Opioid use is going down – but not among young women.
Despite all the efforts to plug America’s drug addiction epidemic, the dam is not water tight and some cracks seem harder to patch up.
There is progress – patients are being prescribed fewer pills post-operatively, doctors have been charged for dishing out opioids without a diagnosis, and polls show more and more people are aware that painkillers can be addictive within days.
But a new report by shows that the broad sweeping measures taken to curb opioid use don’t cater to all groups – particularly females aged 18 to 35. Last year, the number of millennial women hooked on addictive painkillers went up 17 percent (compared to six percent of men the same age).
The report also revealed that prescription is still rampant for some surgery patients, particularly after weight loss surgery, and while most patients have leftover pills, few of them return or dispose of them, which can lead to misuse.
It comes the same day as a survey of nearly 200 doctors, in which most admitted they have prescribed opioids to patients they suspect to be hooked on drugs.
Last year, the number of millennial women hooked on addictive painkillers went up 17 percent compared to six percent of men the same age
Dr Paul Sethi, an orthopedic surgeon, helped compile the report funded by Pacira Pharmaceuticals Inc which promotes their own anesthesia as a way to lower the need for opioids.
He insists he’s optimistic about ‘the direction we’re moving in’.
When it comes to women, though, it will take more than implementing some policies.
Auto-immune diseases are more common in women, and while there are alternatives for post-operative care, opioids are still the most effective for conditions such as lupus and arthritis.
For those that don’t have an auto-immune condition, Dr Sethi explains, the problem is bigger than cracking down on prescriptions: it has a lot to do with a culture of pressure on women to perform both at work and at home.
It’s become clear that many women get hooked on pills prescribed to them after a cesarean or a particularly complicated childbirth.
Opioids offer a quick fix to get back to normal as soon as possible.
Women are under ‘increased pressure to return back to work and at the same time starting to raise families,’ Dr Sethi says. ‘So they’ve got a lot of pressure on them to perform in the work place and at home.’
What’s more, he says, many physicians believe it is harder to spot dependence in women: ‘Women are generally tougher than men, it’s a realization you get being a surgeon.’
Even so, spotting addiction is one thing – refusing care is another.
Seven states (pictured) are still prescribing enough pills for every citizen to have some each
One of the most stubborn areas of opioid use is among patients undergoing surgery for obesity (sleeve gastrectomy) or age-related bone problems (knee replacements and hip replacements) – which will become increasingly common as the nation fattens and ages
Part of the issue that led to today’s addiction epidemic was that physicians feared leaving their patients in the lurch, without anything to ease their pain, if they ran out over a weekend or at night, when the clinic is closed.
With more data and reports on the risks of opioids, patients and more aware and physicians are empowered to explain why they are prescribing a smaller dose (studies show 25 pills should be enough for most surgeries).
Indeed, Dr Sethi gleefully said one of his mentors at Yale recently texted him saying he was prescribing fewer opioids than ever.
But the concern lingers, and for whatever reason – benevolent or ambivalent – many doctors still find it difficult to say no.
That dilemma is laid bare in a new survey of 185 medical professionals – doctors, nurses and pharmacists – by Delphi, a support group for addiction survivors.
There was widespread agreement that opioids lead to addiction, and that there are effective alternatives.
However, most medical professionals (72 percent) said they suspected they had given opioids to an addict.
The majority of doctors in the survey said they believed one of their patients had developed a dependency on opioids from their prescriptions.
The states that suffered the highest overdose rates have reduced their prescriptions rates more than anywhere else – but still prescribe more than the national average
Even still, it will take a while for reduced prescription rates to translate into real change. The Pacira report, part of a campaign called Choices Matter, shows that the states that suffered the highest overdose rates have reduced their prescriptions rates more than anywhere else.
However, many of them still lead the country in prescriptions – including Alabama, which reduced prescriptions by 10 percent, but is still the top prescriber.
Seven states are still prescribing enough pills for every citizen to have some each.
What’s more, one of the most stubborn areas of opioid use is among patients undergoing surgery for obesity (sleeve gastrectomy) or age-related bone problems (knee replacements and hip replacements) – which will become increasingly common as the nation fattens and ages.
Dr Sethi insists that the more reports there are, the more doctors and patients will be aware of the risks.
‘I’m optimistic. We’re not going in the wrong direction,’ he said.