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Biggest jump in drug overdoses was among middle-aged women

The rate of deaths from opioid overdoses soared by nearly 500 percent among women over 30, the CDC found.
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The epidemic of drug overdose deaths is worsening at a startling rate among middle-aged women, federal health experts reported Thursday.

Drug overdose deaths have soared among women over 30 starting in 1999 — with the biggest increase among women aged 45 to 64, the team at the Centers for Disease Control and Prevention found. Deaths from drug overdoses increased by 260 percent among women aged 30 to 64 between 1999 and 2017.

And the rate of drug overdose deaths from opioids increased by an enormous 492 percent among women aged 30 to 64.

While men are far more likely than women to die of drug overdoses, the pattern shows that the dangers of painkiller overuse across the U.S. population.

The U.S. is battling an ever-worsening epidemic of deaths from opioid drugs. Last year, the government reported more than 70,000 Americans died from drug overdoses, a 10 percent increase in just one year. By far the biggest cause was opioid drugs, especially synthetic opioids such as fentanyl.

Statistics show that most of those who die from overdoses first used opioids with a legitimate prescription from a doctor. The CDC has been advising doctors to think twice before prescribing an opioid and advises patients to question their doctors before accepting a prescription.

The CDC’s Karin Mack and colleagues analyzed death certificates from all 50 states, looking at suicides, homicides, accidental and unknown causes of death. They took note of which drugs were in a person’s system at the time of death, including antidepressants, opioids, anxiety drugs, heroin and cocaine.

Many of those who died had more than one drug in their system at the time. “Deaths might have involved more than one substance,” Mack’s team wrote.

“Increases in deaths involving certain drugs might be the result of increases in certain drug combinations.” For instance, the CDC and other groups have been warning about the special danger of taking opioids and anxiety drugs such as Xanax or Valium at the same time. Both slow breathing and, taken together, can make people stop breathing.

But what stuck out was the increase in deaths among women 30 and older, and especially among women aged 45 and older.

"Prescription opioid–related deaths increased between 1999 and 2017 among women aged 30–64 years, with the largest increases among those aged 55–64 years," Mack's team wrote in their report, published in the CDC's weekly report on death and disease.

"Prescription opioids clearly were overutilized for more than a decade," said Dr. Michael Lynch, medical director of the Pittsburgh Poison Center at the University of Pittsburgh Medical center, who was not involved in the CDC study.

"We've seen overall prescribing decline since 2010 to 2012, but I think it's informative to see that among women ages 30 to 64, prescription opioid overdose deaths still represent such a large number," Lynch said.

Lynch also suspects suicide might be a bigger factor than the coding on death records can indicate.

"Most likely there are hidden suicides here," he said. "It can be very difficult to tell. As we know from postmortem evaluation, a determination is made whether it was intentional or not. But of course rarely do we know the individual's mindset before these tragic events," he added.

"Sometimes there are clear indicators like suicide notes. And sometimes unfortunately, people have died and we find a fatal amount or combination of drugs in their system but we don't know how or why they got there. I'm sure there's a lot of overlap between misuse and unintentional overdose and those who intentionally overdose to kill themselves."

Doctors treating patients for depression, for pain, for anxiety and for other conditions need to be aware, the CDC team said.

“Substantial work has focused on informing women of child­bearing age about the risk and benefit of the use of certain drugs, particularly for the risk posed by neonatal abstinence syndrome as a result of opioid use during pregnancy,” they wrote. “The current analysis demonstrates the remaining need to consider middle-aged women who remain vulnerable to death by drug overdose."