Gender Gap in Prescription Pain Drug Abuse
Study Shows Men and Women Have Different Risk Factors for Abuse of Prescription Painkillers
April 29, 2010 -- Gender appears to play a role in the risk of abuse of
prescription pain drugs, a study shows.
Predictors of such abuse are different in men and women, researchers say,
and knowing this could help doctors adopt treatment plans that are less likely
to cause misuse of opioid medications.
The finding comes from a study involving 662 chronic noncancer patients
taking opioid drugs for pain relief.
Researchers say misuse by women seems to be closely related to psychological
distress. Prescription pain drugs are more likely to be misused by men who have
social and behavioral problems.
"Since little has been published about gender differences and misuse of
prescription pain medication, it is valuable to document whether risk factors
for abuse are gender specific to some degree," says study researcher Robert N.
Jamison, PhD, a clinical psychologist at Harvard's Brigham and Women's
The study shows that men and women have similar frequencies of aberrant drug
behavior but different risk factors for abuse of opioids.
Women who misuse pain drugs are more likely "to admit to being sexually or
physically abused or have a history of psychiatric or psychological problems,"
Women who are being treated for pain not caused by cancer and who exhibit
signs of significant stress should be treated for mood disorders and counseled
on dangers of relying on pain pills to help them sleep or reduce stress, the
Men taking pain pills should be closely monitored for suspected behavioral
problems, Jamison says. In addition, their pills should be counted to check
adherence, and frequent urine screens also should be done.
Abuse of Opioids Is Growing
Jamison and colleagues write in the study that the use of opioids for
chronic pain has been growing, and that between 3% and 16% of the population
has a substance use disorder.
Indeed, some pain centers that dispense opioids "are overwhelmed with
patients who are known or suspected to be abusing" their medications, the
The study involved patients who had been prescribed opioids for chronic
noncancer pain; about half the participants were men, half were women.
Five months into the study they were interviewed and had to submit a urine
sample. Physicians also completed a substance misuse behavior checklist.
The researchers write that women in the study tended to display signs of
emotional issues and affective distress, compared with men.
Men tended to show signs of worrisome behaviors, such as association with
other people who abused drugs and alcohol and engaging in criminal
For women, a history of sexual abuse was an issue in later misuse of
prescription drugs. "These results are in agreement with past research that
highlighted the importance of sexual and physical abuse history in predicting
opioid misuse," the researchers write. "These same studies also showed that
women with a significant history of anxiety and depression tend to do less well
in properly managing opioids prescribed for pain, possibly because of the
tendency to self-medicate a mood disorder using opioids."
The researchers also say that past research has suggested that women may be
more open and truthful about behaviors and to seek psychological help than
"Given the prominence of sex differences in a variety of pain-related
processes, we may eventually arrive at a method for tailoring risk assessment
and risk-reducing interventions in part as a function of gender," the
researchers say, adding that more research is called for by their study.
The study is published in the April issue of The Journal of Pain.