Opioid Use Disorder & Pregnancy | Effects, Risks, & Treatment

Opioids, whether prescription medications or illicit drugs like heroin, are not recommended for use by pregnant women and may cause negative effects related to pregnancy and the earliest stages of childhood development.

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Opioid/opiate drugs are important resources in professional medical care, allowing healthcare providers to manage severe forms of pain, chronic pain, and other medical conditions for both short and long periods of time.

However, all opioid medications, as well as illicit opioid agonists like heroin and fentanyl, also come with severe concerns and risks.

This includes a high risk for misuse and the development of opioid use disorder as well as concerns related to women who are pregnant or breastfeeding.

Pregnancy & The Use Of Opioids

Opioid drug use during pregnancy is not recommended as there is the potential for severe harm to both the mother and the baby.

Information published by the FDA in relation to oxycodone and other opioids advises that pregnant women consult with their doctor about the effects of opioids and other drugs during pregnancy.

Other Pain Management Tools

Other recommended options for pain management during prenatal care, including chronic pain management, include physical therapy, massage, stretching, exercise, behavior therapy, and non-opioid pain medications.

Opioid Treatment Plan During Pregnancy

In cases where pain management using an opioid is the best option, prescribing healthcare providers and obstetricians will generally recommend a treatment plan in which the medication is used:

  • for the shortest time possible
  • using the lowest effective dose
  • with an emphasis on careful adherence to dosage and dosing schedule
  • with a high level of caution for side effects
  • with regular follow-up appointments and evaluations

The Risks Of Opioid Abuse During Pregnancy

Unfortunately, many women who are pregnant still seek out and abuse prescription opioid medications that were not prescribed to them, take their prescription drugs in higher doses or more frequently than instructed, or use high-risk illicit opioids like heroin or fentanyl.

This kind of opioid abuse can cause serious and well-documented problems related to development in utero, including:

  • neonatal abstinence syndrome (NAS), a condition wherein a newborn is born with opioid dependence and experiences dangerous drug withdrawal symptoms
  • neural tube defects, which can include birth defects impacting the brain or spinal column
  • other birth defects, potentially including gastroschisis (a condition where the intestines emerge from the body) and congenital heart defects
  • miscarriage or stillbirth
  • preterm birth before 37 weeks
  • unusually low birth weights
  • death of the mother/baby due to opioid overdose (treatable with naloxone)
  • Neonatal Abstinence Syndrome (NAS)

Newborns with NAS may show signs of opioid withdrawal around 72 hours after birth. This is when the last of the specific opioid compound in their bodies, passed along through the umbilical cord before birth, is metabolized and removed from their systems.

Signs and symptoms of NAS can include:

  • tremors
  • seizures
  • excessive crying
  • sleep problems
  • hyperactive reflexes
  • yawning or sneezing
  • poor feeding
  • vomiting
  • loose stools
  • sweating
  • dehydration

Not all infants whose mothers use opioid drugs develop NAS, though its prevalence increases in cases in which a mother abuses opioid drugs or has opioid use disorder.

Is NAS Treatable?

Fortunately, NAS is treatable using perinatal support as well as medication-assisted treatment (MAT) and tapering/weaning with either morphine, methadone, or buprenorphine.

However, NAS treatment can see newborns hospitalized for weeks with soaring medical costs. Additionally, the other potential long-term effects of prenatal and postnatal opioid exposure are not clearly understood and require further research.

Risk Factors For Opioid Use Disorder (OUD)

While anyone can develop an OUD, there are known factors that can put a pregnant woman at an increased risk for opioid abuse and for drug addiction in general, including:

  • traumatic childhood events
  • genetic factors or a family history of substance abuse
  • untreated psychiatric conditions (anxiety, depression, PTSD, etc.)
  • living with a high level of stress (financial insecurity, domestic abuse, etc.)
  • past experiences with substance abuse

Additionally, evidence suggests that women (and women between the ages of 18 and 29 in particular) may be more predisposed to becoming dependent on opioids than men.

Women are also more commonly diagnosed with chronic pain and are more frequently prescribed opioids at higher relative doses for longer periods of time.

Treating Opioid Use Disorder

Pregnant women and those who are postpartum who struggle with opioid addiction or other forms of drug abuse should seek prompt and effective professional treatment from a behavioral health provider like Bedrock Recovery Center.

At our residential treatment center, our evidence-based substance use disorder treatment options include:

  • medical detoxification to manage opioid withdrawal symptoms and cravings
  • inpatient/residential treatment for focused, personalized care
  • dual-diagnosis care for co-occurring mental health issues
  • medication-assisted treatment programs
  • peer support programs
  • aftercare support and case management

To learn more about enrolling in professional substance abuse treatment, please reach out to our team today.

  1. Centers for Disease Control and Prevention (CDC) - About Opioid Use During Pregnancy https://www.cdc.gov/pregnancy/opioids/basics.html#:~:text=Neonatal%20Abstinence%20Syndrome%20(NAS),were%20exposed%20to%20before%20birth.
  2. Food and Drug Administration (FDA) - Oxycontin HCl Label https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/020553s059lbl.pdf
  3. The Journal of Pediatric Pharmacology and Therapeutics - Neonatal Abstinence Syndrome: Essentials for the Practitioner https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4187528/#:~:text=Primary%20treatment%20for%20NAS%20consists,option%20with%20promising%20initial%20experience.
  4. Substance Abuse and Mental Health Services Administration (SAMHSA) - Medications, Counseling, and Related Conditions https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions

Written by Bedrock Recovery Center Editorial Team

Published on: August 24, 2023

© 2024 Bedrock Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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