Last month, the Centers for Disease Control and Prevention (CDC) reported that the drug overdose death rate among women aged 30-64 years old increased 260% from 1999-2017. In the same report, the CDC found that there were 4,314 total drug overdose deaths in 1999 compared to 18,110 in 2017. During this time, the rate of drug overdose deaths involving any opioid increased 492%. What does this new information mean for the drug epidemic in the United States?

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Overdose deaths involving opioids in the US, per 100,000 population. Courtesy of CDC Injury Center.

Currently, the drug epidemic in the US is largely focused on the opioid crisis. In fact, more than 130 people in the US die from opioid pain reliever overdose every day. The misuse and abuse of opioids in the US can be traced back to the late 1990s, when physicians began more frequently prescribing opioid pain relievers to their patients. Pharmaceutical companies reassured physicians that patients would not become addicted to opioids. As a result, physicians increased the number of prescriptions. Companies like Purdue Pharma aggressively started promoting opioid pain relievers, such as OxyContin, among primary care physicians. The number of prescriptions consequently increased into the millions only a few years after their introduction.[1] With the increase in prescribed opioid pain relievers, misuse and overdose death rates also escalated.

In 2015, National Survey on Drug Use and Health (NSDUH) reported that the main reasons adults misused prescription pain relievers were to relieve physical pain or for the “feel good” high. This data is coupled with the CDC’s findings that approximately 68% of more than 70,200 drug overdose deaths in 2017 involved an opioid. The statistics are troubling, as opioid overdose rates in the US have continued to rise.[2] Now that middle aged women have been identified as a group significantly affected by pain reliever misuse and overdose, can this increase be attributed to something specific?

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10mg of Oxycodone.


Hannah Cooper, ScD, is the current Chair of Substance Use Disorders at Emory University’s Rollins School of Public Health. According to Dr. Cooper, the findings may reveal a problem in drug program availability. “I would guess one major issue is there are few drug programs that exist for women. Most were designed for men and only accept men.” She further elaborates , “Things get much worse if you’re raising kids, as only a handful of programs allow women to bring their children into residential programs…the treatment infrastructure is failing women.”
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Dr. Cooper’s comments bring forth an important point that general addiction treatment models seem to be based on treatment for men. This, combined with the responsibilities of caregiving and employment, creates barriers for women seeking treatment. To combat this, Dr. Cooper suggests that “the most important thing is to create an on-demand drug treatment infrastructure where people get same day treatment.” Specifically for women, she implores that “drug treatment programs need to address trauma as that is an important driver for drug dependence in women.”

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Pre-filled syringe of naloxone HCl preparation. Courtesy of Mark Oniffrey.

In her final statements, Dr. Cooper highlighted the importance of drug overdose treatment training. “We need to do a better job of pushing out opioid overdose medication into the community. It is a smart idea to have trainings for administration of naloxone and accessibility to it in the community.”

There is clearly room for growth and improvement in reducing drug overdose rates in the US. With more available data showing the dangers of opioid addiction and misuse, it is imperative that action steps be taken to combat this harrowing epidemic. As a now nationwide public health concern, it merits active cooperation from physicians, patients, legislators, and health officials alike.  

References

  1. Van Zee A. (2009). The promotion and marketing of oxycontin: commercial triumph, public health tragedy. American journal of public health, 99(2), 221-7.
  2.  Vivolo-Kantor, A. M., Seth, P., Gladden, R. M., Mattson, C. L., Baldwin, G. T., Kite-Powell, A., & Coletta, M. A. (2018). Vital Signs: Trends in Emergency Department Visits for Suspected Opioid Overdoses — United States, July 2016–September 2017. MMWR. Morbidity and Mortality Weekly Report, 67(9), 279-285. doi:10.15585/mmwr.mm6709e1

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