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July 3, 2013

Drug overdose deaths spike among middle-aged women

(Continued)

ATLANTA —

The report highlights the need for "a mindset change" by doctors, who have traditionally thought of drug abuse as a men's problem, he said. That means doctors should consider the possibility of addiction in female patients, think of alternative treatments for chronic pain, and consult state drug monitoring programs to find out if a patient has a worrisome history with painkillers.

The CDC report focuses on prescription opioids like Vicodin and OxyContin and their generic forms, methadone, and a powerful newer drug called Opana, or oxymorphone.

"These are dangerous medications and they should be reserved for situations like severe cancer pain," Frieden said. He added that there has not been a comparable increase in documented pain conditions in the U.S. public that would explain the boom in painkiller prescriptions in the last 10 or 15 years.

Some experts said the increase in prescriptions can be traced to pharmaceutical marketing campaigns.

CDC researchers reviewed death certificates, which are sometimes incomplete. Specific drugs were not identified in every death. In others, a combination of drugs was involved, such as painkillers taken with tranquilizers.

CDC officials think more than 70 percent of the overdose deaths were unintentional.

One striking finding: The greatest increases in drug overdose deaths were in women ages 45 through 54, and 55 through 64. The rate for each of those groups more than tripled between 1999 and 2010.

In 2010, overdose deaths in those two groups of middle-aged women added up to about 7,400 — or nearly half the female total, according to CDC statistics.

It's an age group in which more women are dealing with chronic pain and seeking help for it, some experts suggested.

Many of these women probably were introduced to painkillers through a doctor's prescriptions for real pain, such as persistent aches in the lower back or other parts of the body. Then some no doubt became addicted, said Dr. Andrew Kolodny, a psychiatrist who specializes in addiction at Maimonides Medical Center in New York City.

There aren't "two distinct populations of people being helped by opioid painkillers and addicts being harmed. There's overlap," said Kolodny, president of a 700-member organization Physicians for Responsible Opioid Prescribing.

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