The Impact of the Opioid Epidemic on Women: Sources and Solutions

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1 The Impact of the Opioid Epidemic on Women: Sources and Solutions Nicole Cartwright Kwiek, PhD Ohio State University College of Pharmacy Clinical Associate Professor of Pharmacology Co-Director, Generation Rx

2 We are a medication-taking culture Over 4 billion prescription filled in retail U.S. pharmacies last year (Kaiser Family Foundation) Pharmaceutical populism A pill for every ill A growing culture of selfdiagnosis and self-prescription (Greg Critser)

3 Medications can Help us to live longer, healthier lives Be just as dangerous and addictive as illicit street drugs when misused Taking someone else s prescription medication Taking a prescription medication in ways other than prescribed Taking a medication for reasons other than prescribed

4 Commonly misused prescription drug classes Opioids (e.g., Vicodin, Oxycontin ) Stimulants (e.g., Ritalin, Adderall ) Depressants (e.g., Valium, Xanax )

5 Opioids Morphine Heroin Codeine Hydrocodone Oxycodone Methadone Fentanyl Carfentanil Others Harry Cobbold, Flickr, Creative Commons

6 Opioids Morphine Heroin Codeine Hydrocodone Oxycodone Methadone Fentanyl Carfentanil Others Harry Cobbold, Flickr, Creative Commons

7 Opioids have different potencies

8 So, how did we get here?

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16 Philip Montgomery for The New Yorker

17 Medications and the opioid crisis CDC

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19 Medications and the opioid crisis OxyContin Heroin People who are addicted to prescription opioid painkillers are 40x more likely to be addicted to heroin. National Survey on Drug Use and Health (NSDUH)

20 Medications and the opioid crisis Ohio Department of Health The vast majority of heroin users started misusing prescription opioid painkillers first

21 How is the opioid epidemic disproportionately impacting women?

22 Allison Weiss got her happy ending a handsome husband, adorable daughter, a job she loves, and the big house in the suburbs. But while waiting in the pediatrician s office, she opens a magazine to a quiz about addiction and starts to wonder Is a Percocet at the end of the day really different from a glass of wine? Is it such a bad thing to pop a Vicodin after a brutal Jump & Pump class or if your husband ignores you? The pills help her manage the realities of her good-looking life: that her husband is distant, that her daughter is acting out, that her father s Alzheimer s is worsening and her mother is barely managing to cope. She tells herself that they let her make it through her days

23 The opioid epidemic and women Women more likely to: - Suffer from chronic pain (Kennedy, Roll et al, 2014) - Be prescribed opioids (Raofi and Schappert, 2006) - Use opioids for longer time periods (Campbell, Weisner et al, 2010) - Become dependent on opioids more quickly (Tuchman, 2010) and experience more cravings than men (Back, Lawson et al, 2011) - Face additional barriers to treatment for substance use disorders, such as lack of child care (NIDA, 2016)

24 The opioid epidemic and women CDC, 2013

25 The opioid epidemic and pregnant women

26 So what do we do now?

27 A multi-targeted solution is necessary

28 A multi-targeted solution is necessary: Prescribing changes CDC

29 A multi-targeted solution is necessary: Harm reduction

30 A multi-targeted solution is necessary: Drug courts

31 A multi-targeted solution is necessary: Rethinking addiction

32 But prevention is also important

33 About Generation Rx Started in 2007 at the College of Pharmacy Now a national movement in partnership with the Cardinal Health Foundation Our mission: educate people of all ages about safe medication-taking practices and the potential dangers of misusing prescription medications

34 Key messages

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36 The Generation Rx resources Educational toolkits Digital activities

37 We ve got a toolkit for that

38 The impact of our work

39 Where we started

40 Where we are now Photo by Robb McCormick, Courtesy of COSI

41 Where we are going

42 Rallying Generation Rx champions Students (past and present) Cardinal Health employees Pharmacists Extension Community organizations Anyone

43 Take action We have an important role to play - let s work together to end this epidemic. Contact info@generationrx.org

44 Acknowledgments College of Pharmacy Dr. Ken Hale Extension HECAOD Office of Research Collegiate Recovery Community Office of Student Wellness Student Health Center WOSU Cardinal Health Foundation Kroger Pharmacy American Pharmacists Association COSI Prevention Action Alliance Working Partners Hope Blooms Youth-to-Youth More, more, more

45 The future of Generation Rx is female Betsy Walker Dr. Molly Downing Dr. Chelsea Pekny Brittany Sandidge Dr. Cynthia Canan Dr. Kelsey Schmuhl Emily Keeler Dr. Nicole Kwiek

46 Questions? Nicole Kwiek, PhD