Gender Roles in Pain Medication Abuse

It's long been accepted that men and women experience pain differently. They feel it in different parts of their bodies, have different ways of expressing it and even have different pain thresholds and durations. When doctors prescribe pain medication, especially if it is opiate-based, like Vicodin or Oxycontin, they consider these gender differences. And the gender differences don't stop at pain experiences. New research has now determined that men and women misuse pain medication differently.

Researchers at the Harvard Medical School studied 600 patients (men and women) who were prescribed opiate pain medications for chronic, non-cancer related pain. These included migraines, fibromyalgia, chronic back pain and other chronic pain conditions. After five months, the patients and their physicians completed questionnaires about their prescription drug use. Researchers studied under what conditions patients took their pain medication.

The results showed that women scored higher on questionnaire items relating to psychological distress, indicating they took their pain medicine for emotional pain as well as physical pain; for example, to help them sleep or deal with stress. Male patients reported having more legal and behavioral problems associated with their medication use. For example, they might sell their medications, display worrisome behaviors, associate with other people who abused drugs and alcohol and engage in criminal activity.

The questionnaire revealed that a significant percentage of women who misused their prescription drugs had a history of sexual and/or physical abuse, anxiety and/or depression. This research was linked to previous studies that showed women with these histories tended to self-medicate for mood disorders and had a more difficult time properly managing their pain medication prescriptions. They indicated, however, a more open and truthful attitude about their behaviors and greater willingness to seek psychological help than the men did.

Researchers concluded that doctors should structure their pain medication refill policies for opiate-based prescriptions while keeping gender differences in mind.

Women who exhibit signs of significant stress should be treated for mood disorders. They should be counseled on dangers of relying on pain pills to help them sleep or reduce stress. Men should be closely monitored for suspected behavioral problems. Their pills should be counted to check adherence and frequent urine screens should be done.

Patients should be aware their health and psychological histories could impact their prescription pain medication use. Prescription drug abuse is a common problem that requires careful and thoughtful support to solve. If patients and/or doctors notice they're taking them improperly, they should have a frank discussion about other pain management resources and other treatment possibilities for total wellbeing. 


The Journal of Pain, April 2010

Gender Differences in Risk Factors for Aberrant Prescription Opioid Use

Robert N. Jamison, Stephen F. Butler, Simon H. Budman, Robert R. Edwards, Ajay D Wasan

Top of Form

Bottom of Form