Although pain can strike anyone irrespective of gender, there are significant differences in the way pain is experienced by men and women and how they respond to treatment. Findings of a new report titled, United States for Non-Dependence, published on Sep. 26, 2017, reveal that women face greater problems in pain management and may be at a higher risk of developing an addiction. The analysis, undertaken by QuintilesIMS Institute and sponsored by Pacira Pharmaceuticals, found that in 2016, 9 out of 10 patients were prescribed opioid painkillers after a surgery, with an average of 85 pills per person.
More importantly, the study found that women aged 40-59 years were prescribed twice the number of opioids than their male counterparts, higher than any other age group. In this age range, more women died due to overdoses from opioid use than in any other. Although the overall average opioid prescription rates for managing post-surgical pain were similar among men and women, 40 percent more women became persistent opioid users than men for all surgical procedures except hysterectomies. The analysis highlights that “differences in women and men are most pronounced among newly persistent opioid users ages 45-54 (12.8 percent vs. 8.5 percent).”
Patricia A. Rehmer, senior vice president for behavioral health at Hartford HealthCare in Connecticut, says that the public perception of middle-aged women not being “typical opioid addicts” is incorrect. She explains that prescribers are usually hesitant to decline patient requests for painkillers after surgery or in case of injuries. By the time addictive behaviors are noticed “it could be too late,” says Rehmer.
Age group of 40-59 vulnerable to various potential surgeries
According to Rehmer, the age group of 40-59 is vulnerable to various potential surgeries. During this period, certain cancers are diagnosed and women may undergo hysterectomies. For the analysis, seven inpatient and outpatient surgical procedures were examined: hernia, total knee replacement, colectomy, hysterectomy, total hip replacement, sleeve gastrectomy and rotator cuff surgery. Rehmer adds that people are reluctant to challenge middle-age women when they request for additional pain medication.
Paul M. Sethi, an orthopedic surgeon at Orthopaedic & Neurosurgery Specialists (ONS) in Connecticut, says that the reasons for gender discrepancies are not fully understood and this requires a discussion between doctors and patients. Women may be at a higher risk of opioid dependence due to “differences in body fat, metabolism and hormones.” Past research on rats has found that female rats experience pain more severely than male rats, with higher neural activity in the pain regions of female brains. Women also experience higher chronic pain conditions such as migraines for which opioids are often prescribed.
As per the overall analysis, 11.7 billion pills were prescribed to Americans in 2016, “enough for every man, woman and child to have 36 pills each.” Over-prescription of post-surgical opioid painkillers resulted in 3.3 billion unused pills finding their way into communities, making them liable for diversion and misuse. Nearly 3 million people who underwent surgeries in 2016 became “newly persistent opioid users.”
The analysis shows that a 10 percent reduction in post-surgical opioid prescription rates will lead to 332 million fewer pills finding their way into communities, significantly reducing opportunities for their diversion and misuse. It will also result in 300,000 fewer post-surgical patients becoming persistent opioid users every year and save $830 million in annual drug costs.
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