Op-ed: A Problem That's Hard To Swallow

Women are in danger. This time the threat is coming from within.

The Centers for Disease Control released a disturbing report last week about women and painkillers. Women are dying from overdoses of prescription drugs at an epidemic rate. More women are now dying each year from overdoses than from car accidents or cervical cancer. The number of deaths from painkiller overdoses is four times those from cocaine and heroin combined.

A woman dies every hour from overdosing on painkillers. The next woman could be you, your girlfriend, or a woman in your family.

CDC director Dr. Tom Friedan was emphatic that this is a crisis. Fatal prescription painkiller overdoses have increased 400% in the last decade. Friedan said this is a problem impacting all women–mothers and daughters, sisters, girlfriends, wives. He also said that women were dying at "rates that we have never seen before." Friedan called it "a sleeper problem," under-recognized by both doctors and patients themselves.

Women are becoming increasingly reliant on painkillers like Vicodin, OxyCotin and Diluadid. But women are also more likely to be on psychotherapeutic drugs like Prozac, Paxil, and Wellbutrin than men, which can lead to interactions that are fatal. Women are more likely to be prescribed medications and pharmaceutical advertising is directed at women. Women are 50% more likely to be given a painkiller by a doctor than a man, even if they are being treated for the same thing. Women are also more easily addicted to painkillers, because their addiction threshold is lower.

The highest rates of overdose are in women in their 40s and 50s, but the highest rate of opiate abuse is among women in their 20s and 30s. Which means the majority of adult women are at risk for addiction—and where it might lead.

There are no clear-cut reasons for the increase in abuse among women, but it seems women are simply more prone to abusing prescription drugs and have a lower threshold for addiction to them.

The CDC points to studies that show women suffer from more health issues that cause chronic pain, like fibromyalgia and are more likely to remain on painkillers for extended periods of time due to those health issues or due to pain from accidents or surgeries.

Women are also more likely to visit the doctor and ask for painkillers and also to do what the CDC calls "doctor shopping," or going to several doctors to get multiple prescriptions. Overdoses happen when women build up a tolerance to the drugs and need more and more to get the high or feeling of well-being that first got them hooked.

Not surprisingly, fatal overdoses occur because women take more pills than have been prescribed: The CDC says that because women have a smaller body mass than men, "the gap between a therapeutic dose and an overdose is narrower."

The CDC asserts that nearly a half-million ER visits are the result of misuse and abuse of painkillers, but in 2010 over a million women were hospitalized for drug overdoses.

Sales of these drugs–legally prescribed–have increased 300% in less than a decade, which means these drugs are more available. About one-half of prescription painkiller deaths also involve at least one other drug, including benzodiazepines, cocaine, and heroin. Alcohol is also involved in many overdose deaths.

According to the CDC, overdoses occur because prescription painkillers decrease the perception of pain. These drugs are so powerful, they can cause a feeling of euphoria in many users. But they also are sedatives: they slow down your breathing. If you take more than prescribed, your breathing can simply stop. That’s a fatal overdose.
The CDC reports that in 2010 (the latest year with statistics), one in 20 people over the age of 12 reported taking prescription painkillers in a "non-medical" way. More than three-quarters of people misusing prescription painkillers use drugs that were prescribed to someone else, drugs they got from a relative or friend. Enough painkillers were prescribed in 2010 to medicate every adult in America around the clock for a month.

Lesbians could easily be among those most at risk. Many lesbians have substance abuse issues and/or are on psychotherapeutic drugs due to depression, stress and other problems related to living daily with homophobia and sexism. Isolation is another corresponding factor, as is being low-income, as many lesbians are.

Another risk factor is race. Whites and Native Americans are most at risk for painkiller abuse. One in 10 Native American women and one in 20 white women will abuse these drugs as compared with one in 30 black women or Latinas.

The CDC recommends monitoring your use of these drugs to guard against abuse. Only use prescription painkillers as directed by a health care provider. Make sure you are the only person using your prescription. Not selling or sharing them with others helps prevent misuse and abuse. Store prescription painkillers in a secure place to avoid other people taking them. And most importantly, get help for substance abuse problems if you have them. (1-800-662-HELP)

The epidemic is only getting worse, not better, which means access to these drugs will likely continue to increase. When drugs are easy to obtain, the temptation to use them is great. Addiction impacts many lesbians. The best choice you can make is to not start taking drugs to begin with, but if you do, get help before you become one of the million women going to the ER each year–with many of them never leaving again.

VICTORIA A. BROWNWORTH is a Pulitzer Prize nominated journalist. The first out lesbian to have a column in a daily newspaper, she has won the Society of Professional Journalism Award, the NLGJA Award, Lambda Literary Award among others. Her work has appeared in the New York Times, Philadelphia Inquirer, Baltimore Sun and The Nation, as well as other national publications. She is a frequent contributor to the Advocate and SheWired. Follow her at @VABVOX