More Women 50 and Older Landing in ERs for Drug-Related Suicide Attempts

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Evidence of the troubling increase in prescription drug abuse has reached hospital emergency rooms, which report increasing medication-related suicide attempts among women 50 and older.

From 2005 to 2009, suicide attempts in which drugs played some role rose from 11,235 to 16,757 among women ages 50 and up, a federal survey found. The increase, driven in part by the last of the Baby Boomers entering their sixth decade, provides a new example of the toll wrought by the nation's prescription painkiller epidemic. In 2009, 16 million Americans age 12 and up had taken a prescription pain reliever, tranquilizer, stimulant or sedative for non-medical reasons in the previous year, according to the National Survey on Drug Use and Health.

The trends involving women and suicide appeared in a Drug Abuse Warning Network (DAWN) report dated May 12, 2011, but released Thursday to coincide with a meeting of the public-private Action Alliance for Suicide Prevention. The report, prepared by the Substance Abuse and Mental Health Services Administration, wasn't limited to suicide attempts involving deliberate overdoses; its authors counted any suicide attempt in which drugs were involved, such as a woman slashing her wrists while smoking marijuana.

Among women of all ages, emergency hospital visits for attempted suicide involving alcohol or illicit drug use remained "relatively stable" from 2005 to 2009, but increased for particular drugs. Drilling deeper into the report reveals that:

ER visits for suicide attempts associated with women taking drugs intended to counter anxiety and insomnia rose 56 percent, from 32,426 to 50,548. Hospital visits for attempted suicides involving a class of anxiety drugs known as benzodiazepines rose 67 percent. Those involving alprazolam (Xanax) went up 74 percent. Hospital visits for suicide attempts in which the insomnia drug zolpidem (Ambien) played a role rose 158 percent, from 2,177 visits to 8,190 visits, for all women, but only were statistically significant among women 35 to 49.

ER visits for women's suicide attempts associated with pain relievers grew more than 30 percent, from 36,563 to 47,838. Suicide attempts involving narcotic pain relievers remained relatively stable overall, but climbed 67 percent among women who took hydrocodone (Vicodin), from 4,613 to 7,715. They soared 210 percent for suicide attempts involving oxycodone (Oxycontin), from 1,895 to 5,875. A closer analysis found statistically significant increases in ER visits for attempted suicide involving oxycodone for women 21 to 34, and attempted suicide involving hydrocodone for women 35 to 49. Those age ranges span the years during which women typically marry, have children, build careers and reach menopause, all of which can contribute to stress.

Adult addiction specialist Dr. Elizabeth F. Howell, a past president of the American Society of Addiction Medicine and associate professor of clinical psychiatry at the University of Utah School of Medicine in Salt Lake City, said the report findings reflected higher overall rates of prescription abuse and addiction. They weren't surprising, she said, because as doctors spend less time with their patients, they rely more on pharmaceutical treatments for physical and psychological problems.

"When you go to the physician, there's not as much time to talk to the doctor. If I'm not sleeping very well, the doctor is more likely to give me a prescription, rather than talk to me for 5 minutes about sleep hygiene," she said. "There are not as many psychiatrists as we need. Even suicidal patients have trouble getting to see a psychiatrist."

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