opioid crisis

The Gender Disparity of the Opioid Crisis

/ Thomas Cohn, MD

chronic pain pills womenA recent opinion piece in the Star Tribune shined a light on the problem different genders face in the opioid crisis, particularly the challenges faced by women.

One of the main talking points is that deaths from opioid overdoses have increased much faster for women than for men. Female deaths from opioid overdoses have increased 400 percent in recent years compared to 265 percent for men. Both of these numbers are very problematic, but it helps to show that the opioid crisis is affecting each gender differently.

When opioids affect women, it can oftentimes have a bigger trickle down affect than when it affects men. As the article states, in most American families the woman is the primary caregiver, and the woman’s well-being is often closely tied to the health and future of the children. Opioid abuse by the primary caregiver can often lead to problems down the road for the children, and it increases their likelihood of having their own battles with substance abuse. When opioids negatively affect women, it rarely impacts just one person.

Fixing The Problem

The article went on to suggest some ways to reduce opioid disparity and the larger problem of gender-based health disparities in the United States. Some of the proposed solutions include:

  • Addiction risk education for doctors and patients
  • More education has led to fewer opioid prescriptions and in some places, a downturn in overdose deaths
  • Better emergency room treatment
  • Education campaigns to change dosage standards for women
  • Increased doctor education in states where women disproportionately suffer from conditions like obesity, high blood pressure, diabetes, chronic pain and heart problems
  • Stop cutting insurance coverage for certain programs like Medicaid and Medicare

It’s clear that there’s no one-size-fits-all answer for fixing the opioid crisis and gender-based healthcare disparities throughout the country, but the first step is to help spread awareness that a problem exists. Then we need to put a plan of action in place and stop making the bottom line a higher priority than the health of the patient in our office.

Opioids certainly have a place to help patients when properly assigned and administered, but far too often they are being blindly prescribed and without safety measures in place if abuse begins. The Star Tribune article is a step in the right direction by calling attention to the problem, but now we need doctors, patients and our legislatures to follow through. For the sake of women and families across the country, I hope we can work towards a solution.

Obama Weighs In On Opioid Crisis in America

/ Thomas Cohn, MD

President Barack Obama shot down a proposal on Monday from the nation’s governors designed to curb America’s opioid and heroin crisis. The proposal called for limiting the number of high-powered painkillers a doctor could prescribe at a time, but Obama said the move could block access to drugs that people truly need.

“If we go to doctors right now and say ‘Don’t overprescribe’ without providing some mechanisms for people in these communities to deal with the pain that they have or the issues that they have, then we’re not going to solve the problem, because the pain is real, the mental illness is real,” Obama said. “In some cases, addiction is already there.”

Pain Pills Minnesota

The recommendation had received bipartisan support at the National Governors Association’s winter meeting, but President Obama rejected the sweeping proposal. The president thanked the governors for crossing party allegiances to come to a solution, but he didn’t think it adequately addressed the full scope of the problem.

“This is an area where I can get agreement from Bernie Sanders and Mitch McConnell. That doesn’t happen that often,” Obama said.

Opioids in America

According to the Centers for Disease Control and Prevention, heroin and prescription painkillers play a roll in the deaths of 78 Americans every day. Certain prescription opioids are seen as gateway drugs to heroin, which is cheaper and often much easier to obtain.

Vermont Govermor Peter Shumlin criticized Obama for rejecting the proposal, saying, “You can’t convince me that we’ve got 250 million Americans in chronic pain.”

The fact of the matter is that opioids are likely over-prescribed in this country, and while some doctors certainly hand them out too easily, for some patients, it is truly the only option that keeps their pain at bay. For others, surgery or costly therapy sessions are out of the question, so they rely on those painkillers to manage their pain. Dr. Steven Stack, president of the American Medical Association, praised Obama for shutting down the blanket rule which would have undoubtedly hurt a large portion of actual chronic pain sufferers.

“The complexity of the problem makes it difficult to create a successful one-size-fits-all approach,” Stack said.

Stack is right. There is no perfect one-size-fits-all approach to chronic pain care, just like there is no magic pill to solve one’s pain. In the end, we need comprehensive exams to understand to underlying cause of pain, and we need to work with patients to understand their treatment options and the potential implications of each. It’s much harder than simply prescribing a painkiller, and it also takes work on the patient’s end to work to get better and not just rely on their pain pills, but this duel-responsibility approach is what it’s going to take to start reversing the opioid crisis.