Poor women taking painkillers? Sound the alarm!

Nothing helps fan the war on drugs like poor people getting high. It doesn’t matter if the high is authorized or not either; the poor are evil, they’re takers, they are despicable for being poor, and the idea that the despicable poor might be getting some relief from pain and suffering is not a feature, it’s a bug! If only hatred of the poor could be combined with hatred of women, better yet, hatred for affordable healthcare, better yet, in fact ideally, if only it could be linked to some good ole fashioned slut shaming and something to do with babies … hey, is there a new study we can use for that?

CBS — It finds that more than a third of reproductive-aged women enrolled in Medicaid, and more than a quarter of those with private insurance, filled a prescription for an opioid pain medication each year between 2008 and 2012. … The researchers found that, on average, 39 percent of reproductive-aged women on Medicaid filled an opioid prescription from an outpatient pharmacy each year, as did 28 percent of those with private health insurance. The CDC suggested a number of reasons why opioid prescription rates are higher among Medicaid enrollees, including differences in which drugs are covered under various insurance plans, greater use of health services or more prevalent underlying health conditions among patients with Medicaid.

The researchers also noted significant differences among racial groups and regions of the country. Non-Hispanic white women were nearly one and a half times more likely to get opioid prescriptions than black or Hispanic women, according to Medicaid data. Private insurance claims show opioid prescriptions rates were highest in the South and lowest in the Northeast.

The quoted material is from the CDC, I suppose they have to do the responsible thing, but you can bet it has already fueled some nice, subtle, jabs at “those women” who “can’t handle their periods” on social media. That last part about white girls and the south won’t fit into the shaming narrative as well, and the difference between a fourth on private insurance versus a third on Medicaid in one study is not exactly jaw dropping, is it? But to put it in context, just how many women out there of child bearing age reading this were unaware that powerful prescription narcotics might have an effect on fetal development and that those women with questions and concerns should discuss that with their doctor? Assuming they’re lucky enough to have a doctor … and that might be the big factor here, huh?

These days it’s hard to find PCP’s who will even take Medicaid patients, mostly because conservative politicians, with the occasional assist from democrats, have systemically nerfed it for decades on end until it’s not profitable for those in private practice. Private employer sponsored group insurance is a whole different ballgame, those patients have a lot more choices in who will treat them. It makes sense that the better the insurance coverage, the better underlying conditions will be managed before they get to Defcon 1 pain levels. It stands to reason those with long term painful injuries or chronic auto-immune disorders (I’m lucky enough to belong to both those groups and further restricted from OTC anti-inflammatory drugs like ibuprofen thanks to a heart stent) who enjoy regular, comprehensive healthcare and low Rx copays will have better access to non-narcotic, newer, and really expensive pain relief drugs, like Humira or Lyrica, and thus be less motivated to seek cheaper, more immediate relief wherever and however they can get it.

As someone on a relatively modest pain management regimen, I’m going to go way out on a limb here and wildly guess another big factor in why some women on Medicaid or private insurance are taking painkillers is … the pain. A reader brings up a related point in comments:

Without any researching, studying, and off-the-cuff, I would say more minority women of child bearing age are taking more opioids than their more well off compatriots is that the minority women are working their fucking asses of, on their feet all day, doing body breaking labour for minimal wages. The opioids allow them to continue working and ruining their bodies.

There are even times when :::gasp!::: those meds might produce a mild quasi-euphoria mingling into the temporary relief for a couple of hours, especially when they’re being hoarded for economic reasons and not taken very often. Fortunately, I don’t have a uterus, so I only have to worry about the DEA, the state of Texas, local police departments, and the occasional meddling employer randomly trolling through my urine or barging in without a warrant to inspect my medicine cabinet.

And by the way, if you think that’s hyperbole about employers, I know of a back injury patient who traveled to Colorado on vacation, got a script at the urging of a friend for a supposedly non-psycho-active hemp derivative touted as a pain reliever, used it only once — completely legally mind you — because in his words “it didn’t do shit to relieve pain,” came back, and guess what? He got nailed on a drug test at his pain management clinic which then promptly cut him off. Then he got caught on a random test at work and was summarily fired on the spot, presumably with “tested positive for illicit drugs” now on his employment record. Fortunately, he’s really well off, was able to keep his insurance using Cobra, and was able to jump through the hoops required to eventually be seen and treated by a new doc.

My condolences to suffering uterine Americans who work for a living and may now have an additional hurdle to clear.


  1. Donnie says

    Without any researching, studying, and off-the-cuff, I would say more minority women of child bearing age are taking more opioids than their more well off compatriots is that the minority women are working their fucking asses of, on their feet all day, doing body breaking labour for minimal wages. The opioids allow them to continue working and ruining their bodies. It could be a leading factor regarding the difference in life expectancy between well of individuals versus the poor.

  2. magistramarla says

    In my experience, doctors are also very quick to brush women off with a quick prescription without bothering to investigate the underlying cause of the pain.
    I’m highly allergic to opioids. Heck, I can’t even eat something containing poppy seeds, since it causes my throat to swell up. Even though I tell doctors that, I’m often sent home with prescriptions for opioids. I always research any new meds before filling the prescription. I’ve had one doc call me a hypochondriac, another accuse me of being a drug-seeker and another one write a prescription for a sedative the first time that she saw me.
    Like you, I have an autoimmune issue – Sjogren’s syndrome. I finally found a doctor who discovered the underlying cause of my debilitating pain. I have spinal stenosis, with three discs that are disintegrating so badly that even I could easily see it on the MRI. It’s closing off the nerves in my spine that go to my legs. That explains the leg spasms, the numb feet and the horrible pain that has kept me from being able to drive.
    I feel lucky that I have that allergy. I think that has saved me from being another statistic – just another suburban housewife hooked on narcotics. Meanwhile, I wonder what the hospital will be able to give me for pain when I have the surgery to repair those discs.

  3. says

    You have Sjogren’s? My mom has that, and it took almost a year back in the 70s to diagnose. As far as pain meds, there are options. I have friend who is super allergic to opiates and she had a broken cheekbone that had to be repaired. Sure enough they tried to use another optiate, dilaudid I think it was, and she didn’t react to it as badly as she does to hydrocodone or morphine, but they still had to shoot her up with benedryl and finally some adrenaline, which didn’t exactly ease the pain, They ended up using Lyrica and a valium-like drug, Versed I think. It was the latter that really did the trick, mostly by just letting her sleep for a couple of days and avoid the worst of the immediate post surgical pain that way.

    But don’t be afraid to get that surgery done when and if the time comes Magi. My 70 plus year old mom just had it done, and it was indeed painful for weeks, really bad for the first few days. But now just three months later she’s like a different person, active, second lease on life kinda thing, almost bouncing around like a kid, going for long walks all the time. It’s almost become a little bit of a pain in the pass for us real kids because now she’s constantly fidgeting and wanting to go places and do things for holidays and vacations that we don’t have the time or money to keep up with. Not that I’m bitching, it’s a great problem to have and I’m really happy for her!

    But she was terrified, I mean truly petrified, almost fatalistic, almost as in “my life will be essentially over once I do this,” because of all that crap they install and so much nightmare stuff you hear about, those kinds of ops going wrong, so she postponed it until she could barely walk and was in constant pain. Now she tells me if she had known how much better she would feel even with a couple of pounds of screws and braces and verts fused in her lower spine she would have done it years ago. She feels like she wasted years of her life that could have been spent being more active.

    I think part of it is, for so-called ‘normal people,’ going from a ‘normal spine’ to having screws and braces and fused discs might indeed be painful and debilitating as hell. But because of Sjogren’s she didn’t have a normal spine anymore and hadn’t for years, and it sounds like you might be getting there one day. For someone whose spine is basically disintegrating and has slowly grown to tolerate insane amounts of pain, they’re already so messed up that stabilizing it is a huge improvement by any measure.

  4. magistramarla says

    Thank you for that information, my friend.
    It only took a year for your Mom to get a Sjogren’s diagnosis? That’s better than what I went through. I was suffering from 2006 on. Finally, in 2008, my rheumatologist in SA said probably Sjogren’s, maybe Lupus, maybe rheumatoid arthritis.
    Out in California, the rheumy disagreed with all of that. I got a lip biopsy in San Francisco, which verified the Sjogren’s.
    My legs have been spasming and my feet have been numb for years. I haven’t been able to drive for two years and my quality of life has been shit for a long time, especially since we moved back to Texas, where you need a car to get anywhere. Just getting my husband to take me to the beauty shop is a pain in the ass. I’m stuck in my house most of the time.

    The surgeon at UT Medicine finally figured this out last summer. I’ve been putting the surgery off until the AF set up the hubby’s trip to three bases in Europe. I wasn’t going to give up going with him for that! I’ve been to Japan and Greece, but this trip is to England, Germany, Paris and Italy. This old Latin teacher can’t wait to see Rome and Pompeii! We just set up my tickets today – we leave Feb. 27 and return March 27.
    I’ll be seeing the surgeon on Wednesday, and I’ll tell him to schedule it for as soon after March 27 as possible.

    I’ve been hearing some good stories about the impact of that spinal surgery. Your Mom’s story really makes me feel better. I’ve always been scared to death about any surgery – the only one I’ve ever had was an appendectomy. I’ve also always been really freaky about my back. The very thought of an epidural was so scary to me that I gave birth to my babies at home.
    Now, I’ve had epidural injections for the pain in my back and I look forward to getting another one before I travel.
    I’m scared about the surgery, but I’ve made up my mind and now I’m anxious to get it over with.
    The worst part of my recovery will be the fact that my hubby can’t cook at all, so I worry about our nutrition.

    My poor dog has carpal hyperflexion and he needs surgery, too. We’re considering getting his surgery at about the same time as mine so that my hubby can take care of both of us and take both of us to physical therapy. He’s very, very lucky. He can take 6-8 weeks of Family Medical Leave. That’s another reason that we’ve been waiting for him to get done with this important trip to Europe.

    Thanks for the info about your Mom. How is your friend doing? Please give us all an update.
    I’ll let you know when I get my surgery scheduled.

  5. says

    I was just a kid, so maybe it was more than a year. I just remember she was real sick and in and out of hospitals for a long time. We spent one of our summer vacations in Galveston down at the UT med center, I remember that. Part of that illness was the long term effect of lots of cortisone, which was one the only effective meds they had to throw at stuff like that back then. I remember she puffed up real bad, especially in the face, several times she became delirious, I don’t know if that was cortisone or the disease … I think the worst part of the disease itself was weird swelling, pain out of nowhere, and her mouth and eyes drying out real bad all the time. I remember bringing her a new toothbrush and her brushing her teeth for a long time commenting on how good it felt to wet her mouth. It was scary for a kid to watch, and she got borderline diabetes for a while, too, and at one point they told her it might be a weird form of leukemia. Once they dialed in Sjogren’s, and some newer meds came online, she responded really well and it got more manageable. But over the decades, as you know, that particular disorder is always progressive, it slowly took its toll.

  6. lanir says

    So… Isn’t the timespan on this a bit off for the particular rabbit they want to pull out of that hat? I remember hearing about the Affordable Care Act mostly in 2010 especially since I was briefly working for at one of the major healthcare insurance providers (outsourcing to turn highly skilled technical jobs into low paying temp work is great, huh?) and they were making “We’re Very Concerned About This” noises. I think that last was reflexive, everyone understood they were about to get stuffed full of money but I they were always angling for more money and less responsibility.

    But anyway, before the ACA took effect it isn’t like everyone had Medicaid. You got put on it at reproductive ages for a reason. So this is effectively comparing a population selected for having a stronger need for medication to a random sampling of more well off people unless I’ve misunderstood something. Which is entirely possible – my parents had a strong Republican influence so I mostly didn’t know about any programs that could have helped me when I was poor until after the fact.

  7. magistramarla says

    Hi Stephen,
    I hope that you see this. I just saw my surgeon this morning. He’s scheduling my surgery for April 13.
    I’ve talked to a couple of people who had good results with this surgery, and your story about your Mom really helped.
    Wish me luck!

  8. magistramarla says

    LOL – Yeah, Stephen, I’m coming to get you if it goes wrong. Bwhahahaha.
    Really, my attitude is that if there is even a little improvement, it’s better than my quality of life right now.
    If something goes wrong and I wind up paralyzed, at least I will hopefully not be feeling the pain that I live with now.
    If things really go wrong and I die, then I’ll definitely be out of pain. My kids are raised, and after this trip next month, most of my bucket list will be checked off, so I’m OK with it.
    I trust that the UT surgeons are pretty darned good, so I’m not worried.
    The thing that I’m more worried about is living on my hubby’s excuse for cooking when I come home. His idea of making dinner is a peanut butter and nutella sandwich or a take-out order of pho.
    Then again, if I come out of this several pounds lighter, that’s a good thing, too. I tend to be optimistic.

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