How Painkiller Addiction Affects Pregnancy

pregnant lady holding a glass of water in one hand and a pill in the other

Roughly 1% to 3% of all pregnant women in the U.S. abuse a prescription pain medication at least once. Significant numbers of these women are addicted to painkillers and repeatedly abuse pain medications. Unfortunately, a painkiller addiction can have disastrous effects on the pregnancy.

What Are Painkillers?

Prescription painkillers are a large family of medications that typically contain addictive substances called opioids. These substances, which come directly or indirectly from the same plant source as heroin, reduce pain symptoms by slowing down your central nervous system and producing an intense form of pleasure called euphoria. Unfortunately, the euphoria produced by painkillers sometimes serves as the motivation for abuse of these medications. In turn, repeated abuse of an opioid pain medication can trigger changes inside your brain that lead to diagnosable addiction. The list of widely used prescription opioids includes:

  • OxyContin (active ingredient: oxycodone)
  • Vicodin (active ingredient: hydrocodone)
  • Demerol (active ingredient: meperidine)
  • Fentanyl (sold under brand names that include Actiq and Fentora), and
  • Codeine

Effects During Pregnancy

Painkiller addiction can lead to several dangerous or tragic outcomes during pregnancy. The first of these outcomes is premature childbirth. Doctors define this condition as any childbirth that occurs before the 37th week of pregnancy. All premature newborns have increased chances of experiencing serious health problems at birth. They also have heightened risks for health problems that develop later in life. In the womb, the fetuses of pregnant women addicted to opioid pain medications have significantly increased chances of experiencing serious birth defects. These defects are the result of opioids’ impact on the normal course of fetal growth and development.

Another major problem for pregnant women with a painkiller addiction is an increased chance of experiencing stillbirth. Doctors use this term to describe any situation in which a developing fetus dies in the womb at least 21 weeks into a pregnancy. Finally, if pregnant women addicted to painkillers abruptly stop their substance use, they can go into premature labor, a situation that can in turn lead to premature birth.

Neonatal Abstinence Syndrome

Doctors use the term neonatal abstinence syndrome (NAS) to refer to a collection of symptoms that can appear in the newborns of women who use opioids during pregnancy. This syndrome occurs when, after birth, babies withdraw from medications found in the bloodstream they shared with their mothers. The long list of problems that may occur includes:

  • An inability to feed properly
  • Frequent, unexplained crying
  • Muscle tremors and seizures
  • Skin that appears mottled or blotched
  • Diarrhea
  • High body temperature or fever
  • Unusually active muscle reflexes
  • Excessive sweat output
  • Sleep disruptions
  • A reduced rate of weight gain, and
  • An irritable temperament

Neonatal abstinence syndrome typically occurs when opioid use continues into the last week of pregnancy. The type and severity of NAS symptoms depend on several factors, including the specific medication in use, the extent of medication use during pregnancy, the speed at which the mother’s body can break down opioids and eliminate them, and whether or not childbirth occurs prematurely. Problems can appear within a day to a week after childbirth. Depending on the severity of those problems, it can take a newborn anywhere from one to six months to recover from NAS with proper medical care.

 

Resources:

“Prescription Opioids During Pregnancy” – March of Dimes
http://www.marchofdimes.org/pregnancy/prescription-opioids-during-pregnancy.aspx

“Neonatal Abstinence Syndrome” – U.S. National Library of Medicine: MedlinePlus
https://medlineplus.gov/ency/article/007313.htm

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