Middle-Aged White Women Most at Risk for Opioid Overdose

A study conducted by Geisinger Health System found that middle-aged, white women in Pennsylvania overdose on opioids more than any other demographic.

Researchers evaluated the medical history of 1.2 million patients, covering 10 years of electronic health records. The purpose of the study was to predict who is at the highest risk of overdose from opioids, such as OxyContin and hydrocodone.

The average overdose patient was 52 years old. Most individuals were female, unmarried and unemployed. Thirty-five percent of overdose patients had at least one mental health disorder.

The findings concluded:

  • Less than 1 percent of patients overdosed at least once.
  • Nearly 10 percent of overdose patients died within 12 months of the incident.
  • Only 9 percent of overdose patients received naloxone, an opioid overdose reversal medication.
  • History of addiction, mental illness and other chronic diseases contributed to adverse effects.
  • Those with private health insurance, a primary care physician and a job were less likely to overdose.

The findings mirror a national trend.

Women aged 25–54 are more likely to have an opioid-related emergency room visit than other age groups, according to the Centers for Disease Control and Prevention. Close to 48,000 women died of prescription drug overdose from 1999 to 2010.

“[Middle-aged women] is the group that is more likely to visit doctors and more likely to complain about a chronic pain problem,” Andrew Kolodny, founder of Physicians for Responsible Opioid Prescribing, told the American Grandparents Association.

Young adults abuse prescription drugs at high rates as well. More than 1,700 adults aged 18–25 died of prescription drug overdose in 2014. However, the death rate is much higher among older adults than younger, according to Kolodny.

While women aged 45–54 show the highest risk of fatality from prescription painkiller overdose, men overdose at higher rates than women. CDC statistics show that the gap is closing at a high rate.

What Makes Women Vulnerable to Opioids?

Biological makeup may contribute to the problem.

Dr. Nora Volkow, director of the National Institute on Drug Abuse, says women have higher percent body fat and lower percent body water than men.

Opioids allocate heavily to the fatty tissue, she explained, creating toxic effects. As a result, drugs stay in women’s systems longer, increasing the risk of health complications.

Women also experience chronic pain at higher rates than men. They are prescribed medications in higher doses and for longer periods of time.

This, says Kolodny, leads to the development of a substance use disorder, which could contribute to overdose and death.

Anxiety and tension may contribute to this epidemic, according to Volkow. Women are twice as likely to battle anxiety and 70 percent more likely to have depression than men, according to the Anxiety and Depression Association of America. This gives way to drug use.

Reversing the Trend

The CDC reports that women visit doctors more than men. As a result, they are 50 percent more likely to receive prescriptions than men with the same condition. They are also more likely to engage in doctor shopping.

The CDC also reported a 300 percent increase in prescription painkiller abuse during pregnancy between 2000 and 2009.

Health care providers can help reduce these trends. The CDC says physicians should discuss treatment options and the risks and benefits of prescription medication use. They should also use prescription drug monitoring programs (PDMPs).

States can use PDMPs to identify improper prescribing, increase access to treatment and brainstorm alternative steps for entering people into rehab.

Women can do their part, as well. They should use prescription medications only when directed by a physician and properly dispose of them after use. They should also discuss with their physician all medications they are taking.

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