Women, Chronic Pain & Addiction

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Contributor: Staff at Sierra Tucson

Chronic pain is common in the United States.

The Centers for Disease Control and Prevention reports that more than 20% of U.S. adults have chronic pain. More than 7% of adults have what the CDC refers to as “high impact chronic pain,” which is defined as pain that frequently limits a person’s ability to work or engage in other activities [1].

People who have chronic pain are at increased risk for a wide variety of negative outcomes, including substance use and addiction. The risk may be particularly high for women who are disproportionally affected by chronic pain. Multiple sources report that about 70% of people who experience chronic pain are women.

Women & Chronic Pain

Researchers have not yet identified a cause for such a disparity in cases of chronic pain among women and men, but experts believe that genetic factors, environmental concerns and implicit bias within the medical and scientific communities may all play a role.

As noted in a May 30, 2019, article on the Cleveland Clinic website, hormone levels, reproductive status, musculoskeletal development, mental health concerns, and a history of trauma can all contribute to a woman’s risk for chronic pain [2].

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The International Association for the Study of Pain (IASP) has reported that several health conditions that cause chronic pain are much more common among women than among men. These include migraines, fibromyalgia, chronic pelvic pain, irritable bowel syndrome, rheumatoid arthritis, osteoarthritis and temporomandibular joint disorder [3].

Unfortunately, bias within the medical field may also contribute to an elevated prevalence of chronic pain among women. A May 22, 2018, article on the BBC website reported the following about the possible impact of systemic bias against women:

  • Prior to 1990, most clinical trials and diagnostic research on pain in the U.S., Canada and the U.K. focused on men.
  • A Swedish study found that women who visit emergency rooms typically wait longer than men do to see a doctor and are less likely to have their case classified as urgent.
  • Researchers with the University of Pennsylvania determined that women who report experiencing acute pain are less likely to be given opioid pain medication and more likely to be prescribed anti-anxiety medications.
  • A French study revealed that patients of all genders who present more traditionally feminine characteristics are more likely to have diminished access to healthcare [4].

Chronic Pain & Addiction

There is no single, universal direct relationship between chronic pain and addiction. However, among women who are living with chronic pain, three factors that increase their risk for developing a substance use disorder are:

  • Self-medicating with alcohol or other drugs in a misguided attempt to relieve their pain
  • Receiving a prescription for an opioid-based medication and becoming addicted to that medication
  • Supplementing a prescribed medication with an illicit substance in an attempt to experience increased pain relief

Nature Lone Tree in Field representing chronic pain and addictionA May 2016 study in the Journal of General Internal Medicine suggests that most primary care patients who misuse or abuse alcohol or other drugs may be doing so as a means of managing chronic pain. This study, which was led by Daniel P. Alford, M.D., MPH, of Boston University, involved 589 adult patients who tested positive during a substance use screening.

In-person interviews that were conducted with these 589 patients revealed the following:

  • 87% of the patients who had used illegal drugs, abused prescription medications or engaged in heavy alcohol use said that they were living with chronic pain.
  • 81% of the patients who had abused prescription medications said that they were trying to treat pain.
  • 74% of the patients said that they experienced some form of pain-related dysfunction.
  • 50% of the patients rated their pain as severe [5].

The National Institute on Drug Abuse (NIDA) has reported the following about the association among prescription medication use, substance use and addiction:

  • Experts estimate that as many as 29% of people who are prescribed an opioid to treat chronic pain will misuse or abuse the medication.
  • Between 8% and 12% of people who use prescription opioids to treat chronic pain will develop opioid use disorder (which is the clinical term for opioid addiction).
  • About 80% of people who use heroin say that their opioid use began with prescription painkillers [6].

Limiting the number of painkiller prescriptions that are written each year has been one component of the effort to combat the nation’s opioid epidemic. However, if women who are living with chronic pain are not able to access the legal medications that can help them, and they do not receive professional assistance to develop other pain management strategies, the research cited above strongly suggests that they will turn to alcohol or illicit drugs as a means of easing their pain.


References

1. Centers for Disease Control and Prevention. (2020, November 4). Products – DATA Briefs – NUMBER 390 – NOVEMBER 2020. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/products/databriefs/db390.htm.

2. Cleveland Clinic. (2020, October 6). Here’s Why Women Are More Likely to Have Chronic Pain. Health Essentials from Cleveland Clinic. https://health.clevelandclinic.org/women-are-more-likely-to-have-chronic-pain-heres-why/.

3. International Association for the Study of Pain (IASP). Pain in women. International Association for the Study of Pain (IASP). (2021, July 29). https://www.iasp-pain.org/advocacy/global-year/pain-in-women/.

4. Billock, J. (2018, May 22). Pain bias: The health inequality rarely discussed. BBC Future. https://www.bbc.com/future/article/20180518-the-inequality-in-how-women-are-treated-for-pain.

5. Alford, D. P., German, J. S., Samet, J. H., Cheng, D. M., Lloyd-Travaglini, C. A., & Saitz, R. (2016, May). Primary care patients with drug use report chronic pain and self-medicate with alcohol and other drugs. Journal of general internal medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4835374/].

6. National Institute on Drug Abuse. (2021, July 1). Opioid overdose crisis. National Institute on Drug Abuse. https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis.


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The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental, and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Published on September 7, 2021
Reviewed by Jacquelyn Ekern, MS, LPC on September 7, 2021
Published on AddictionHope.com

About Baxter Ekern

Baxter Ekern is the Vice President of Ekern Enterprises, Inc. He contributed and helped write a major portion of Addiction Hope and is responsible for the operations of the website.