Drug Deaths - Women

Drug Deaths - Women in United States

United States

Drug overdose deaths have risen steadily in the U.S. over the past two decades and have become a leading cause of injury death. In 2020, more than 91,000 Americans died of a drug overdose, including around 28,000 women. Though these statistics reflect all drug deaths, opioids — fentanyl in particular — have been identified as the most significant contributor. Over 75% of drug deaths in 2020 involved an opioid. Other drugs that contribute to drug deaths in the United States include stimulants such as cocaine and tranquilizers such as benzodiazepines. The use of multiple illicit substances simultaneously has also led to increases in drug deaths as the risk of overdose increases when drugs are combined. 

Certain circumstances put women at higher risk of misusing drugs, including:

• Domestic violence.
• Misusing prescription opioids to self-treat other problems such as anxiety or tension.

Heavy drug use and overdoses are costly to society, burdening individuals, families, the health care system and the economy. Annual cost estimates for prescription opioid misuse and illicit drug use in 2017 were $78.5 billion and $193 billion, respectively. Additionally, the effects of substance misuse contribute to public health problems like neonatal abstinence syndrome (NAS), HIV/AIDS and hepatitis. More than 2 million children have been affected by parental opioid use, including 240,000 children who lost a parent to opioid overdose. For pregnant women, accessing proper treatment for opioid use disorder may be challenging. Lack of training and fear of being sued prevents some physicians from treating pregnant patients.

The drug death rate is highest among

• Women ages 35-44 compared with those ages 20-24.
• American Indian/Alaska Native women compared with Asian women.

The rate of drug deaths among women ages 30-64 increased by 260% between 1999 and 2017. Within this age group, the largest increase was reported among older women ages 55-64. Moreover, women living in rural counties have a higher rate of drug overdose deaths compared with those living in urban areas. 

A multifaceted and coordinated approach between public health and public safety has been a crucial component of the response effort. CDC’s current response efforts include:

• Supporting surveillance and funding research on strategies to prevent opioid-related harms.
• Building state, local and tribal capacity to, among other things, coordinate prescription drug monitoring programs and respond to drug overdose outbreaks.
• Supporting providers, health systems and payers in their efforts to improve opioid prescribing for pain management, including use of the CDC Guideline for Prescribing Opioids for Chronic Pain. 
• Partnering with public safety by supporting law enforcement strategies to reduce the illicit opioid supply and improve distribution and timely use of naloxone (an antidote to reverse an opioid overdose). 
• Empowering consumers to make safe choices by increasing their awareness of the potential harms associated with prescription opioid misuse through their Rx Awareness Campaign. 

The Substance Abuse and Mental Health Services Administration (SAMHSA) has published an opioid overdose prevention toolkit for providers, communities, local governments and consumers. The National Institute on Drug Abuse offers resources and advice about what to do if someone you know has a problem with illicit drugs. Additionally, the Office on Women’s Health is helping fight the opioid epidemic by funding state projects to test innovative solutions to prevent opioid misuse in women and girls.

Healthy People 2030 has several objectives related to alcohol and drug use, including:

• Reducing drug overdose deaths.
• Increasing abstinence from illicit drugs among pregnant women.
• Reducing the proportion of women who use illicit opioids during pregnancy.
• Reducing the proportion of adolescents who used drugs in the past month.

Dowell, Deborah, Tamara M. Haegerich, and Roger Chou. “CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016.” MMWR. Recommendations and Reports 65, no. RR-1 (March 18, 2016): 1–49. http://dx.doi.org/10.15585/mmwr.rr6501e1.

Drug Enforcement Administration. “2020 National Drug Threat Assessment (NDTA).” U.S. Department of Justice, Drug Enforcement Administration, March 2, 2021. https://www.dea.gov/sites/default/files/2021-02/DIR-008-21%202020%20National%20Drug%20Threat%20Assessment_WEB.pdf.

Hedegaard, Holly, Arialdi Miniño, Merianne Rose Spencer, and Margaret Warner. “Drug Overdose Deaths in the United States, 1999–2020.” NCHS Data Brief No. 428. Hyattsville, MD: National Center for Health Statistics, December 30, 2021. https://doi.org/10.15620/cdc:112340.

Hedegaard, Holly, and Merianne Rose Spencer. “Urban–Rural Differences in Drug Overdose Death Rates, 1999–2019.” NCHS Data Brief No. 403. Hyattsville, MD: National Center for Health Statistics, March 1, 2021. https://doi.org/10.15620/cdc:102891.

McHugh, R. Kathryn, Elise E. DeVito, Dorian Dodd, Kathleen M. Carroll, Jennifer Sharpe Potter, Shelly F. Greenfield, Hilary Smith Connery, and Roger D. Weiss. “Gender Differences in a Clinical Trial for Prescription Opioid Dependence.” Journal of Substance Abuse Treatment 45, no. 1 (July 1, 2013): 38–43. https://doi.org/10.1016/j.jsat.2012.12.007.

Patrick, Stephen W., Melinda B. Buntin, Peter R. Martin, Theresa A. Scott, William Dupont, Michael Richards, and William O. Cooper. “Barriers to Accessing Treatment for Pregnant Women with Opioid Use Disorder in Appalachian States.” Substance Abuse 40, no. 3 (October 9, 2018): 356–62. https://doi.org/10.1080/08897077.2018.1488336.

Phillippi, Julia C., Rebecca Schulte, Kemberlee Bonnet, Peter R. Martin, Katy B. Kozhimannil, Stephen W. Patrick, William O. Cooper, and David D. Schlundt. “Reproductive-Age Women’s Experience of Accessing Treatment for Opioid Use Disorder: ‘We Don’t Do That Here.’” Women’s Health Issues, June 2, 2021. https://doi.org/10.1016/j.whi.2021.03.010.

VanHouten, Jacob P., Rose A. Rudd, Michael F. Ballesteros, and Karin A. Mack. “Drug Overdose Deaths Among Women Aged 30–64 Years — United States, 1999–2017.” MMWR. Morbidity and Mortality Weekly Report 68 (2019). https://doi.org/10.15585/mmwr.mm6801a1.

Wilson, Nana, Mbabazi Kariisa, Puja Seth, Herschel IV Smith, and Nicole L. Davis. “Drug and Opioid-Involved Overdose Deaths — United States, 2017–2018.” MMWR. Morbidity and Mortality Weekly Report 69, no. 11 (March 20, 2020): 290–97. https://doi.org/10.15585/mmwr.mm6911a4.