among women is a growing and under-recognized problem.

Between 1999 and 2010, nearly 50,000 women died from painkiller overdoses in the United States, he said.

“This was a 400 percent increase for women, as compared to a 265 percent increase in men,” Mahanes said.

Prescription painkillers are in involved in 1 in 10 suicides among women, he said.

For each woman who died during that period of time, another 30 women attended emergency rooms for drug abuse and misuse.

Women age 45-54 have the highest risk of dying from a painkiller overdose.

“We've actually found that in Pickens County,” said Mahanes, who served as Pickens County Coroner. Coroner Kandy Kelley's experience is bearing that out as well, he said.

From May 2012 to May 2013, there were 26 overdoses admissions at Cannon Memorial Hospital in Pickens.

“Of those, 10 were men and 16 were women,” he said. “Thank goodness, they all survived and went home.”

Last year, according to Kelley, there were 17 women and 12 men who died of fatal overdoses.

Oconee County Coroner Karl Addis told Mahanes that painkiller overdose deaths are increasing in his county as well, from 14 in 2009 to 24 in 2012. Addis has already worked seven painkiller overdose deaths so far this year.

The Center for Disease Control has posed many questions regarding this issue and its causes, Mahanes said.

Are women more likely to have chronic pain?

“Things like fibromyalgia and those disease processes seem to be common in women, especially women in that middle age category,” Mahanes said. “I'm not sure I quite understand why they're getting dilaudid or something of that nature for fibromyalgia, but that's the case. They wear fentanyl patches and a lot of other patches to go along with that, which, to me, is out of the mainstream.”

Why are women given higher doses?

“Is there something about the drug itself that limits its activity in a woman versus a man, the brain receptors or something like that?” Mahanes asked. “I think that's something interesting to look into.”

Research also indicates that women use prescription painkillers longer than men,” he said.

Dr. Mary Cumming said codependency is a factor in abuse and addiction for women.

“Their codependent relationships impact their influence on the doctor,” she said. “For instance, the family members will call and say, 'So-and-so is really in trouble and they really need some help.' All of that kind of emotional stuff impacts the prescription writing. They dramatize it in an emotional, relational way and other people come in – family members and so forth – and put pressure on. There's a lot of that going on.”

Cannon Memorial Hospital CEO Norm Rentz asked what medical students are being taught regarding physicians' responsibility to eliminate patients' pain.

“It seems to me that one of the problems that we have we have made it our culture and our response totally to eliminate pain,” he said. “Sometimes we can do it if you drug them up enough. But is that the right thing to do or should we be trying to educate patients that there's going to be some pain and that we may have to manage that pain in some way other than drugs?”

In previous discussions, the group had discussed that some patients expect to lead pain-free lives, even regarding the aches and pains that come with getting older.

“We're having to go back and look at how we're educating our patients,” said Nursing Administrator Mary Ann Holder. “We can't assure you that we can totally eliminate the pain. We're beginning to shift that to a different perception. We have an obligation to manage your pain, which does not necessarily mean that you will be completely pain-free.”

Dr. Lori Carnsaw said an outside agency is now tracking outpatient doctors based on 2010 Medicaid claims data.

“It categorizes on prescriptions you have written, percent of your patients that have gotten narcotics, percent who have gotten anti-psychotics, cost per prescription,” she said.

That data to find out which physicians are a “pill-pushers or hurtful,” Carnsaw said, but abusers and misusers could use that same information to seek out doctors likely to over-prescribe painkillers.

Women are more likely to “doctor shop,” Mahanes said.

According to the Mayo Clinic, 25 percent of women age 50-64 were on some sort of antidepressant.

“It's hormonal,” said Donna Anderson with Cannon Memorial Hospital. “I think instead of treating the hormone situation, they treat them with antidepressants. I went through the same thing. They wanted to put me on antidepressants. It wasn't that, it was hormones.”

Options available to medical personnel to help deal with the problem following the guidelines for responsible prescribing, using the prescription monitoring program to help identify abusers and addicts, discussing options for treatment more diffusely with patients, including risks and benefits and avoiding prescribing, if possible, a combination of opioids and antidepressants.

Mahanes said the message about women falling victim to prescription pill addiction and overdosing needs to get out.

“It's hard to get groups together to talk about things like this but we need to continue to try,” Mahanes said.