The Star Beacon; Ashtabula, Ohio

World, nation, state

July 5, 2013

Pain-pill deaths soar among Ohio, U.S. women

Prescription-drug overdoses are increasing more rapidly among women than men in the United States and in Ohio, prompting calls for more-careful prescribing of the drugs and attention to the potential for addiction.

Women are dying at rates that the country has never seen, said Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, as his agency shared numbers tracking deaths by overdose from 1999 through 2010.

More men die from drug use, but opiate-related deaths among women increased 415 percent in that period, compared with a 265 percent increase among men. The largest number of deaths was among women 45 to 54.

In 1999, 1,287 U.S. overdose deaths in women were attributed all or in part to opiates - strong painkillers that include Vicodin and oxycodone. In 2010, that number was 6,631.

“These are really troubling numbers,” Frieden said on a call with reporters.

Ohio’s death toll tells the same story. Deaths from unintentional drug overdoses jumped 436 percent among women and 276 percent among men from 2000 to 2011.

All of this coincides with an increase in prescribing of the drugs despite the absence of evidence of much-greater legitimate demand for them, Frieden said.

Nobody has a single definitive answer for why this is happening, but there are prevailing theories.

Women are more often diagnosed with abdominal pain, musculoskeletal pain and migraines, Frieden said.

Doctors should take care to prescribe addictive painkillers only for those who have severe pain, including cancer patients, he said. “In many other situations, the risks far outweigh the benefits,” he said.

Women also metabolize drugs and alcohol differently than men, making overdose more likely, said Paul H. Coleman, president and CEO of Maryhaven, which treats addiction and mental illness in and around Columbus.

Seven in 10 people admitted to Maryhaven for detox last year were addicted to an opiate. Most started with prescription drugs and eventually moved on to heroin, Coleman said.

Patients typically say their addiction started with a prescription for pain, such as an ailing back, he said.

The pharmaceutical industry also bears some responsibility, Coleman said.

Christy Beeghly, violence and injury-prevention program administrator for the Ohio Department of Health, said state leaders are working hard to cut back on overprescribing by well-meaning physicians. Already, prescribing guidelines have been shared with emergency departments throughout the state.

Now, a committee is working on a document that would help other physicians identify patients who might be at risk of trouble, Beeghly said.

The state also has an electronic system for checking up on patients who might be getting prescriptions from more than one provider.

“I think sometimes prescribers get put between a rock and a hard place where their patients are expecting particular types of drugs. A lot of times, it may be easier to give a patient what they want.”

There also can be obstacles to alternative pain care, including lack of insurance reimbursement for such treatments as physical therapy.

Coleman said both doctors and patients have a responsibility when pain management is being discussed.

“I think the patients should always say, ’Doctor, is this the least-problematic intervention that we can engage in? Is there another drug that doesn’t have the potential for addiction?’”

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