Opioids: An Evolving Health Crisis for Women

Women experience painful chronic conditions at higher rates than men for which

a prescription for an opioid medicine might be prescribed, putting them at higher

risk for OUD. Those conditions include chronic migraines, fibromyalgia and

some forms of arthritis, and painful ob/gyn conditions, such as endometriosis,

fibroids, ovarian cysts, pelvic adhesions and pelvic inflammatory disease. Pain

management related to caesarian delivery may also lead to an opioid

prescription.

The rate of OUD in pregnant women increased significantly from 2011 to 2014,

with the rate of newborns experiencing opioid withdrawal symptoms increasing

to 14.4 per 1000 births in 2014. Newborns who were exposed to opioids in utero

have a higher risk of developmental, behavioral and educational problems.

Because women often are the primary caregiver for their families, OUD,

overdoses and opioid-related deaths can have dramatic and lasting effects on

women themselves and as they support family members with their OUD, or

grieve the loss of a child or spouse from an opioid overdose; and

When an OUD treatment center or clinician is available—and centers can be

hard to find or have long waiting lists—women may find the costs unaffordable.

For example, a Federal Reserve study found that in 2018 about 40 percent of

households would be unable to afford a surprise $400 expense. Since women still

earn less than men and have less savings, paying for treatment for themselves or

 a family member may be a significant challenge.

Like a ship in crisis mode, the response to the opioid epidemic needs to be “all

hands-on deck.”

The good news is that governments, clinicians, media and advocacy

organizations (including HealthyWomen) have responded:

The federal government has provided more funding and flexibility through

various programs to address the opioid epidemic ($3.3 billion in 2017 and $7.4

billion in 2018), the Centers for Disease Control and Prevention (CDC) recently

clarified their 2016 guidelines on the use of opioids for treating pain, and the

Food and Drug Administration (FDA) approved a generic version of the nasal

spray version of naloxone – the medicine that reverses opioid overdoses.

State governments have been working with clinician organizations to reduce the

use of prescription opioids, with some states enacting laws that limit opioid

prescriptions to three or seven days, with exceptions for clinical need. Those

efforts are having positive effects, resulting in opioid prescribing declining 12

percent in 2017 and 17 percent in 2018.

In parallel with government actions, patient and public health organizations have

been advocating for more access to medication assisted treatment (MAT) for

people with OUD, and for greater distribution of naloxone. MAT (e.g.,

methadone or buprenorphine) is the gold standard of medical care for people

with OUD, and government agencies, clinicians and researchers have been

creating better ways for to get people with OUD access to treatment with

methadone. For example, starting people with OUD on buprenorphine in the

emergency room reduces the likelihood that they will not follow-up for

treatment, or overdose again.

Getting people with OUD treatment is important not only for reducing their risk

of overdose and death, but also for improving their overall health. People who

use illicit medicines for their OUD are at higher risk for contracting infections

such as HIV or hepatitis C, and women with OUD are at higher risk for intimate

partner violence. For these reasons, some law enforcement and judicial systems

(such as Gloucester, MA, and the state of Texas) are prioritizing OUD treatment

 instead of incarceration since treatment is much more clinically effective and

more cost-effective.

HealthyWomen has responded to the threat the opioid epidemic poses for

women

and families by providing women state legislators with resources to craft local

solutions for improving responses to the opioid epidemic.

HealthyWomen also is working to confront the stigma connected to opioid use,

which continues to be a major barrier to expanding access to care.

HealthyWomen educates our audiences through our online content about OUD as

 a chronic biological disease, like diabetes or high blood pressure. These

complicated conditions require both medical treatment and other supportive

measures specific for the disease and the individual patient. We will continue to

 work with partners to