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Women and prescription drug addiction
NEVADA WOMAN
January/February 2005
Real Life
Women are more likely than men to be prescribed an addictive prescription drug and twice as likely to become addicted.
BY MICHAEL S. LEVY, D.O., FASAM
Women today must deal with unprecedented challenges. The demands of women as parents, wives, family members and employees have led the modern American woman to face new challenges and difficulties.
Because fatigue, overwork, poor self-esteem and depression are known risk factors for drug addiction, women may be especially prone to drug or alcohol abuse. According to the Center for Substance Abuse Prevention, women are one of the fastest growing substance abuse groups in the United States, with nearly 3 million American women currently experiencing abuse of drugs or alcohol. In fact, estimates suggest close to 20 percent of women will suffer from some sort of drug, alcohol or chemical dependency at some point in their lives.
In the past, abuse of illicit drugs and alcohol was predominantly considered a male issue. However, based on my own clinical experience, the numbers of men versus women becoming addicted to drugs have evened and remained relatively constant at 50/50. A survey of the National Center on Addiction and Substance Abuse (CASA) at Columbia University showed 4.5 million women abuse alcohol or drugs, 3.5 million misuse prescription drugs and 3.1 million report regularly using illicit drugs.
Although the gap between the number of men and women who use tobacco, illegal drugs and alcohol has narrowed, what has changed is the growing abuse of and dependence on prescription opiates or narcotic pain pills by women. The biggest reason for this increase is the availability of these drugs on the street and the increased prescribing practices based upon pain complaints. The most common drugs of dependence or abuse among women include prescription opiates, such as oxycodone, hydrocodone and propoxyphene.
According to The Waismann Institute's 2004 Opiate Dependency Report, 86 percent of female patients seeking treatment were battling a dependency to physician prescribed painkillers. Based upon research conducted by the opiate dependency treatment center, the drug most commonly found to be a problem for women was OxyContin at 21 percent, while 19 percent sought treatment for Vicodin dependency.
Additionally, fentanyl, butalbital/aspirin/caffeine capsules and alprazolam are other drugs with high abuse potential. In fact, the National Institute on Drug Abuse (NIDA), a division of the National Institutes of Health, has reported that because women are two to three times more likely than men to be prescribed drugs such as sedatives; they are also about two times more likely to become addicted.
This stems in large part from the fact that women are more likely than men to be prescribed an addictive prescription drug, particularly narcotics and anti-anxiety drugs. Prescription drug abuse is more likely among adolescent girls aged 12 to 17 than boys the same age. This increased risk for prescription drug abuse among teenage girls most likely stems from a willingness to experiment with prescription and over-the-counter drugs because they may mistakenly believe these drugs are safer than street drugs.
However, more than any other group of adults, women over 59 have problems related to alcohol and psychoactive prescription drugs, and get addicted faster by using smaller amounts.
Despite increased incidents of addiction and abuse of prescription painkillers, women are definitely seeking help for their problems because of the negative consequences that may be associated with abuse and dependence. Girls and women with addictive disorders are at an increased risk of suicide, being victims of domestic and other violence, including rape.
Regardless of whether a woman abuses street or prescription drugs, and regardless of her age, the negative consequences are significant. However, for women of reproductive age, these consequences may also extend to her potential offspring. Research now shows addiction has a genetic element, which can be inherited by children of those who abuse drugs and alcohol.
When Is It Addiction?
How do you know when abuse has crossed the line to addiction? Addiction is defined by the American Society of Addiction Medicine as “a primary chronic, neurobiological disease with genetic, psychosocial and environmental factors influencing the development and manifestation. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.”
The Signs
Because many women already know of a friend, family member or co-worker with an abuse or addiction problem, or if you are taking a prescription pain medication, the signs of abuse should be recognized. The warning signs of prescription addiction include:
- Overemphasis on opioid issues during pain clinic visits that persist beyond the third treatment session.
- A pattern of early refills or dose escalation in the absence of acute changes in medical condition.
- Multiple phone calls or visits to request more opiates or refills.
- A pattern of prescription problems, such as lost, spilled or stolen medication.
- Supplemental sources of opiates obtained from multiple providers, emergency rooms or illegal sources.
If any of these are present, patients should pursue treatment as soon as the problem is recognized.
The Treatment
Once the need for treatment has been recognized, women may face additional barriers. Women who seek treatment are more likely than men to lack support and face opposition from their partners or other family members. Other obstructions include a lack of health insurance or financial resources necessary to cover the cost of treatment.
All patients seeking addiction treatment should look for a program that is individualized to their own specific needs. Many substance abuse treatment programs were developed for, and by, men. However, because drugs affect women differently than men, women have different treatment needs than men. They also have different social needs and face different barriers to treatment than men.
Given their different physiological, psychological, and social needs, women should ask some general question to be certain the treatment will be as effective as possible. For example, most women want to know if a drug treatment program is medically based, with oversight from a licensed physician. Many women also want to be aware of the level of family involvement in the treatment program, as a woman’s interpersonal relationships are often important factors in the recovery process.
Modern rehabilitation and recovery programs offer a variety of treatment options that can be highly successful. While a major increase in female patients has not currently occurred in my own practice, providing adequate information on the nature of addiction as a disease and individualized treatment that recognizes the unique – which sometimes includes female – traits, is key to successful recovery. Addiction is a disease, and hope exists among the improved treatments available to women and all those who suffer from it.
Dr. Michael Levy established the Las Vegas-based Center for Addiction Medicine in 1995. It is the only private medical practice in Southern Nevada specializing in addiction medicine. The center, located as 6000 W. Rochelle Ave., Suite 800, offers a full range of medical and therapeutic services to patients in the Las Vegas valley. For more information, contact Dr. Levy at (702) 873-7800.