SAFE Glen Cove Coalition: On Opioid Use and Pregnancy

Opioid use among pregnant women is a resurfacing topic of concern. According to the Center for Disease Control and Prevention (CDC) national rates of opioid use disorder at delivery hospitalization more than quadrupled between 1999 and 2014. Recent reports further indicate that the number of pregnant women using opioids is rapidly increasing due to the widespread opioid epidemic. During this time the national prevalence of opioid use disorder increased 333%, from 1.5 cases per 1,000 delivery hospitalizations to 6.5, an average annual increase of 0.4 per 1,000 delivery hospitalizations per year.

In New York, that rate was 4.9 in 2014, the latest year that data was available. That's up from what it was in 1999, when the rate was 1.6 cases per 1,000 deliveries.

Opioid use and exposure during pregnancy is associated with severe maternal and neonatal health risks. According to the CDC, such risks include preterm labor, stillbirth, neonatal abstinence syndrome, infant opioid withdrawal, and maternal mortality. Untreated opioid use disorder during pregnancy can have devastating consequences for the unborn baby. Fluctuating levels of opioids in the mother may expose the fetus to repeated periods of withdrawal, which can harm placenta function.

Other direct physical risks include neonatal abstinence syndrome (NAS) (occurs when an infant becomes dependent on opioids or other drugs used by the mother during pregnancy), stunted growth, preterm labor, fetal convulsions and fetal death. Other indirect risks to the fetus include increased risk for maternal infection (HIV), malnutrition and poor prenatal care, dangers from drug seeking (violence and incarceration).

The National Institute on Drug Abuse (NIDA) maintains buprenorphine and methadone have both been shown to be safe and effective treatments for opioid use disorder during pregnancy. While NAS may still occur in babies whose mothers received these medications, it is less severe than in the absence of treatment. Research does not support reducing medication dose to prevent NAS, as it may lead to increased illicit drug use, resulting in greater risk to the fetus.

Compared to untreated pregnant women, women treated with methadone or buprenorphine had infants with lower risk of NAS, less severe NAS, shorter treatment time, higher gestational age, weight, and head circumference at birth.

It is clear that efforts at national, state and provider levels are needed in order to prevent, monitor, and treat opioid use disorder among reproductive-aged and pregnant women. Efforts might include improved access to data in Prescription Drug Monitoring Programs, increased substance abuse screening, use of medication-assisted therapy, and substance abuse treatment referrals.

According to the CDC, only eight states mandate pregnant women to be tested for opioids if there is suspected drug abuse and that many doctors nationwide insist that in order to prevent severe heath risks from affecting their child that mothers report any opiate use and misuse as soon as possible.

The Centers for Disease Control and Prevention (CDC) is the leading national public health institute of the United States. The CDC is a US Federal agency whose main goal is to protect public health and safety through the control and prevention of disease. For more information about this topic please visit the CDC website at https://www.cdc.gov/mmwr/volumes/67/wr/mm6731a1.htm?s_cid=mm6731a1_w.

The National Institute on Drug Abuse (NIDA) is a US Federal-government research institute whose mission is to "lead the Nation in bringing the power of science to bear on drug abuse and addiction”. For more information on NIDA please visit www.drugabuse.gov.

The SAFE Glen Cove Coalition is conducting an opioid prevention awareness campaign entitled "Keeping Glen Cove SAFE" to educate and update the community regarding opioid use and its consequences. To learn more about the SAFE Glen Cove Coalition please follow us on www.facebook.com/safeglencovecoalition or visit SAFE’s website to learn more about the Opioid Epidemic at www.safeglencove.org.