It starts with back pain or fibromyalgia, or the painful after-effects of surgery. Your doctor prescribes a powerful painkiller—OxyContin or Demerol, perhaps, or Dilaudid, Vicodin or Fentora. You start taking the pills. You feel better and you can’t stop. Next thing you know, you’re one of the growing numbers of midlife women—particularly white women— addicted to legal or black-market opioids.
Or worse, you could become one of thousands of midlife women dying from overdoses of legal or illegal opioids. Since 1999, opioid overdose deaths among midlife women—particularly rural white women—have increased by 400 percent. Imagine living in Wayne County, Utah, where the death rate for white women over age 50 jumped by 65 percent between 1999 and 2014. Much of the jump is attributable to opioids.
A mostly white-woman problem
For once, black women are actually benefiting from racial disparities in medical treatment. Here’s why: Most of the rise in opioid abuse among middle-aged women has come from prescriptions for chronic pain, rather than for acute injury or pain from a terminal illness. Amazingly, in at least 30 counties in Southern states, middle-aged black women now have a lower mortality rate than white women.
One reason is that, if you’re black, you’re much less likely to be prescribed opioids for chronic pain that is the least bit ambiguous. Even if you have a prescription, that doesn’t mean you can actually find the medication in your neighborhood.
Now, if you think you couldn’t possibly know anyone who is addicted to opioids, you are probably wrong. Opioids, which include prescription painkillers as well as heroin, caused the majority of an estimated 62,500 drug overdose deaths in 2016. That number represents a 19 percent increase over 2015 overdose deaths and the biggest annual jump ever recorded in the United States.
Midlife women are particularly at risk for opioid abuse, because we are more likely than men or younger people to have chronic pain and more likely to use prescription painkillers for longer periods than other groups do. Another risk factor is that midlife women are five times more likely than other groups to receive concurrent prescriptions for dangerous anti-anxiety drugs like Xanax and opioid painkillers. The combination can be lethal.
Prescription opioid addiction is also driving skyrocketing use of heroin, the illegal and much cheaper version of prescription opioids. In West Virginia, for example, one oxycodone pill (the generic version of OxyContin and related drugs) sells for about $80—but a dose of heroin costs about $10. If you were poor, desperate and anxious about the return of pain or horrible withdrawal symptoms, heroin might look pretty good.
When opioids are the only thing that works
Despite the risks, opioids do have a place in medical treatment. For major pain, a lesser drug won’t do. If you are so unfortunate as to need a serious painkiller, you should talk to your doctor about how to prevent addiction and a future life of doctor-shopping, lying and disastrous consequences.
In general, that means taking the minimum effective dose for the shortest appropriate period of time—generally less than a month. After that, you’ll likely experience withdrawal if you try to quit. Also, experts recommend taking a painkiller before the pain Kraken is unleashed, when you might be tempted to take more than the recommended dose.
If you are already using opioids for a medical condition, how do you know whether you are addicted? Well, you could try this quiz. If you think you’re addicted and you’re concerned, we implore you to get help. We’ve said it before and we’ll say it again: Dames, we’ve got to take care of ourselves.