The opioid crisis in America has reached epidemic proportions, according to the Surgeon General’s recently released landmark report.
- In 2016, 12.5 million Americans misused prescriptions
- 174 deaths are caused each day by a drug overdose.
- Its reported that only 20% of people who need treatment for opioid use receive any care at all—and still fewer receive care based on research and evidence.
Because women experience pain differently than men and are more likely to experience chronic pain, women are particularly vulnerable to opioid dependency. Since 1999, death from opioid overdose in women has increased by more than 400%, compared to 265% in men.
Research has also found that pregnant women are even more susceptible to the negative effects of opioid misuse. Use of opioids can stop menstruation, causing some women to believe they can’t become pregnant, and making it difficult to know when a pregnancy has started.
Research shows that when a mother uses opioids while pregnant, the metabolites of the drug are able to enter the baby’s bloodstream. Those metabolites can break through the fetal blood-brain barrier and interfere with the brain’s development. Opioid use also causes fluctuations in the mother’s serum levels, so the fetus experiences the same highs and withdrawals that the mother feels. Additionally, using opioids while pregnant can also have a detrimental effect on the mother’s ability to care for her developing baby – by eating well, accessing prenatal care, and keeping herself stress- and disease-free.
When a baby who was exposed to opioids in the womb is born, the infant may show signs of Neonatal Abstinence Syndrome. NAS affects the central, autonomic, and gastrointestinal systems and includes a wide range of symptoms including:
- Excessive high-pitched crying
- Poor sleep
- Poor feeding
- And other negative effects
Babies born with NAS are more likely to have respiratory issues and lower birth weight, may face developmental issues, and need to stay in the hospital nearly two weeks longer—resulting in $1.5 billion in hospital costs.
Research has shown that women with substance use disorders who receive prenatal care— including opioid maintenance treatment—have better birth outcomes than those who do not. The sooner a woman begins to receive treatment, the better the outcome for her baby. Many organizations, including the World Health Organization and harm reduction programs, support providing prenatal care for people addicted to opioids.
Prenatal care for those with substance use disorders also has another benefit: It brings women in for treatment. In the same way that syringe access programs allow medical professionals to interact with clients they might otherwise not have the opportunity to treat, women seeking prenatal care can be screened by their OBGYNs for substance use disorder or can receive treatment for medical issues related to the use of opioids.
How it works
Effective prenatal care for women with opioid substance use disorders includes medication-assisted treatment of opioid maintenance, rather than an attempt at detoxification. Treatment is intended to manage the woman’s substance use disorder to prevent further use of opioids while pregnant and to reduce the impact on the developing fetus.
Research shows that babies born to women who receive medication-assisted treatment during pregnancy fare better than those whose mothers receive no treatment. Studies have also shown that opioid maintenance is more effective than opioid detoxification. A study compared methadone-assisted withdrawal with methadone maintenance and found pregnant women who were treated through methadone maintenance were more like to stay in treatment longer, were more consistent about obstetric appointments, and delivered their babies at the hospital where their program was offered.