Opioid Use in Pregnancy
by Vanessa Amoah, MBS 2018,
Geisinger Commonwealth School of Medicine
Mentor: Pamela Lucchesi, PhD
The story I am about to tell you is not an unusual story. In fact, it’s quite common. The story is about a woman named Brittany. When she was 14, she started to get migraines. She went to the doctor and was told that the headaches would eventually go away as she got older. But it didn’t happen. She started experiencing symptoms associated with migraines, like vomiting, impaired vision and other unbearable effects. The prescribed beta-blockers helped with the pain, but then Brittany got pregnant. She was told that the medication that she was taking would harm the baby. The doctors decided to prescribe her a strong opioid -- oxycodone -- to protect her and her baby. At that point, Brittany became one of millions of patients prescribed opioids by a doctor, only to become dependent on the drugs. These are the types of prescriptions that contributed to the current opioid epidemic.
As I said, this isn’t an unusual story. It all started in the 1990s, when pharmaceutical companies convinced health providers that patients would not get addicted to prescription opioid pain relievers. This eventually led to a widespread misuse of the medications, which are, in fact, highly addictive. Opioid usage began to increase and this issue became a public crisis with devastating consequences, including the rising incidence of neonatal abstinence syndrome due to opioid use during pregnancy.
According to an article on Healthline, up to 22 percent of women are prescribed opioids during pregnancy. The article also states that over the past 10 years, the rate of pregnant women who are dependent on opioids has gradually increased in the United States. On average, about 21,000 pregnant women aged 15 to 44 misused opioids in the past month, according to combined 2007 to 2012 national surveys on drug use and health from the Substance Abuse and Mental Health Services Administration (Abate 2018).
by Vanessa Amoah, MBS 2018,
Geisinger Commonwealth School of Medicine
Mentor: Pamela Lucchesi, PhD
The story I am about to tell you is not an unusual story. In fact, it’s quite common. The story is about a woman named Brittany. When she was 14, she started to get migraines. She went to the doctor and was told that the headaches would eventually go away as she got older. But it didn’t happen. She started experiencing symptoms associated with migraines, like vomiting, impaired vision and other unbearable effects. The prescribed beta-blockers helped with the pain, but then Brittany got pregnant. She was told that the medication that she was taking would harm the baby. The doctors decided to prescribe her a strong opioid -- oxycodone -- to protect her and her baby. At that point, Brittany became one of millions of patients prescribed opioids by a doctor, only to become dependent on the drugs. These are the types of prescriptions that contributed to the current opioid epidemic.
As I said, this isn’t an unusual story. It all started in the 1990s, when pharmaceutical companies convinced health providers that patients would not get addicted to prescription opioid pain relievers. This eventually led to a widespread misuse of the medications, which are, in fact, highly addictive. Opioid usage began to increase and this issue became a public crisis with devastating consequences, including the rising incidence of neonatal abstinence syndrome due to opioid use during pregnancy.
According to an article on Healthline, up to 22 percent of women are prescribed opioids during pregnancy. The article also states that over the past 10 years, the rate of pregnant women who are dependent on opioids has gradually increased in the United States. On average, about 21,000 pregnant women aged 15 to 44 misused opioids in the past month, according to combined 2007 to 2012 national surveys on drug use and health from the Substance Abuse and Mental Health Services Administration (Abate 2018).
The use of opioids during pregnancy leads to infants born dependent on drugs, a condition called neonatal abstinence syndrome (NAS). NAS is triggered by the fact that the fetus is exposed to the drugs in the womb, and then goes through withdrawal after birth because the baby no longer receives the constant dose of opioids through the mother. The baby goes through symptoms like tremors, fussiness, poor feeding, breathing problems, fever, diarrhea and trouble sleeping.
What can be done to help mothers with opioid use disorder? If pregnant and taking opioids, they can tell their health providers so that an alternative is plan is designed. This is important because quitting suddenly can cause problems for the baby and the mother. Health providers can help pregnant and addicted to opioids women with medication-assisted treatment (MAT) with methadone and buprenorphine. If the women are not pregnant and are addicted to opioids, they can use birth control until they are ready to get pregnant.
What can be done to help infants born with NAS? Infants are treated with medications to help with the withdrawal symptoms. Other approaches include swaddling, skin-to-skin care and breastfeeding. Although there are a lot of treatments, more research needs to be conducted.
Watch the animation:
https://www.powtoon.com/online-presentation/d7xHRUk3P13/?mode=movie#/
References
Abate, Carolyn. Pregnant Women and Opioid Withdrawal. Healthline, Healthline Media, 9 May 2018, www.healthline.com/health-news/pregnant-women-on-opioids-should-not-go-cold-turkey.
Prescription Opioids during Pregnancy. March of Dimes, 2017, www.marchofdimes.org/pregnancy/prescription-opioids-during-pregnancy.aspx.
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