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Why Drug Overdose Deaths Among Women Have Increased

A study released this year by the Centers for Disease Control and Prevention (CDC) found that from 1999 to 2017, the unadjusted drug overdose death rate for women aged 30–64 years increased 260%. For women in this age bracket, the average age of those dying from a drug overdose increased by nearly 3 years. Perhaps even more surprising is that statistics show the biggest increase in drug overdose deaths was in middle-age women.

The CDC study found that drug overdose deaths involving antidepressants, benzodiazepines, cocaine, heroin, prescription opioids and synthetic opioids all increased during that time period. Another alarming finding of the study was that decreased life expectancy for Americans over the previous two years appears to be linked to opioid use.

Other surprising results of CDC study include:

  • Prescription opioid–related deaths increased between 1999 and 2017 among women aged 30–64 years, with the largest increases among those aged 55–64 years.
  • Americans now have a 1 in 96 chance of dying from an opioid overdose. The probability of dying from a motor vehicle accident is 1 in 103.
  • Between 2006 and 2016, death rates from drug overdoses increased 72 percent.
  • Despite great advances in medications and other treatments that have extended how long people live, deaths from drug overdoses, chronic liver disease, suicide, Alzheimer’s and blood infections (septicemia) have all gone up, resulting in a shortened average life span.

Possible reasons for increase in drug overdose deaths

There are many indicators as to why the overdose death rate for women, especially middle-aged women, has risen so dramatically. CDC survey statistics show that the highest overdose death rate is linked to opioids, including:

  • Prescription painkillers: morphine, hydrocodone, oxycodone, oxymorphone, hydromorphone (up 485%)
  • Synthetic opioids: fentanyl, methadone (up 1,643%)
  • Illegal opioids: heroin (up 915%)

Other drug classes contributing to high rates of overdose deaths include benzodiazepines (up 830%), cocaine (up 280%), and antidepressants (up 176%).

A 2009 study in the Journal of Pain found “women are at greater risk to misuse opioids due to emotional issues and affective distress, while men tend to misuse opioids due to legal and problematic behavioral issues.” Additional research looking at the gender differences in prescription opioid use concluded, “women are more likely to use prescription opioids compared with men. Risk factors included depression, pain and polydrug use.” Contributing to the gender difference is the fact that women tend to seek help from their doctors more often than men. And women, especially older women, are more likely to be taking multiple medications and/or have a co-occurring disorder.

Not only are women more likely to visit their doctors, they are also more likely to request a prescription to treat chronic pain. According to a report issued by the NIH Office on Women’s Health, “women are more likely than men to experience chronic pain and use prescription opioid pain medications for longer periods and in higher doses. Women make up 65 percent of total opioid prescriptions and 40 percent more women than men become persistent opioid users following surgery.”

The National Women’s Health Network identifies the most common surgeries linked to opioid misuse in women are colectomy, rotator cuff and hysterectomy. A 2017 analysis, the Impact of Opioid Overprescribing in America Surgeries found that women ages 40-59 received twice as many opioid prescriptions as men. When prescribed opioids after surgery 13% of this age group, “…continue to use opioids three to six months after surgery, which puts them at high risk for dependence and addiction. Among women, this age group has been shown to have the highest death rates from opioids.”

Mixing opioids with alcohol has been shown to have an even more deadly effect. A 2015 report issued by the Office of Women’s Health found, “…almost 30 percent of all drug overdose deaths, and close to half of all opioid overdose deaths, involved a prescription opioid. Alcohol increases the risk of harm from opioid misuse. It contributes to 18.5 percent of emergency department visits involving opioids and roughly 15 to 20 percent of deaths due to opioid overdoses.”

The National Women’s Health Network says there is a link between women receiving Medicaid and higher opioid prescription rates, including documented misuse. They reference a study that found, “40 percent of Medicaid enrollees with opioid prescriptions had at least one indicator of potentially inappropriate use. Women make up nearly 70 percent of adults on Medicaid.”

Do body image concerns contribute to drug-related deaths?

University of Nevada professor Dr. Cortney Warren writes in Psychology Today about possible explanations for the rising number of drug-related deaths in middle-aged women. She concluded that one contributing factor may be weight and body image-related issues. Warren notes “it is critical that researchers and treatment providers understand and address body image components of drug use in women.”

Pressure to be thin has long been an issue for women. As Warren’s article points out, more women are reporting “body weight and shape dissatisfaction as a primary motivator for both legal and illicit drug use.” She cites a study of 350 adult methamphetamine users that found 36% of the females reported they started using drugs to lose weight, as compared to only 7% of the males studied. Study statistics also revealed that of the female study participants, 43% were concerned that gaining weight after treatment could trigger a relapse.

Stimulants are often used to lose weight, increase energy and elevate mood, and include both illegal drugs like cocaine and MDMA and prescription drugs like Adderall or Dexedrine. As Warren stated, “despite the clear relationships between substance abuse and body image/weight concerns among women, very few existing substance abuse treatment programs that include body image, weight, eating pathology and health knowledge as core intervention targets.” It is important to find a substance abuse treatment program that recognizes and treats co-occurring disorders, including eating disorders, concurrently.

Turning Point of Tampa’s goal is to always provide a safe environment and a solid foundation in 12-Step recovery, in tandem with quality individual therapy and groups. We have been offering Licensed Residential Treatment for Substance Abuse, Eating Disorders and Dual Diagnosis in Tampa since 1987. If you need help or know someone who does, please contact our admissions department at 813-882-3003, 800-397-3006 or admissions@tpoftampa.com.