Dangers of Opioids While Pregnant

The Dangers of Misusing Opioids During Pregnancy

Opioid use during pregnancy is an aspect of the opioid crisis that isn’t discussed enough. Of the 7% of women who report using prescription opioid pain relievers during pregnancy, one in five report that they’ve misused opioids. Care providers have also seen the number of women with opioid-related diagnoses documented at delivery increase by 131% between 2010 and 2017. Knowing about the risk level involved in using opioids while pregnant is important.

What Counts as Opioid Misuse During Pregnancy?

Opioid misuse can be defined in two ways. The first is obtaining prescription opioid pain relievers from a source outside of a licensed healthcare setting. The second is using opioid pain relievers for any other reason than relieving pain. Both are signs of opioid use disorder (OUD). Here’s a look at the most common symptoms of OUD:

  • Taking larger amounts of opioids than intended
  • Experiencing strong cravings for opioids
  • Developing a strong tolerance for opioids
  • Using opioids for a longer period of time than anticipated
  • Being unable to cut down or control opioid use
  • Spending a large chunk of time obtaining opioids
  • Spending a large chunk of time recovering from the effects of opioid use
  • Struggling to fulfill obligations in your work life, academic life, or home life due to opioid-related behaviors
  • Experiencing recurring social or interpersonal problems due to opioid use
  • Changing your lifestyle due to opioid use
  • Performing psychically hazardous tasks as a result of opioid use
  • Continuing opioid use while opioids cause or exacerbate ongoing physical or psychological problems 
  • Experiencing withdrawal symptoms when going without opioids
  • Taking opioids to relieve withdrawal symptoms

Common prescription opioids that are misused include fentanyl oxycodone, hydrocodone, morphine, and methadone. Heroin is an example of an illegal opioid.

Why Is Misusing Opioids While Pregnant Dangerous?

Opioid exposure during pregnancy is linked with a number of poor health outcomes for both mother and child. Struggling with untreated OUD during pregnancy increases risks for:

  • Stillbirth
  • Birth defects
  • Preterm birth
  • Poor fetal growth
  • Maternal death
  • Neonatal abstinence syndrome 

It’s important for expectant mothers to avoid leaning on “positive” anecdotal evidence they have heard from others who have misused opioids during pregnancy. The short-term and long-term effects of prenatal opioids on children are not fully known yet. For reasons that aren’t clear to researchers, not all babies exposed to opioids in the womb are born with symptoms. However, the long-term effects on a child’s development could still be negative. 

Neonatal Abstinence Syndrome (NAS)

NAS is one of the most common repercussions of opioid misuse during pregnancy. When children are exposed to opioids and other addictive substances during pregnancy, they undergo painful withdrawal periods after birth. It’s estimated that NAS affects between 55% and 94% of babies born to mothers who were either addicted to or treated with opioids during pregnancy. 

Babies with NAS generally begin showing signs within 72 hours of birth. NAS signs include:

  • Tremors
  • Seizures
  • Excessive crying
  • Nasal congestion
  • Poor feeding and latching
  • Dehydration
  • Vomiting or diarrhea
  • Excessive sweating
  • Sleep disturbances

NAS symptoms can vary based on the type of substance used, the amount of substances taken, and the last time a substance was used by the mother. Symptoms can also vary based on a baby being born premature or at full term. NAS symptoms in newborns can last anywhere from a few hours to several weeks.

It’s important to note that opioids given at the time of delivery to help laboring mothers manage pain do not produce NAS symptoms. 

NAS is a growing crisis. Rates of NAS have been significantly increasing each year in the United States since 2017. 

How Will I Know If My Baby Has Withdrawals From Opioids After Birth?

Medical professionals are trained to detect signs of withdrawal after birth. Using a special chart, doctors and nurses are able to determine how severe withdrawal symptoms are. If a baby has a high withdrawal score, they may be transferred to a special care unit or administered medication. 

It’s important that expectant mothers don’t avoid medical care for themselves and their babies because they are afraid that withdrawal symptoms will be detected. Untreated withdrawal symptoms can be dangerous for a baby. Immediate care following birth can help a baby to remain safe and comfortable during painful withdrawal symptoms. 

New approaches to helping newborns with NAS that are being ushered in at places like Yale Children’s Hospital focus on using parent involvement to help ease symptoms. Using the eat, sleep, console approach, care providers tap into the benefits of keeping babies and moms close to allow infants to be soothed. This approach also focuses on supporting families after babies are born. 

Risks for Mothers Who Misuse Opioids During Pregnancy

Over time, opioid users develop a high tolerance for the medications and substances they are habitually using. In order to get the same effects, they will need to increasingly take larger doses of opioids. This pattern dramatically increases the risk of overdosing. 

What to Do if You’re Concerned About Your Opioid Use During Pregnancy

Any pregnant woman who is concerned that she may be misusing or abusing opioids should be screened for opioid use disorder. Screening for substance use is often part of standard prenatal visits in obstetric care. While an OBGYN may detect signs of OUD, they cannot provide treatments for substance use. Support for OUD is instead provided by behavioral health or addiction specialists on either an inpatient or outpatient basis. 

Care Options Available for Opioid Use During Pregnancy

Many women who learn they are pregnant assume that the care and concern they have for their babies will give them the willpower to quit. However, opioid addiction is a powerful biochemical and physiological force that makes the body chemically dependent on opioids. This is why attempts to stop taking opioids without professional help are often unsuccessful. 

Opioid withdrawal symptoms can be excruciating. When combined with morning sickness, aches and pains, and hormonal changes that occur with pregnancy, opioid withdrawal symptoms can be extremely severe. People who attempt to quit opioids “cold turkey” in an unsupervised setting often experience extreme bouts of:

  • Nausea
  • Vomiting
  • Diarrhea
  • Fatigue
  • Muscle aches
  • Whole-body aches
  • Irritability 

Unfortunately, the severity of withdrawal symptoms causes many people to revert back to opioid use in order to get relief. A professional rehabilitation setting offers pregnant opioid users a carefully monitored setting where they can safely and comfortably detox in order to focus on making a full recovery from opioid use.

Detoxing From Opioid Use During Pregnancy

Recovery from opioid use disorder during pregnancy can be especially delicate due to the extra health-related and emotional implications involved. Treatments should be tailored to meet the needs of each client. 

Medically assisted detox programs are commonly used to help pregnant women discontinue opioid use. Methadone and buprenorphine are considered first-line therapy options for detoxing during pregnancy. In the medical world, these substances are called medications for opioid use disorder (MOUD).

Like all medications, methadone and buprenorphine come with benefits and risks that must be balanced. Expectant mothers should coordinate closely with their prenatal care teams and rehabilitation specialists to ensure that care is managed properly throughout pregnancy, during delivery, and during the postpartum period. 

A recovery plan for opioid use should also include therapy and behavioral support. An effective rehab treatment model should be based on the latest evidence-based practices for supporting healthy long-term recovery. 

Other Treatment Options for Overcoming Opioid Use During Pregnancy

Treatment for opioid use is complex because providers need to treat the physical, behavioral, and emotional components of addiction. In most cases, care professionals want to prioritize stabilizing an expectant mother’s health using MOUDs for a medically supervised detox. This can provide a great sense of relief for the mother.

Once opioid use is stabilized, the next priority is to provide emotional support to help a pregnant mother tackle the underlying causes of addiction. Common approaches include:

  • Cognitive behavioral therapy
  • Dialectical behavior therapy
  • Family therapy
  • Contingency management
  • 12-step programs

Based on the severity of opioid use, an expectant mother’s circumstances, and other factors, a patient may choose a variety of methods for getting help. This can include residential treatment, partial hospitalization, intensive outpatient care, and aftercare. 

Finding an Opioid Addiction Treatment Center That Treats Pregnant Women

Women who are trying to overcome opioid use disorder during pregnancy often feel like they are in an uphill battle. Juggling recovery and pregnancy isn’t easy. What’s more, not all rehabilitation centers have the experience and expertise needed to help pregnant women comfortably pursue treatment to overcome opioid use before their babies are born. 

White Light Behavioral Health is a licensed rehab center in Columbus, Ohio, specializing in recovery services for OUD. Clients can receive custom treatments under the care and supervision of a top-notch team. Treatment plans at White Light Behavioral Health include:

  • Expressive therapy
  • Group therapy
  • Trauma-focused treatment
  • Motivational interviewing
  • Family therapy
  • Cognitive-behavioral therapy
  • Dual diagnosis treatment

During the admissions process, a specialist assesses each patient’s medical history. A program will then be recommended by a counselor assigned to the incoming client. With admissions services available 24/7, getting help for opioid use during pregnancy doesn’t have to wait. 

There’s one thing that all pregnant women who are struggling with opioid usage need to know. Care providers want to erase the stigma about addiction during pregnancy because they see it as a blockage to life-saving care for mothers and children. While reaching out for help can feel scary, it can make a world of difference in creating a healthy outcome for mother and child during pregnancy and delivery.

Reviewed By:

Dr. Ryan Wakim, M.D.

Dr. Wakim is a board-certified psychiatrist with a passion for and expertise in addiction, mood disorders, trauma-related disorders and the subspecialty of interventional psychiatry. He obtained his medical degree from West Virginia University where he also completed his residency training, finishing as chief resident. Dr. Wakim co-founded and served as the CEO of Transformations leading to a successful merger with Shore Capital in May 2021. He is purpose driven towards improving the standard of and removing stigma related to behavioral healthcare. Dr. Wakim enjoys golf, traveling and time spent with his two dogs, Lulu and Rayna.

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