July 2013

 www http://www.cdc.gov/vitalsigns

Prescription Painkiller Overdoses 

See page 4

Want to learn more? Visit

A growing epidemic, especially among women

About 18 women die every day of a prescription painkiller 

overdose in the US, more than 6,600 deaths in 2010. 

Prescription painkiller overdoses are an under-recognized 

and growing problem for women.

Although men are still more likely to die of prescription 

painkiller overdoses (more than 10,000 deaths in 2010), 

the gap between men and women is closing. Deaths from 

prescription painkiller overdose among women have risen 

more sharply than among men; since 1999 the percentage 

increase in deaths was more than 400% among women 

compared to 265% in men. This rise relates closely to 

increased prescribing of these drugs during the past decade. 

Health care providers can help improve the way painkillers 

are prescribed while making sure women have access to safe, 

effective pain treatment. 

When prescribing painkillers, health care providers can

◊ Recognize that women are at risk of prescription 

painkiller overdose.

◊ Follow guidelines for responsible prescribing, including 

screening and monitoring for substance abuse and 

mental health problems. 

◊ Use prescription drug monitoring programs to identify 

patients who may be improperly obtaining or using 

prescription painkillers and other drugs.

Nearly 48,000 women died of 

prescription painkiller* overdoses 

between 1999 and 2010.

48,000

For every woman who dies of a 

prescription painkiller overdose, 30 

go to the emergency department for 

painkiller misuse or abuse.

30

Deaths from prescription painkiller 

overdoses among women have 

increased more than 400% since 

1999, compared to 265% 

among men. 

400%

*“Prescription painkillers” refers to opioid or narcotic pain relievers, 

including drugs such as Vicodin (hydrocodone), OxyContin (oxycodone), 

Opana (oxymorphone), and methadone.
2

Prescription painkiller overdoses are a 

serious and growing problem among women.

◊ More than 5 times as many women died from 

prescription painkiller overdoses in 2010 as in 1999.

◊ Women between the ages of 25 and 54 are more 

likely than other age groups to go to the emergency 

department from prescription painkiller misuse or 

abuse. Women ages 45 to 54 have the highest risk of 

dying from a prescription painkiller overdose.* 

◊ Non-Hispanic white and American Indian or Alaska 

Native women have the highest risk of dying from a 

prescription painkiller overdose.

◊ Prescription painkillers are involved in 1 in 10 

suicides among women.

*Death data include unintentional, suicide, and other deaths. 

Emergency department visits only include suicide attempts if 

an illicit drug was involved in the attempt.

The prescription painkiller problem affects 

women in different ways than men.

◊ Women are more likely to have chronic pain, be 

prescribed prescription painkillers, be given higher 

doses, and use them for longer time periods than men. 

◊ Women may become dependent on prescription 

painkillers more quickly than men. 

◊ Women may be more likely than men to engage in 

“doctor shopping” (obtaining prescriptions from 

multiple prescribers). 

◊ Abuse of prescription painkillers by pregnant women 

can put an infant at risk. Cases of neonatal abstinence 

syndrome (NAS)—which is a group of problems 

that can occur in newborns exposed to prescription 

painkillers or other drugs while in the womb—grew by 

almost 300% in the US between 2000 and 2009. 

Problem

The prescription painkiller 

epidemic is killing more 

women than ever before.

Potential risks 

of combining medications

Medicines for treatment of pain and mental illness have benefits and risks. 

For women, 7 in 10 prescription drug deaths include painkillers. But other 

prescription drugs play a role in overdoses as well. Women are more likely 

than men to die of overdoses on medicines for mental health conditions, like 

antidepressants. Antidepressants and benzodiazepines (anti-anxiety or sleep 

drugs) send more women than men to emergency departments. Mental health 

drugs can be especially dangerous when mixed with prescription painkillers 

and/or alcohol. If you take mental health drugs and prescription painkillers, 

discuss the combination with your health care provider.
3

Prescription painkiller overdose deaths are a growing problem among women. 

Women between the 

ages of 25 and 54 

are most likely to go 

to the emergency 

department because 

of prescription 

painkiller misuse 

or abuse.

0

20,000

10,000

30,000

40,000

50,000

AGE GROUP

NUMBER OF DEATHS

NUMBER OF EMERGENCY DEPARTMENT VISITS

<18 18–24 25–34 35–44 45–54 55–64 65+

Every 3 minutes, a woman goes 

to the emergency department for 

prescription painkiller misuse or abuse.

7,000

6,000

5,000

4,000

3,000

2,000

1,000

Cocaine

Heroin

Opioids

Antidepressants

Benzodiazepines

199920002001200220032004200520062007200820092010

SOURCE: National Vital Statistics 

System, 1999-2010 

(deaths include suicides)

SOURCE: Drug Abuse Warning 

Network, 2010. (Suicide attempts 

are included for the cases (.03% of 

total) where opioids were combined 

with illicit drugs in the attempt.) 
4 CS238899B

 www http://www.cdc.gov/vitalsigns

 www http://www.cdc.gov/mmwr

For more information, please contact 

Telephone: 1-800-CDC-INFO (232-4636)

TTY: 1-888-232-6348

E-mail: cdcinfo@cdc.gov

Web: www.cdc.gov

Centers for Disease Control and Prevention

1600 Clifton Road NE, Atlanta, GA 30333

Publication date: 7/2/2013

The US government is

◊ Tracking prescription drug overdose trends to 

better understand the epidemic.

◊ Educating health care providers and the public 

about prescription drug misuse, abuse, suicide, and 

overdose, and the risks for women.

◊ Developing and evaluating programs and policies 

that prevent and treat prescription drug abuse and 

overdose, while making sure patients have access to 

safe, effective pain treatment. 

◊ Working to improve access to mental health and 

substance abuse treatment through implementation 

of the Affordable Care Act. 

Health care providers can 

◊ Recognize that women can be at risk of prescription 

drug overdose.

◊ Discuss pain treatment options, including ones that 

do not involve prescription drugs.

◊ Discuss the risks and benefits of taking prescription 

painkillers, especially during pregnancy. This 

includes when painkillers are taken for 

chronic conditions. 

◊ Follow guidelines for responsible painkiller 

prescribing, including: 

■ Screening and monitoring for substance abuse and 

mental health problems. 

■ Prescribing only the quantity needed based on 

appropriate pain diagnosis. 

■ Using patient-provider agreements combined 

with urine drug tests for people using prescription 

painkillers long term.

■ Teaching patients how to safely use, store, and dispose 

of drugs.

■ Avoiding combinations of prescription painkillers 

and benzodiazepines (such as Xanax and Valium) 

unless there is a specific medical indication.

◊ Talk with pregnant women who are dependent on 

prescription painkillers about treatment options, 

such as opioid agonist therapy.

◊ Use prescription drug monitoring programs 

(PDMPs)—electronic databases that track all 

controlled substance prescriptions in the state—to 

identify patients who may be improperly using 

prescription painkillers and other drugs. 

States can

◊ Take steps to improve PDMPs, such as real 

time data reporting and access, integration with 

electronic health records, proactive unsolicited 

reporting, incentives for provider use, and 

interoperability with other states.

◊ Identify improper prescribing of painkillers and 

other prescription drugs by using PDMPs and 

other data.

◊ Increase access to substance abuse treatment, 

including getting immediate treatment help for 

pregnant women.

◊ Consider steps that can reduce barriers (such as 

lack of childcare) to substance abuse treatment 

for women. 

Women can

◊ Discuss all medications they are taking (including 

over-the-counter) with their health care provider.

◊ Use prescription drugs only as directed by a health 

care provider, and store them in a secure place. 

◊ Dispose of medications properly, as soon as 

the course of treatment is done. Do not keep 

prescription medications around “just in case.” (See 

www.cdc.gov/HomeandRecreationalSafety/Poisoning/

preventiontips.htm) 

◊ Help prevent misuse and abuse by not selling or 

sharing prescription drugs. Never use another 

person’s prescription drugs.

◊ Discuss pregnancy plans with their health care 

provider before taking prescription painkillers.

◊ Get help for substance abuse problems (1-800-

662-HELP); call Poison Help (1-800-222-1222) for 

questions about medicines.

What Can Be Done