Drug Deaths - Women in North Carolina

North Carolina

Drug overdose deaths have risen steadily in the United States over the past two decades and have become a leading cause of injury death. In 2022, more than 100,000 Americans died of a drug overdose, including more than 32,000 women. Though these statistics reflect all drug deaths, opioids — fentanyl in particular — are the most significant contributor. More than 76% of drug deaths in 2022 involved an opioid. Overdose deaths caused by using multiple illicit substances simultaneously have also been rising and often include opioids. Other drugs that contribute to drug deaths in the U.S. include stimulants like cocaine and tranquilizers such as benzodiazepines. 

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. The effects of substance misuse contribute to public health problems like neonatal abstinence syndrome, HIV/AIDS and hepatitis. In 2017, 240,000 children lost a parent to opioid overdose and parental opioid use affected approximately 1.4 million children. For pregnant women, accessing proper treatment for opioid use disorder may be challenging as some providers will not treat pregnant patients.

According to America’s Health Rankings analysis, the drug death rate is highest among:

• Women ages 35-44 compared with those ages 20-24. 
• American Indian/Alaska Native women, who have a prevalence more than 18 times higher than Asian women.

A multifaceted and coordinated approach between public health and public safety has been a crucial component of the response effort. The Centers for Disease Control and Prevention’s (CDC’s) prevention strategies include:

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

The Substance Abuse and Mental Health Services Administration 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 is struggling with illicit drug misuse. 

In 2020, the Office on Women’s Health published a toolkit to help health care professionals and social services organization leaders improve care coordination for women with opioid use disorder.

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.

Brundage, Suzanne C., Adam Fifield, and Lee Partridge. The Ripple Effect: National and State Estimates of the U.S. Opioid Epidemic’s Impact on Children. United Health Foundation, 2019. https://media.uhfnyc.org/filer_public/6e/80/6e80760f-d579-46a3-998d-1aa816ab06f6/uhf_ripple_effect_national_and_state_estimates_chartbook.pdf.

Dowell, Deborah, Kathleen R. Ragan, Christopher M. Jones, Grant T. Baldwin, and Roger Chou. “CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022.” MMWR. Recommendations and Reports 71, no. 3 (November 4, 2022): 1–95. https://doi.org/10.15585/mmwr.rr7103a1.

Drug Enforcement Administration. “National Drug Threat Assessment 2024.” U.S. Department of Justice, Drug Enforcement Administration, May 2024. https://www.dea.gov/sites/default/files/2024-05/NDTA_2024.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.

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.

Spencer, Merianne, Matthew Garnett, and Arialdi Miniño. “Drug Overdose Deaths in the United States, 2002-2022.” National Center for Health Statistics (U.S.), December 26, 2023. https://doi.org/10.15620/cdc:135849.

Substance Abuse and Mental Health Services Administration. “SAMHSA Overdose Prevention and Response Toolkit.” Rockville, MD: Substance Abuse and Mental Health Services Administration, 2023. https://store.samhsa.gov/sites/default/files/overdose-prevention-response-kit-pep23-03-00-001.pdf.

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.