Fatal Drug ODs Soaring Among Middle-Aged Women: CDC

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By E.J. Mundell
HealthDay Reporter

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THURSDAY, Jan. 10, 2019 (HealthDay News) — The rate at which middle-aged American women die from overdoses involving opioids and other drugs nearly quadrupled between 1999 and 2017, new government data shows.

In 1999, about seven out of every 100,000 deaths among U.S. women aged 30 to 64 was caused by a drug overdose, but by 2017 that rate had risen to about 24 women per 100,000 — a 260 percent increase, the U.S. Centers for Disease Control and Prevention said.

At the same time, rates of fatal ODs from opioids, specifically, rose nearly sixfold for middle-aged women.

The steepest increase was actually seen among older women — those aged 55 to 64 — noted a team led by Karin Mack, of the CDC's National Center for Injury Prevention and Control.

In fact, the average age of death from overdose crept up by about three years over the course of the study period. In 1999, the average age of a fatal OD in middle-aged women was 43.5 years, but by 2017 it had risen to 46.3 years, Mack's team reported.

The bottom line, the researchers said, is that "efforts are needed to reduce the number of deaths in this evolving epidemic among middle-aged women."

One physician on the frontlines of the overdose crisis said multiple factors are contributing to these tragedies.

"We know that prescription opioids are still the main driver of the current opioid epidemic, but it's important to understand the sharp rise of fentanyl-laced heroin responsible for increased numbers of deaths," said Dr. Robert Glatter. He's an emergency physician at Lenox Hill Hospital in New York City.

Fentanyl is an opioid that's thought to be 50 times more potent than heroin and 100 times more potent than morphine.

"Cheap, illicitly manufactured fentanyl from China and Southeast Asia is making its way onto the streets in the U.S.," Glatter explained.

He said that while men tend to have higher rates of drug abuse than women, women can be especially vulnerable.

"Women's substance use tends to progress more rapidly from first-time use until addiction develops," Glatter said. "Withdrawal can also be more intense for women, and they may also respond differently than men to specific medical treatments."

The new CDC study relied on 1999-2017 data from the National Vital Statistics System.

The data revealed that for women aged 30 to 64, deaths linked to "synthetic opioids" — a class that includes fentanyl — rose about 17-fold during the study period. Steep increases were also seen for deaths involving heroin (a 10-fold rise), as well as those involving Valium, Xanax or other benzodiazepine drugs (a ninefold rise). Often, overdoses involved multiple drugs.

Why are women in middle age being hit especially hard by the opioid abuse crisis? Addiction specialist Dr. Harshal Kirane had some theories.

"Middle-aged women are often prevented from accessing care due to family responsibilities, child care considerations and financial disparities," said Kirane, who directs addiction services at Staten Island University Hospital in New York City.

"Moreover, certain mental health issues — such as anxiety and depression — tend to occur at higher rates in women, which create profound obstacles to engagement in care," he said.

Glatter agreed.

"People with untreated or undertreated depression or anxiety are at higher risk for substance abuse, with middle-aged women in this demographic at higher risk for opiate as well as benzodiazepine abuse," Glatter said. "Women who are victims of domestic violence are also at higher risk of substance abuse."

All of this means that more outreach must be done to help women who are vulnerable to addiction.

Kirane suggested that "we must expand the entire infrastructure for addiction care in our country, and address the comprehensive needs for women struggling with opioid-related issues."

Crucial to these efforts are boosting women's access to education about overdose, allowing them easy access to the overdose antidote naloxone, and widening the availability of medication-assisted treatments aimed at weaning people off addictive drugs, Kirane said.

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The new report was published Jan. 11 in the CDC's Morbidity and Mortality Weekly Report.

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SOURCES: Robert Glatter, M.D., emergency physician, Lenox Hill Hospital, New York City; Harshal Kirane, M.D., director, addiction services, Staten Island University Hospital, New York City; Jan. 11, 2019, Morbidity and Mortality Weekly Report

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