When used during pregnancy, opioids can affect both the mother and the unborn baby. So whether prescribed or not, it's essential to know the risks.
Women may use opioids as prescribed, misuse prescription opioids, or use illicit opioids like heroin to face difficulties. Using fentanyl during pregnancy is unlikely to have been anticipated by the user, but this fact makes no difference when trying to take the first steps to sobriety. Taking steps to sobriety is vital when planning on expanding your family.
Women who take opioids during pregnancy, for any reason, should be aware of the risks and treatment options for opioid use disorder. What are the concerns about opioid use?
Opioids are made from the well-known poppy plant and are sometimes called narcotics. Prescription drugs are available for some opioids.
Long-term use of these substances can lead to dependence, physical tolerance, cravings, an inability to control usage, and persistent use despite unfavorable consequences (opioid use disorder). As a result, the risks of addiction and overdose are grave.
Talk to your doctor about the risks of using prescription opioids for pain, as well as your treatment goals. In addition, let your medical practitioner know if you are pregnant and talk about your family planning goals.
Health Outcomes From Exposure During Pregnancy
Pregnancy exposure to opioids has been linked to various adverse health impacts in both mothers and newborns. For example, opioid use disorders have been associated with maternal death in women. Opioids have been connected to poor fetal growth, premature birth, stillbirth, specific birth abnormalities, and neonatal abstinence syndrome in children.
The long-term implications of prenatal opioid exposure on children are uncertain. However, in some circumstances, such as treating opioid use disorder during pregnancy, the benefits of taking opioid drugs as recommended outweigh the dangers.
Before discontinuing or modifying any prescribed medication, women should speak with their doctor.
Neonatal Abstinence Syndrome (NAS)
Some babies may develop neonatal abstinence syndrome (NAS) due to opiate usage or medication-assisted therapy for opioid use disorder during pregnancy.
NAS is a collection of diseases that can arise when babies withdraw from substances they were exposed to before birth, such as opioids.
Neonatal opioid withdrawal syndrome (NOWS) refers to opioid withdrawal within the first 28 days of life.
Withdrawal symptoms commonly appear 72 hours after birth and include the following:
● Trembling
● Irritability, including non-stop, crying
● Insomnia
● Hyperactive reactions
● Seizures
● Poor feeding and sucking
● Vomiting
● Dehydration
● Sweating
The signals that a baby may experience and the severity of those signals are determined by various circumstances.
The type and amount of drug the child was exposed to before delivery, the last time a substance was used, whether the infant was born full-term or prematurely, and whether the newborn was exposed to additional substances before birth is all things a family should consider.
Pregnancy opioid use has been associated with poor birth outcomes. Furthermore, babies who have been exposed to opioids may be at a higher risk of developing addiction later in life.
● Be born before 37 weeks of pregnancy - preterm
● Have poor fetal growth
● Have more extended hospital and medical intervention once born
● Stand the chance of being hospitalized within 30 days of being born
● Be born with congenital disabilities.
Longer-Term Developmental Outcomes
Longer-term effects of children exposed to opioids prenatally, including those with or without NAS, are little understood.
Although not all newborns exposed to opioids during pregnancy show signs of NAS, they may still suffer long-term effects that aren't visible at birth. It's unclear if these effects are caused by opioids, other substance exposures, or other environmental factors.
Before, During, and After Pregnancy - Available Treatments for Opioid Abuse
The first step for a pregnant woman or a woman wanting to be pregnant is to consult with a healthcare provider. Before becoming pregnant, a woman can improve her chances of having a safe pregnancy by developing a treatment plan for opioid use disorder and other co-occurring health disorders.
Stopping opioids abruptly during pregnancy is not recommended because it can result in severe consequences such as premature labor, fetal discomfort, and even loss. Current recommendations made by clinical professionals for pregnant women with opioid use disorder is medication-assisted treatment (MAT). MAT is recommended rather than supervised withdrawal due to better results and a lower risk of recurrence.
It's critical to understand that NAS is a common side effect of MAT exposure. Therefore, the individual should not use the risk of neonatal abstinence syndrome to avoid giving MAT.
Close collaboration with a pediatric care team can help ensure that a newborn delivered to a mother who was addicted to opioids while pregnant is monitored for NAS, receives appropriate treatment, and is connected to needed supports.
Support for women going through opioid use disorder treatment is crucial throughout the postpartum period, a time of readjustment and heightened stressors leading to relapse and overdose episodes.
According to data, some women with opioid use disorder may not be diagnosed until after delivery or throughout the postpartum period. Therefore, it is critical to maintaining access to health care and treatment for substance use disorders and other co-occurring diseases after birth.
MAT should be continued as prescribed in the postpartum period for women who developed an opioid use disorder during pregnancy. Learn about treatment options for women with opioid use disorders before, during, and after pregnancy.
Is It Ever OK To Use Opioids During Pregnancy?
In a report released by the American College of Obstetricians and Gynecologists, pregnancy should never be used as an excuse to put off treating acute pain due to concerns about opiate addiction or neonatal abstinence syndrome.
Your doctor will try to avoid or limit the use of opioids if you're pregnant and have chronic pain. Instead, he or she will most likely emphasize nonopioid drugs and alternative therapies such as exercise, physical therapy, and behavior therapy.
If you're prescribed opioids while pregnant, doctors will probably tell you to take them for as little time as possible. Your doctor will prescribe an opioid-substitution medicine if you are pregnant and have an opioid use disorder.
Treatment can entail the use of methadone, an opioid drug, in conjunction with counseling and behavior therapy. This treatment has been demonstrated to lower the likelihood of relapse, prevent opiate withdrawal symptoms, and promote commitment to prenatal care and addiction treatment programs.
The use of opioids is always risky whether you're pregnant or not, the medication is prescribed, or you're using it illegally for recreational purposes. However, knowing the risks involved could be what saves your life and the life of your unborn child.