A Mother’s Many Faces: Opioid Addiction among Middle Age Women

Most people think “addiction” means hollowed-out eyes, missing teeth, or track lines or bruises on the inner arms. They envision needles, syringes, or maybe shady trailers with the broken blinds drawn, while filthy people huddle around an ash-covered table, getting their next fix. Or maybe they only notice that word “overdose”.

But that’s not what my mother looked like at all.

The Beginning

Back in the mid-90s, my mother experienced a series of health issues, from carpal tunnel to degenerative bone and joint disease. Then, she was prescribed a “miracle” medication that would “make it so you get sick if you don’t take it, so you won’t forget or skip doses, but it’s not addictive. It’s just something to help the brain deal with the pain.”

The hydrocodones, percocets, and lortabs were just a part of her routine—taken every single day. It was quite normal for her to be active and energetic—and then crash and sleep heavily for entire days. As the years ticked by, I graduated college and married a soldier, and we lived where we were told. I didn’t see her addiction evolving.

The Middle

In 2011 my stepfather died of a sudden heart attack, and I watched the last bits of her disappear. They had been married for almost two decades, and yet within months, she had moved another man into their home.

Being naive, I thought I could help if I just broached the subject gently enough. I expressed my concern and helped to move her closer to us to be with us and our two young children. My husband and I paid for her divorce and her outstanding debts and chipped in on her bills and rent while she helped with watching the children.

This lasted a few months when we began truly noticing. Her tone became openly mocking and cruel--and then a switch would flip, and she would be back to joking as though nothing had happened. She would make up lies that were easily proven false. By this point, the pain pills had been an almost daily thing for almost twenty years, and her behavior was becoming erratic and increasingly concerning.

That’s when it dawned on me: her pain pill prescriptions had run out, and she was going through withdrawal.

When I wouldn’t let her watch the kids anymore, she stole thousands of dollars that my husband and I had been giving her for bills and ran away with another man—leaving us with the unpaid bills we’d co-signed for. She began calling for more money, leaving cruel messages on my voicemail until I went no contact.

The End

Fast forward another few years, and we were on awkward speaking terms.

This version of her rarely asked about the children. She would send them birthday cards some years, some years not—and usually in the wrong month, sometimes with the wrong age. We spoke every few months, conversations that were barely anything more than a litany of the people with whom she was angry that day.

The kids no longer knew who she was.

In 2022, she was diagnosed with stage-four lung cancer that quickly spread through her body.

She wouldn’t provide me with details—wouldn’t say who her doctors were or where she was receiving treatment. Mind you—my mother was not “elderly” or mentally-affected; she was fifty-eight when diagnosed; only 15 years older than I am now. My own therapist asked me point-blank if my mother was telling the truth about the cancer—and I had to honestly tell her that I didn’t know. My mother had in fact faked serious illnesses before.

All this time, Mom remained on her pills—by this point for almost three decades. And all this time, they were prescribed by the same doctor. She would drive back to southeastern Ohio just to have an occasional appointment and renew her scripts.

She had taken to throwing things—trays, silverware—across hospital rooms to get nurses’ attention. Minutes after one of these episodes, she would call me and say things that made no sense whatsoever (for example, acting like we were in cahoots about some secret that only we shared and were keeping from the nurses). Then, she would wax poetic about how wonderful my brother was for taking care of her. By that point, they were both homeless and living out of motels, refusing any kind of help that was not cash-based.

She would call me from a hospital bed, screaming that the doctors and nurses were torturing her. And from her perspective, that might have been true.

Long-term opiate use actually lowers a person’s pain tolerance, causes serial heart attacks and strokes, and even perpetuates the speed of osteoporosis resulting in brittle bones that break easily—all of which affected my mother.

Through all of this, she wouldn’t allow her doctors or nurses to speak with me or give me information. Finally, I called a nurse’s station during an especially intense stay and told them: don’t forward my call to her room. You don’t have to tell me anything. Please listen. She’s been on hydrocodone regularly since the 90s.

The nurse on the phone sucked in a deep breath: “That explains a lot.”

We often see the more intense toll that addiction takes on a person—for example, short term quick decline or overdoses. But what I see missing from the conversation is the life-long damage that still occurs with consistent and long-term opiate use, even if that use never escalates to syringes or overdosing.

In films and media, we often see teens or young adult users—usually men—even though “women are approximately twice as likely to be prescribed prescription opioids compared to men” (Serdarevic, Striley, and Cottler, 2017) and a “greater proportion of women appear to abuse prescription opioids” (Green, et al.).

This demographic of addiction—the middle-age woman—is one that exists in a great deal of shame. Pill use is hidden, tucked into back cabinets, and never discussed in the light. This might be generational (women of particular ages and their beliefs about society and where and how they fit into it) or familial (family members’ embarrassment and shame), but addressing this shame and bringing these discussions into the light is crucial.

The risks are too high to continue ignoring: “The drug overdose death rate for women increased 260% from 1999 to 2017 for women 30–64 years of age […] demonstrating a critical need for prevention and treatment specifically among middle‐aged women” (Barbosa-Leiker et al.). But that statistic is only the death-rate—not the “affected their own lives and the lives of those they loved negatively” rate. Not the “no longer knew the grandkids” rate, or the “destroyed every relationship that once mattered” rate.

This demographic—middle-aged women—becomes even more complicated when regional culture is considered. As of 2012, the “counties having the highest prescribing rates for opioids were disproportionately located in Appalachia” (McDonald, Carlson, and Izrael). Appalachia, with its much-documented opioid epidemic, where the only thing stronger than a woman’s accent is her pride—well, and maybe her stubbornness and opinions on sugar in cornbread.

These traits combine with a lack of accessible treatments and an aura of being culturally shamed as “white trash”—and so the cycle continues.

Unless someone breaks it.

It’s not enough that programs be physically and financially accessible—they need to be approachable, too, which means collectively reducing the aura of shame surrounding them. This also means expanding our understanding of what addiction—and what someone with an addiction—looks like.

Women are statistically less likely to seek treatment, with 71% in one study reporting that they weren’t ready to seek treatment (Krug). Unemployed responders in the study listed lack of education, employment, or housing as explanations for their inability to seek treatment—indicating that once those needs were met, then they could seek treatment. This same study reported that another category of women—those who were employed—still cited fears that their jobs or reputations would suffer. Women are overwhelmingly refusing treatment due to the stigma society places on addiction.

These women are needed. They are important. And they are suffering.

My mother passed away in April of 2023, but I had been grieving her for many years before that, and I have a feeling I will be grieving for many years to come.

Resources

Barbosa-Leiker, C., Campbell, A. N. C., McHugh, R. K., Guille, C., & Greenfield, S. F. (2021). Opioid Use Disorder in Women and the Implications for Treatment. Psychiatric research and clinical practice, 3(1), 3–11. https://doi.org/10.1176/appi.prcp.20190051. Accessed July 2025.

Green, T.C., et. al. (2009). Women who abuse prescription opioids: Findings from the Addiction Severity Index-Multimedia Version® Connect prescription opioid database, Drug and Alcohol Dependence, Volume 103, Issues 1–2, 2009, Pages 65-73, https://doi.org/10.1016/j.drugalcdep.2009.03.014. Accessed June 2025.

Kotlińska-Lemieszek A, and Żylicz Z. (2021). Less Well-Known Consequences of the Long-Term Use of Opioid Analgesics: A Comprehensive Literature Review. Drug Design, Development, and Therapy. https://www.dovepress.com/less-well-known-consequences-of-the-long-term-use-of-opioid-analgesics-peer-reviewed-fulltext-article-DDDT. Accessed June 2025.

Krug, Melissa. (2023). Women less likely to seek substance use treatment due to stigma, logistics. Penn State https://www.psu.edu/news/social-science-research-institute/story/women-less-likely-seek-substance-use-treatment-due-stigma Accessed 26 June 2025.

McDonald, D. C., Carlson, K, and Izrael, D. (2012). Geographic Variation in Opioid Prescribing in the U.S. The Journal of Pain, Volume 13, Issue 10, 988 - 996. Accessed June 2025.

Pierce, J. Opioid use disorder: Risks for women. Johns Hopkins Medicine, https://www.hopkinsmedicine.org/health/conditions-and-diseases/substance-abuse-chemical-dependency/opioid-use-disorder-risks-for-women. Accessed June 2025.

Serdarevic, M., Striley, C. W., & Cottler, L. B. (2017). Sex differences in prescription opioid use. Current opinion in psychiatry, 30(4), 238–246. https://doi.org/10.1097/YCO.0000000000000337. Accessed June 2025.

University of Utah: https://healthcare.utah.edu/the-scope/health-library/all/2018/03/women-more-likely-experience-drug-addiction