When we think of addictive drugs, we usually think about cocaine or heroin. But what about morphine, oxycodone, and hydrocodone? Sound familiar? Maybe you’ve heard these terms thrown around on shows like Grey’s Anatomy. These, along with heroin, are opioids. What makes opioids different from illicit drugs like cocaine is that they’re prescribed by doctors. They are used to help patients coping with serious pain, like after operations.
But what once were heavy drugs that provided short-term pain relief has turned into a full out crisis in the United States.
This opioid epidemic has been a long time coming. Doctors started prescribing opioids in the 1990s. Problems arose when doctors began over-prescribing the drugs for pain that could be managed by much weaker, and safer, medication. Then, illegal drugs like heroin and fentanyl entered the scene. Patients got addicted to their painkillers, and, once their prescriptions ran out, they got their hands on the easily-accessible illegal ones.
People overdose on opioids because of how the body builds up a tolerance. A tolerance means you need bigger doses in order to feel the pain relief, making it easy to both become dependent and increase your risk of an overdose.
Once the drug has entered your bloodstream it starts doing its job of making you feel better. But it also suppresses brain function that keeps track of how much oxygen is getting to the brain, which can lead to an overdose, When a person overdoses, they essentially die by choking. Not on anything, but because there’s too much carbon dioxide and not enough oxygen in the brain, and the brain is unable to regulate itself as it normally does.
We’ve been aware of this opioid crisis for a long time, and even Trump declared it a public health emergency. But there’s an aspect of this epidemic that doesn’t get nearly enough awareness. The opioid crisis affects women differently than it affects men, and the difference is proving to be especially lethal.
Although men die from opioid overdoses more than women do, the spike in female overdose deaths is alarming: From 1999 to 2010 women who died from prescription painkiller overdoses increased by 400%.
In general, women are at a higher risk of becoming addicted to painkillers than men are. This is because they are more likely to experience chronic pain, which leads doctors to prescribe them opioids at higher rates, and women use them for longer periods of time. As we know, the longer you use drugs like opioids, the higher your tolerance against those drugs becomes.
Women are also at increased risk of becoming dependent on prescription painkillers in comparison to men. And yet, despite these significant differences between how pain presents itself in women and how opioids affect them, as of 2016 doctors are still prescribing women opioids more frequently than they do for men.
Childbirth is an important factor in all of this. A study last summer in Obstetrics & Gynecology found that women are often prescribed opioids in doses that are higher than needed after cesarean sections. The women in the study who were prescribed less medication wound up using less. Those who were prescribed more used all of their medication and then still complained of pain. This points to a significant way that the opioid crisis is just impacting women, and no one is talking about it.
The fact that increasingly more women are becoming addicted to opioids has another important implication: more babies are being born addicted to them. A study last year found that every 25 minutes a baby in the U.S. is born with neonatal abstinence syndrome (NAS).
That is, they’re born addicted to opioids. Women don’t even need to be currently addicted while pregnant in order for their babies to develop NAS. The government loves to interfere with issues regarding pregnancy and childbirth, claiming that it’s to improve the health of women and their children. But we don’t hear impassioned discussions about mothers and their children suffering from opioid addictions, which I believe speaks volumes about where their actual interests lie.
To make things even more complicated, mental health and drug addiction are closely intertwined. Drug abuse and mental health problems often occur together, and already women are more likely than men to suffer from depression and anxiety. There may be a relationship between childhood trauma and future drug addiction for women as well. All of these things should be factors that doctors consider when prescribing women prescription painkillers.
But data shows that it doesn’t seem to be.
The opioid crisis is not just an issue of the disease of addiction: it’s an issue of mental health, psychological care, and healthcare provider awareness. It’s an issue that is uniquely affecting women. And if are ever to hope for change, this must be better understood and acted upon.