Opioid Addiction in Pregnancy

What Are Opioids?

An opioid is a type of narcotic pain management medication that may be abused for recreational purposes or to induce sleep. These drugs, which include but are not limited to morphine, codeine, hydrocodone, fentanyl, methadone and heroin, bind to opioid receptors in the spinal cord, brain and other parts of the body in order to greatly reduce pain.

Opioids are sometimes prescribed by doctors when over-the-counter pain management drugs are not providing the necessary relief. These substances can be dangerous if not taken correctly or abused.

Help Is Available In the Valley

If you or a loved one is struggling with opioid addiction while seeking prenatal care, please call Arizona Associates for Women’s Health in Mesa, AZ at (480) 257-2700.

Stephen Frausto, MD, FACOG is trained in the management of buprenorphine administration for pregnant women addicted to opioids. Buprenorphine is a methadone alternative that can help women overcome opioid addiction during pregnancy. This treatment must be started within the first 20 weeks of pregnancy. Learn more below.

Opioids Can Be Dangerous

When properly prescribed and closely monitored by your doctor, opioids can be a good option for pain management. However, these drugs can become problematic if patients become dependent on or addicted to these drugs.

An addicted opioid user may exhibit a strong desire to obtain and use opioids illegally, despite the social, physical and professional consequences. Types of opioids that are commonly abused may include, but are not limited to:

Morphine
Heroin
Codeine
Oxycodone (“Oxycontin”)
Fentanyl
Hydrocodone/Dihydrocodeine
Hydromorphone
Meperidine (“Demerol”)
Methadone
Oxymorphone

Many opioid-addicted pregnant women are concerned about the health of their unborn child and want to stop using opioids quickly. However, there are sometimes risks involved in stopping opiate use suddenly, including a greater risk for miscarriage. This is one reason why it’s so important to talk to a doctor if you are considering stopping opioid use.

Many complications can occur during pregnancy and childbirth when a patient is opioid-dependent. Some of these complications may include:

Miscarriage
Preterm premature rupture of membranes
Preterm labor
Stillbirth
Concomitant substance use
Psychiatric co-morbidities
Intrauterine growth restriction
Infectious disease exposure (e.g. HIV)
Infection transmission during childbirth

Long-term risks to children born of opioid-dependent mothers

Not only are there dangerous risks to the opioid-addicted mother and her unborn child, but there are also long-term risks to a child born of an opioid-dependent mother. Some of the risks include but are not limited to:

Higher risk of addiction long-term
Lower birth weight
Sudden infant death syndrome (SIDS)
Greater risk for a learning disability
ADHD and behavioral problems
Congenital abnormalities
Birth defects, including heart defects and spina bifida

Treatment options for opioid-dependent mothers

Fortunately, there are treatments for pregnant women who are addicted to opioids. At Arizona Associates for Women’s Health, we are here for you and your unborn child. In addition to counseling, your treatment options may include:

Buprenorphine – Similar to methadone, this is a safer option for both the baby and mother. Though this treatment is newer, the option may be easier on the unborn child in that they may not experience the same difficult withdrawal symptoms in the uterus. This option is associated with a shorter hospital stay and fewer medications.

Benefits of Buprenorphine

Not only does buprenorphine have fewer risks, but it can also lessen withdrawal symptoms.

Low doses of buprenorphine enable patients to stop misusing drugs without suffering intense withdrawal symptoms.

A “ceiling effect” is reached with buprenorphine, meaning that the drug’s effects stop increasing in concurrence with dosage. This makes a buprenorphine overdose much less likely than an overdose with other types of opioids. This therapy must be started within the first 20 weeks of your pregnancy.