The number of overdose deaths from prescription painkillers has soared among American women in the past decade, in part due to the over-prescribing of opioid pain medications, according to the U.S. Centers for Disease Control and Prevention.
The CDC said in a new Vital Signs report that nearly 48,000 women died from painkiller overdoses between 1999 and 2010. During that time, the number of fatal overdoses among women rose by 400 percent, compared to 265 percent in men.
“Prescription drug overdose deaths have skyrocketed in women. Mothers, wives, sisters and daughters are dying from overdoses at rates we have never seen before.” said CDC Director Tom Frieden, MD. “The increase in opiate overdoses and opiate overdose deaths is directly proportional to the increase in prescribing of painkillers.”
While men are still more likely to die from a prescription opiate overdose, the gap between men and women has been shrinking. The CDC says about 18 women die every day from a prescription painkiller overdose, and women are four times more likely to die from a prescribed opioid than from cocaine and heroin combined. In 2010, over 200,000 women were treated in hospital emergency rooms for opioid misuse or abuse.
Various reasons were cited for the rising death toll among women. Women are more likely to suffer from chronic pain, are prescribed painkillers at higher rates and higher doses, and are more likely to use them longer.
“Prescribing trends for opioids have increased more sharply for women than for men, and thus it is unsurprising that we are seeing more opioid risks for women, including overdose from medical prescriptions,” said Beth Darnall, PhD, a clinical associate professor in the Division of Pain Medicine at Stanford University School of Medicine.
“Studies show that girls and women are more likely to be taking prescription drugs of any kind — including opioids — and they are more likely to be taking multiple prescription drugs than are boys and men.”
Darnall says physicians should be more aware of the risks associated with prescribing opioid painkillers to women.
“The increase in unintentional opioid deaths related to methadone, a long acting opioid, as well as to the dangerous combination of opioids and benzodiazepines suggests a need for improved education of prescribers,” said Darnall. “We must also be very mindful of the risks of opioids that exist when taken exactly as prescribed, particularly if the physician is not well informed. Dangerous combinations of medications are routinely prescribed and we must do better at physician education in order to help them reduce patient risks.”
Dr. Frieden went even further, saying opioids are overprescribed – injecting himself into a long running debate over whether the Food and Drug Administration should further restrict access to opioids.
Under current prescription guidelines most opioids are indicated for treatment of moderate to severe pain. The FDA is being petitioned to change the guidelines so that opioids are only indicated for severe pain.
“These are dangerous medications. They should be reserved for situations like severe cancer pain,” said Frieden. “In many other situations, the risks far outweigh the benefits. Prescribing an opiate may be condemning a patient to lifelong addiction and life threatening complications.”
Frieden was asked if opioids should not be used to treat “moderate” pain.
“In the data we have reviewed, we have not seen a clear indication of these drugs for other conditions,” the CDC director said. “What we really want to emphasize is the risks and the benefits. These are risky drugs and there are often other medications and other therapies, like physical therapy, exercise, cognitive therapy, that can be very important in addressing chronic pain.”