Suffice to say, our country has endured a great deal in these past few weeks. The election, as well as the resurgence of COVID-19, have dominated the news cycle, so you might have missed the Center for Disease Control’s (CDC’s) new data briefing about chronic and high-impact chronic pain among U.S. Adults. This report reconfirms the continued disproportionately large effect that chronic pain has on women across America.
The presence of chronic pain was recorded for survey respondents who experienced pain “most days” or “every day” in the three months preceding data collection. High impact chronic pain refers to chronic pain that frequently limits life or work activities. The data brief highlights the well-established finding that women are disproportionately affected by chronic and acute pain. Among those studied (analyzed for factors including biological sex, age, race and Hispanic origin, and urbanization level), women experienced some of the highest rates of pain. In comparison to the 19 percent prevalence of chronic pain and 6.3 percent of high impact chronic pain reported by men, 21 percent of women reported chronic pain, and 8.5 percent of women reported high impact chronic pain.
These findings serve as a reminder of the unique risks that women with pain face while seeking treatment. The over-prescription of opioids for pain management has led to an epidemic of addiction that persists, killing around 128 people each day. Similar to the gender-based differences seen in how people experience pain, researchers also observed differences in opioid use, and subsequently, misuse. In their 2018 article in the Lancet, Dr. Carolyn Mazure, Director of WHRY, and Dr. David Fiellin, Director of the Yale Program in Addiction Medicine, underlined the urgency represented by these differences, explaining that women are more likely to begin using opioids through medical treatment. Furthermore, women who develop opioid use disorder (OUD) present a different clinical picture than men as they are more likely to use opioids to cope with negative emotions and pain. These differences, among others, demonstrate the need to understand and consider gender-specific approaches to treatment of OUD as well as to find less-addictive alternatives to treat pain itself.
Two ongoing WHRY studies seek to investigate non-opioid treatment options for pain. Dr. Irina Esterlis is studying metabotropic glutamatergic receptor 5 (mGluR5) as a molecular target to reduce pain and exploring differences that may exist between women and men when it comes to mGluR5 availability. Meanwhile, Dr. Ansel Hillmer is examining the use of cannabis for pain relief and specifically investigating any differences in how it affects women and men. We need studies like these, which intentionally investigate possible sex-based differences regarding pain treatment. The CDC briefing reminds us that chronic pain is a problem for many people — but especially women. To ensure a future with non-addictive pain treatment that is effective for everyone, scientific research must continue to include the study of differential sex-and-gender-based effects.
Ke'ala Akau is a fellow with Women's Health Research at Yale and a junior in Branford College majoring in the History of Science, Medicine, and Public Health. Read more on her blog: "Why Didn't I Know This?"