As a result, "many more primary care professionals are put in the position of prescribing for anxiety and depression," even when their patients have health insurance and the means to see a specialist. Patients initially prescribed powerful pain medications for sports injuries or after surgery may discover those drugs help them relax or sleep better and begin "self-medicating their psychiatric symptoms and not just the physical pain," Howell said.
Howell said she suspects that women in their 50s, who tend to suffer aged-related aches and pains and have problems stemming from hormonal changes, are complaining to their doctors about "things that may not sound totally like depression or anxiety." She said they leave with prescriptions for anti-anxiety drugs, painkillers or sleeping pills, when they might benefit more from therapy, antidepressants or in some cases, hormonal therapy.
With so many primary care doctors and specialists handing out so many powerful pills, it's little wonder that patients end up with more medications than they need in their medicine cabinets. "If you paid for it, you tend to hang onto it," Howell said. "And then if you become depressed or otherwise impulsively suicidal, you look at your medicine cabinet. Overdose is a very common way to try to attempt suicide."
Although statistics show men more likely to kill themselves than women, women are more frequently treated for attempted suicide, according to 2011 figures compiled by the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention. In 2009, there were more than 215,000 ER visits by women trying to hurt themselves and women accounted for 3 out of 5 ER visits for drug-related suicide attempts.
The DAWN report said hospital emergency rooms are key places to identify at-risk women and refer them for "appropriate mental health and social services" that address underlying anxiety, depression and domestic abuse, before they can succeed in ending their lives. But it said much of that intervention could also take place by having doctors "monitor the frequency of requested refills, assess medical need, and refer to mental health services when indicated."
"The steep rise in abuse of narcotic pain relievers by women is extremely dangerous and we are now seeing the result of this public health crisis in our emergency rooms," said SAMHSA Administrator Pamela S. Hyde, an attorney and former state mental health director. "Emergency rooms should not be the front line in our efforts to intervene."
Given that older women represent one of the fast-growing populations, and that pain and sleep disorders increasingly are treated with prescription drugs, report concluded by saying that "expanded research on women's aging issues and the potential use of these drugs as a method of, or influence on, suicide attempts is critical."