The opioid addiction for more than half of female methadone clinic patients began with painkillers prescribed by doctors, according to a paper in Biology of Sex Differences.
More than half (52%) of women and a third (38%) of men reported doctor-prescribed painkillers as their first contact with opioid drugs, a family of drugs which include prescription medicines such OxyContin and codeine, as well as illicit drugs such as heroin.
What to do? Doctors are routinely demonized as the problem but pain is a non-specific system and women report far more pain than men. We can imagine what would happen to doctors if women showed up in television interviews claiming a misogynist doctor didn't take their situation seriously.
It may be that women report more pain even if they do not have it. The analysis of 503 patients attending Ontario methadone clinics identified significant gender differences between the men and women. Women had more psychological problems and were more likely to have a family history of psychiatric illness, along with reporting more physical problems. Smoking cannabis was relatively high (47%) among both men and women while men smoked more cigarettes and women were employed less.
The analysis also shows that methadone clinics are out-of-date. "A rising number of women are seeking treatment for opioid addiction in Canada and other countries yet, in many cases, treatment is still geared towards a patient profile that is decades out of date -- predominantly young men injecting heroin, and with few family or employment responsibilities," said Monica Bawor, first author of the paper and a recent PhD from McMaster.
Compared to results from studies in the 1990s, the average age of patients being treated for opioid addiction is older (38 compared to 25 years), with opioid use starting at a later age (25 rather than 21 years). Injecting drug use has reduced by 60%, and there has been a 50% reduction in rates of HIV in opioid users as a result. At the same time, there has been a 30% increase in the number of patients becoming addicted to opioids through doctor-prescribed painkillers, usually for chronic pain management.
Canada consumes more opioid painkillers than any other country.
Why is Canada so dependent on painkillers? And why so many women?
"It may be that they are prescribed painkillers more often because of a lower pain threshold or because they are more likely to seek medical care than men," said senior author Dr. Zena Samaan, an associate professor of psychiatry and behavioral neurosciences at the Michael G. DeGroote School of Medicine.
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