The opioid epidemic’s disproportionate effect on middle-aged women

Whether it’s death from opioid overdoses or heart attacks, there are health issues that impact women more than men.

Per the CDC, about 18 women die every day in the U.S. from a prescription painkiller overdose.

Research has found that women are more sensitive to the effects of certain drugs, including opioids, due to their hormones. This is applicable to heart disease as well; for instance, heart disease is more common in women after menopause, which is thought to be related to a decrease in female hormones.

Despite death by drug overdose being classically thought of as more common in men, this gap between men and women is closing. The latest CDC report showed that middle-aged women in particular are now increasingly affected.

In fact, the report highlighted that death by drug overdose has increased in women ages 30-64 by 260 percent from 1999 to 2017.

This number included both prescription painkillers – such as OxyContin (oxycodone) and Vicodin (hydrocodone) – as well as illegal and synthetic opioids like heroin and fentanyl.

However, the death rate from the illegal opioids rose in middle-aged women the most, with deaths from fentanyl increasing by 1,634 percent and from heroin by 915 percent.

Why is the death rate in women of this age group increasing?

For one thing, women are more likely to become addicted to drugs despite using a smaller amount and for a shorter period of time. They are also more susceptible to cravings and are more likely to relapse after treatment.

We also know that women who are victims of abuse or have undergone traumatic life events such as divorce, death of a partner or child, or loss of child custody are more likely to become addicted to drugs. The dependence is also often seen with disorders such as depression and panic attacks.

What can be done?

Spreading awareness and recognizing these unique challenges is a start. A biopsychosocial approach to pain, which considers biological, psychological, and social factors, needs to be used to prevent addiction in the first place. Use of state prescription drug monitoring programs (PDMPs) as well as patient-physician contracts that include random urine drug tests are also beneficial.

Dr. Meroe Morse, assistant professor of medicine at Baylor College of Medicine, has been working with internal medicine residents to teach these approaches and the use of the PDMPs. Medications like methadone and buprenorphine can also help with treatment in certain cases.

In the past, many research studies have included only men. The alarming statistics in this CDC report show the importance of including women in research in order to effectively make a difference in women’s health.

-By Dr. Azka Afzal, internal medicine resident at Baylor College of Medicine