Pregnancy in the Opioid Crisis

In the midst of America’s Opioid Crisis we often fail to discuss one of the most difficult topics – what about women who are pregnant and using opioids?

 

Most women who are using drugs and find out they are pregnant try to stop the drug for the sake of the baby. However, this is very difficult with any drug, and suddenly stopping opioids can put the fetus at risk during the mother’s withdrawal. Additionally, many pregnant women are afraid to seek help. They are afraid of legal ramifications, as well as potential problems with Child Protective Services if they have other children and are found to be using drugs.

The good news, but unfortunately not a well understood fact, is that pregnant women using opioids can be stabilized and safely treated for opioid addiction. This can be successfully done with a medication called buprenorphine, which helps stabilize the withdrawals, and keep mothers stable until the time of delivery. Upon delivery there is a small chance of neonatal opioid withdrawal, but when the baby is breastfed this risk is reduced, and in the proper care setting any withdrawals the newborn may have can be easily managed.

Mothers who are actively using opioids can safely (from a medical and legal standpoint) be stabilized during pregnancy, and continue with the medication even after delivery. This can be done under a plan of treatment that will allow them to gradually work to get off all of the medications and be opioid free. Any pregnant woman dependent on opioids should talk to her obstetrician and consider finding a doctor who can jointly follow her care while treating her with buprenorphine.

Content written by our residential medical doctor, Dr. Reid Lofgran