The opioid crisis has continued to worsen in the United States, and middle-aged women are significantly affected.

Share on Pinterest
The opioid crisis has been a major factor in the rise of fatal overdoses in the U.S. [image source]

No community is immune from America’s drug crisis. And new statistics show that it’s severely affected a group you might not expect: middle-aged women.

In the Morbidity and Mortality Weekly Report published by the Centers for Disease Control and Prevention (CDC) on Jan. 11, researchers found that the drug overdose death rate among women between 30- and 64-years old climbed a staggering 260 percent from 1999 to 2017.

Women aged 55 to 64 were hit the hardest, with drug overdose death rates increasing by nearly 500 percent during the 18-year period.

The average age of overdose death for women was 46.3 years old in 2017, up 2.8 years from 1999. The average age of death increased in all drug categories except synthetic opioids, which stayed the same.

In an effort to address the drug epidemic, the CDC analyzed women’s mortality data from the National Vital Statistics System.

There was an increase in fatal overdoses related to different categories of drugs, including antidepressants, benzodiazepine, cocaine, heroin, prescription opioids, and synthetic opioids.

The latest report highlights the increased vulnerability of women dying from an overdose as they get older.

Comparatively, a November 2018 report from the CDC that looked at overdose deaths of both men and women found that the rates climbed the highest for people of all genders aged 24 to 54. But when you look at the data for just women, those 55- to 64-years old fared worse.

“Everyone wants a simple answer about why this is happening, but it just doesn’t exist,” said Dr. Michael Genovese, a clinical psychiatrist and chief medical officer at Acadia Healthcare, a multinational provider of substance use disorder services.

He added that the trend may be related to women’s changing roles in society.

“There is much more expected of women in the workplace and at home,” Genovese said. “They feel like they need to be all things to all people. It’s not surprising that mental health issues like addiction are on the rise among women given the additional stressors they face and the current societal norms.”

Drug overdose deaths tend to happen in more men than women and to younger individuals. As such, the medical community may have missed warning signs in women aged 55 to 64, leaving them more vulnerable to overdoses over the last 18 years, said Dr. Katherine Michael, a psychiatrist and medical director of community health at Western Connecticut Health Network.

“This is a group that might be overlooked because it’s not the usual demographic doctors would expect to have a problem with substances,” said Michael, who is on a team that recently received a $4.7 million federal grant to expand substance abuse screenings and interventions for families in Connecticut.

Other doctors blame the skyrocketing overdose deaths on the over-prescribing of drugs, especially opioids, and the possibility that women are mixing medications they’ve been prescribed over the years.

“Someone who dies from a drug overdose didn’t necessarily suffer from an addiction,” said Dr. Kevin Zacharoff, a chronic pain and opioid abuse expert and clinical professor at the Renaissance School of Medicine at Stony Brook University.

Zacharoff pointed out that people may end up accidentally overdosing on prescription medications.

“It’s the human condition to try to take control of a painful situation if they feel like they’re not being treated, and perhaps they end up taking a melting pot of medications that lead to a drug interaction with negative consequences,” he said.

Additionally, suicide rates also increased for women in an overlapping age group (45 to 64) from 1999 to 2017, climbing from 6 to 9.7 per 100,000 people.

There’s a link between this trend and the increase in rates of death from drug overdose among women, said Dr. Jonathan Avery, director of addiction psychiatry at NewYork-Presbyterian/Weill Cornell Medical Center, who also runs NewYork-Presbyterian’s community naloxone trainings.

“When you’re suffering from a substance use disorder, it exacerbates everything else in your life, including your physical health and social issues,” Avery said. “It’s one of the biggest risk factors for suicide.”

While experts may have different theories about the cause of the rising rates of drug overdose deaths in middle-aged women, they agree that prevention and treatment programs need to start targeting this particular demographic.

Curbing the increase in fatal overdoses starts by asking all patients — not just those in certain demographics — about their substance-use habits when they go to the doctor, Michael said.

“We can’t make assumptions that someone’s not going to have an issue with substances just because of age or gender,” she said.

The authors of the CDC report also emphasize the importance of providing access to substance use disorder treatment services that focus on the particular needs of women.

“We need evidence-based treatment to be available in settings that feel comfortable to women,” Avery said. “It can be hard to find treatment centers that are focused on women’s mental and physical health issues.”

He added that increasing the availability of medications that can reverse a narcotics overdose is essential to saving lives.

“Naloxone kits are being given across the country to people who are at risk, but at times we might have overlooked giving them to other groups, like middle-aged women,” he said.

Taking another look at their prescriptions

The report recommends that providers consider following the CDC Guideline for Prescribing Opioids for Chronic Pain.

Michael said that in an effort to curb drug-related health problems, her healthcare network already follows opioid prescription guidelines based on those from the CDC, and it’s working on implementing similar measures for prescribing benzodiazepine.

“We’re having doctors look at the dosages they’re prescribing, the duration the drugs are prescribed for, and the potency of the drugs, and to spell out all of the risks to their patients,” she said.

But despite some of the preventive measures now in place to help rein in the drug crisis, some experts say we may still be years away from seeing major improvements in overdose death rates.

“There’s been an ocean liner of devastation over the last 20 years, and it will take a while to turn the ship,” Michael said. “It will require a lot of different modalities, from prevention and screening to treatment programs, and it will take time.”

For now, Avery hopes the findings from the latest report will bring increased awareness and understanding of the drug epidemic and who it impacts. “We often feel like it’s happening to other people, not to me. The real message is that it’s happening to all of us,” he said. “We need to rally around people who are suffering and help them get better.”