Men and Women Have Different Reasons for Abuse

The rates of abuse of prescription pain medication are roughly the same among men and women. Why each gender abuses opioid pain medication, however, is unique to each.

A recent study by Harvard researchers in The Journal of Pain found that women abuse prescription pain medication most commonly for the following reasons:
•    Emotional issues
•    Psychological distress
•    History of psychiatric or psychological problems
•    History of sexual or physical abuse

Men abuse prescription opioids more commonly for these reasons:
•    Social problems
•    Behavioral problems
•    Issues with substance abuse

Opioids such as morphine, oxycodone, oxymorphone and fentanyl are commonly prescribed to treat pain, including pain that results from any of the following:
•    Chronic low-back pain
•    Accident trauma
•    Surgery
•    Arthritis
•    Fibromyalgia
•    Cancer

The prescription of opioids for chronic non-cancer pain has increased in recent years, leading to a corresponding increase in prescription opioid abuse, addiction and misuse.

Proper Use of Prescription Pain Medication

Before men or women are prescribed opioids, the American Pain Society and American Academy of Pain Medicine recommends that physicians first determine if the pain can be treated with other medications that are less addictive. If opioids are the best course of action, physicians should conduct a thorough medical history of the patient and assess their potential risk for substance abuse, misuse or addiction.

People who are at the highest risk for prescription drug abuse are those who have a personal or family history of drug and alcohol abuse. “For patients at higher risk for misuse of opioids, the guideline advises giving patients clear written rules, such as filling prescriptions at one pharmacy only, taking random drug tests, making regular physician visits and locking their medications at home,” said Gilbert J. Fanciullo, MD, of the Dartmouth Hitchcock Medical Center.

The study in The Journal of Pain recommends that women prescribed opioid pain medication who have evidence of trauma or mood disorders should be treated for those co-occurring disorders as well. They should also be counseled on the dangers of relying on the drugs to reduce stress and improve sleep.

For men, the study recommends closer monitoring of known or suspected behavioral problems, frequent urine screenings, pill counts and compliance monitoring to help reduce the risk for prescription drug abuse.

“Regular monitoring of chronic opioid therapy patients is warranted because the therapeutic benefits of these medications are not static and can be affected by changes in the underlying pain condition, coexisting disease, or in psychological or social circumstances,” said Fanciullo. “For patients at low risk for adverse outcomes and on stable doses of opioids, monitoring at least once every three to six months is sufficient, but weekly monitoring is justifiable for those at high risk for abuse and other adverse events.”

Though the reasons men and women abuse prescription pain medication varies, there are steps each can take to ensure that they safely use opioid medications to alleviate the symptoms of their pain without becoming addicted to the drugs.