Last month, the Centers for Disease Control published new information about an alarming health epidemic— overdose death from prescription narcotic medications. The report affirms what we already know—that substance abuse and addiction are a serious health problem in the U.S. But the data from the years 1999 to 2010 also reveals that the impact of this problem on American women in particular has “skyrocketed.” From the CDC report:
- Nearly 48,000 women died of prescription painkiller* overdoses between 1999 and 2010.
- Deaths from prescription painkiller overdoses among women have increased more than 400% since 1999, compared to 265% among men.
- For every woman who dies of a prescription painkiller overdose, 30 go to the emergency department for painkiller misuse or abuse.
*”Prescription painkillers” refers to opioid or narcotic pain relievers, including drugs such as Vicodin (hydrocodone), OxyContin (oxycodone), Opana (oxymorphone), and methadone.
We are deeply aware of the tragic effect of narcotics addiction on women, families, and communities. As obstetricians, we are especially sensitive to the heartbreaking reality of a newborn infant placed in the intensive care unit suffering from drug withdrawal.
Our purpose here is to alert our patients about this serious situation, and give you some insight into how it has developed. A woman addicted to prescription pain killers has seldom come to that situation because of a decision to use narcotics for recreational purposes—to simply “get high.” Most often a narcotic was first prescribed by her doctor for a legitimate medical reason. So why has the problem escalated so severely for women?
Also from the CDC:
- This rise relates closely to increased prescribing of these drugs during the past decade.
- Women are more likely to have chronic pain, be prescribed prescription painkillers, be given higher doses, and use them for longer time periods than men.
- Women may become dependent on prescription painkillers more quickly than men.
- Women may be more likely than men to engage in “doctor shopping” (obtaining prescriptions from multiple prescribers).
Confronting narcotics addiction will require our combined efforts.
What Physicians Can Do
As physicians, we want to use our best efforts to see that you are comfortable, but also (according to our professional ethics) we want to”first do no harm.” To maintain this balance, we will discuss with you the risks of continuing narcotic medication long-term and suggest non-narcotic pain relief options if you experience a prolonged need for pain relief. Our practice uses an electronic prescription system where possible to ensure that all prescriptions are transmitted to the pharmacist accurately and without alterations. One very exciting development in our efforts against prescription painkiller abuse has been the use of robotic surgery for gynecology. Most of our patients experience less post-operative pain and require less narcotic medication for shorter periods of time, compared with an abdominal hysterectomy.
What Women Can Do
- Use only those prescription medications that your healthcare provider has directed. Don’t share medication or use someone else’s medication.
- Throw old narcotics away. Don’t save an old prescription “just in case.” Abusers get narcotics more frequently from an acquaintance or family member (with or without that person’s knowledge) than from a physician.
- Keep us informed of what you are taking, including both prescription and over-the-counter medications.
- Especially inform us if you are taking medications for mental health conditions (such as anti-depressants, anti-anxiety drugs, or sleep medications), and keep us informed about your use of alcohol. These substances can be especially dangerous when used with prescription painkillers.
Your relationship with your ob/gyn physician continues through many years and many of your most important life events. We hope that within this special doctor/patient relationship you will feel comfortable to share any concerns you may have about your use of medications, alcohol or substances, whether prescribed or not. (Being frank with your physician is especially critical if you are pregnant).
Addiction to prescription painkillers happens quietly and insidiously. A woman who struggles with this disease most often describes a fairly normal life. She manages her responsibilities as wife, mother, student, or employee reasonably well until the disease is quite advanced. She holds to the notion that she is “keeping it together” as proof that her problem has not reached the level of addiction. Even those closest to her may be unaware that she is using, or they may share her denial. Tragically, the first undeniable crack in the illusion may be an emergency room admission due to an overdose. One in thirty will arrive too late.
Reversing the statistical trend over the next decade will require frank recognition of the problem by women and their physicians, along with considerable government resources. We are available to provide support and appropriate referrals.