One hundred and thirty people a day is a staggering figure — and one that isn’t likely to shrink anytime soon. In reality, experts say the opioid crisis could get worse before it gets better. And although the number of opioid-related deaths has declined in some states, it’s still increasing nationwide. (The number of opioid overdoses increased 30 percent nationwide between July 2016 and September 2017.)
Simply put, we’re experiencing a public health crisis of huge proportion that affects us all.
It’s important to know, however, that women have their own unique set of risk factors when it comes opioid use. Women are more likely to experience chronic pain, whether related to disorders such as arthritis, fibromyalgia, and migraine or conditions such as uterine fibroids, endometriosis, and vulvodynia that occur exclusively in women.
Research finds that women are more likely to be prescribed opioids to treat their pain, both in higher doses and for longer periods of time. In addition, there may be biological tendencies at play that cause women to become more easily addicted to opioids than men. More research is still needed to understand why.
Opioids include prescription pain medication and heroin. In addition, the synthetic opioid known as fentanyl, which is 80 to 100 times stronger than morphine, has added to the problem. Originally developed to manage the pain of people with cancer, fentanyl is often added to heroin to increase its potency. It’s sometimes disguised as highly potent heroin, adding to the potential of more misuse and overdose deaths.
More than one-third of the entire U.S. adult population used prescription pain medication in 2015, and while the majority of those who take prescription pain medication do not misuse them, some do.
In 2016, 11 million people admitted to misusing prescription opioids during the previous year, citing reasons like the need to relieve physical pain, to help with sleep, to feel good or get high, to help with feelings or emotions, or to increase or decrease the effects of other drugs.
Although many people report needing to take opioids to relieve physical pain, it’s considered misuse if they take more than the dosage prescribed or take the drug without a prescription of their own.
All of this continues to have a tremendous effect on women, their families, and communities. Experts say, for example, that about 4 to 6 percent of those who misuse opioids will go on to use heroin, while other devastating consequences affecting women specifically include neonatal abstinence syndrome (NAS), a group of conditions resulting from a baby’s exposure to drugs taken by their pregnant mother.
As a registered nurse currently practicing maternal and fetal medicine, I know firsthand of the importance of individuals receiving treatment for conditions like opioid use disorder (OUD), and the poor outcomes for both mothers and newborns when that treatment doesn't happen. I know too that this epidemic does not discriminate — it affects mothers and babies from all socioeconomic backgrounds.
Indeed, anyone who takes opioids is at risk for overuse, while only 2 in 10 people who seek OUD treatment will have access to it when they want it. This is why it’s important to remove the stigma and shame associated with OUD — and to encourage more women to get the treatment they need to live healthier lives.
To that end, we must:
Recognize that OUD is a medical illness. OUD does not discriminate, nor is it a sign of moral or personal weakness. Instead, like other diseases, opioid use disorder can be treated by medication.
Lower barriers to treatment and share results. Legislators can communicate that medical treatment for OUD is available, is safe and effective, and delivers proven results, while also helping to improve access to treatment for patients by promoting insurance coverage and enforcing consumer protections.
Expand funding for medically assisted treatments for OUD. Public and private sector groups involved in healthcare, public health, first responders, and the judicial system must work together to foster use of medically assisted treatments for OUD.
Consider the words we use when talking about OUD. An essay in the journal JAMA argues, for example, that clinicians should watch for “loaded language,” recommending instead that we speak to our patients with OUD as we would when treating someone with diabetes or high blood pressure.
Most importantly, if you or a loved one lives with OUD, we must avoid self-blame. Opioid use can alter your brain, producing powerful cravings and compulsions that can make it easier to become addicted and extremely difficult to quit. That doesn’t mean those changes can’t be treated or reversed, though. Just that the road back will be a tough climb.
Beth Battaglino, RN is CEO of HealthyWomen. She has worked in the health care industry for more than 25 years helping to define and drive public education programs on a broad range of women’s health issues. She is also a practicing nurse in maternal child health.