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Dr. Dave Campbell: How the opioid crisis disproportionately affects women

“The social safety nets that women trying to raise children need are profoundly affected," says Dr. Dave Campbell, who has testified before Congress about the crisis.
Dr. Dave Campbell is a Florida-based spine surgeon who has testified before Congress about the opioid crisis.
Dr. Dave Campbell is a Florida-based spine surgeon who has testified before Congress about the opioid crisis.Miller Hawkins

America is in the midst of an opioid-addiction crisis, and in recent years, it’s hit women particularly hard.

Between 1999 and 2015, the rate of deaths from prescription opioid overdoses increased 471 percent among women, compared with an increase of 218 percent among men. Heroin deaths among women increased also at more than twice the rate than among men during this period, according to a government report.

And because women in particular tend to be instrumental to the functioning of their families and communities, the jump in their addiction rates can have enormous effects on society at large.

“Morning Joe” co-host and Know Your Value founder Mika Brzezinski recently interviewed Dr. Dave Campbell, a Florida-based surgeon who has testified before Congress on the opioid crisis, about the pervasive problem.

“It’s disproportionately affecting women in a growing way, and by affecting women, it’s affecting families,” Campbell said. “There are a whole bunch of ways we can look at that: The incarceration rate for women has gone up 50 percent since the start of the opioid crisis. Heroin addiction has gone up 30 percent for women from 2010 to 2013.”

Brzezinski noted that even if it’s not the woman who is addicted, she's likely the one who is stepping in and assisting with childrearing, caretaking and other responsibilities if a family member is struggling with addiction. “If it’s not a woman whose body is literally crumbling from addiction … it’s someone in her family who she has to take care of,” she said.

Campbell agreed, noting “the social safety nets that women trying to raise children need are profoundly affected by this opioid crisis.”

Babies and adolescents

The increase in women addicted to opioids also affects the most vulnerable population: newborns. Babies born to a woman who used opioids during her pregnancy may be born with neonatal abstinence syndrome, a term for a group of conditions that occur when a baby withdraws from narcotics.

“At birth they are addicted to opioids,” Campbell said. “They go through withdrawal, and it takes two days to two weeks to get through it: They’re irritable, they’re crying. They can’t eat.”

Adolescents are another group at particular risk, because “we know that the younger an adolescent is when they start using a substance for the first time — whether it’s alcohol or an illicit drug — the more likely they are as adults to be addicted,” Campbell said.

Making smart decisions about drugs can be challenging for this age group, Campbell said, noting that adolescent brains are not fully formed and their growth comes in stages. The reward system matures first, and the prefrontal cortex — the region that controls judgment — forms last, in their 20s, he explained.

Campbell cited a common analogy about the adolescent brain: It’s like a car with the gas pedal fully engaged, but it doesn’t have brakes yet.

‘It isn’t something you can just think away’

Brzezinski discussed visiting hospitals and talking to nurses who shared endless stories of people who come in and out of the ER trying to get off drugs. “What is that drying-out process like, and why is it so hard to surmount?” Brzezinski asked.

Addiction deeply affects the brain’s reward centers, and it “isn’t something you can just think away,” Campbell explained. “It’s a disease process. When someone comes into the emergency room, whether they are there because they’ve had an overdose … or have some other problem linked to their addiction, they still need treatment.”

Until recently, Campbell added, that kind of care didn’t start in emergency rooms. Fortunately they have become better equipped to implement addiction treatment over time as the crisis has grown.

Brzezinski asked if even the people who do seek treatment are getting true help, or “are they just going back out into the system?”

The challenge, Campbell said, is that for adults the “drying-out” period of withdrawal and recovery can take months. Whether they choose a cold-turkey rehabilitation program, medication-based treatment such as methadone or another method, “treatment takes a long time and has to be inclusive of behavioral therapy. It’s a long process, Mika, and the recovery is often seen in starts and stops.”

Addiction is a social problem, Campbell added, with personal and societal characteristics.

We have “to realize we can all have a role in this,” he said. “We can help our friends and our neighbors; we can help them get treatment. As often happens, you may need to raise the children of your addicted sibling, your family member who is maybe incarcerated or has had their kids taken away from them. This is a giant, giant mix of problems that we in the United States both individually and as professionals are responsible to help.”