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In Opioid Addiction, Both Babies and Their Mothers Deserve Care

It isn't just infants' opiate withdrawal that is concerning: the growing opioid epidemic in the U.S. presents trouble for mother and child both, even after returning home from the hospital.
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Every 19 minutes, an infant is born in the U.S. who will suffer from opiate withdrawal [1].

These babies, whose mothers used opioids (pain-relieving medications such as Vicodin, OxyContin, Percocet, and others) during pregnancy, are born addicted to the drugs and suffer painful withdrawal symptoms as newborns, including seizures, tremors, diarrhea, and fever [2].

But it isn't just infants' opiate withdrawal that is concerning: the growing opioid epidemic in the U.S. presents trouble for mother and child both, even after returning home from the hospital.

Since the passage of the Keeping Children and Families Safe Act in 2003, the number of drug-dependent infants born in the U.S. has increased dramatically [3]. According to Reuters, more than 27,000 such infants were born in 2013 alone, the most recent year for which data is available [3]. Reuters also reports that data kept by state governments suggest that thousands of these babies and their mothers are never referred to child protective services [3]. Because so many drug-dependent newborns go unreported, it is unknown how many children suffer injury or death while in the care of parents struggling with addiction.

Unfortunately, reporting drug-dependent newborns to child protective services can add to the problem. National Advocates for Pregnant Women notes criminalizing drug use during pregnancy might encourage covert continued drug use and avoidance of prenatal care -- negatively impacting both her health and the health of her child, since neither receive the care they need [4].

Addiction to opioids, especially in women, is on the rise. Most women who become addicted to opioids did so after taking legitimate prescriptions from a health care provider for a chronic pain condition, which is more prevalent in women than in men [5].

From 1999 to 2013, more than 220,000 Americans died of opioid-related overdoses -- largely from prescription painkillers being overprescribed [6]. According to Physicians for Responsible Opioid Prescribing, this trend of overprescribing painkillers increased sharply in the 1990s, largely in response to an industry-funded campaign that minimized opioid risks and exaggerated benefits [7].

To combat this epidemic, we must treat expecting addicted mothers with care, not judgement, and encourage an open dialogue about substance use between women and their health care providers. The American Congress of Obstetricians and Gynecologists (ACOG) states that screening for substance abuse is a part of complete obstetric care and should be done in partnership with the pregnant woman. Both before pregnancy and in early pregnancy -- and, SWHR asserts, post-partum -- all women should be routinely asked about their use of alcohol and drugs, including prescription opioids and other medications. The patient should be informed that these questions are asked of all pregnant women to ensure they receive the care they require for themselves and their fetuses and that the information will be kept confidential, states ACOG [8].

The Society for Women's Health Research is committed to the health of women and their children. Learn more about pregnancy and maternal health here, and learn more about women and addiction here. Stay tuned for a forthcoming piece about this growing epidemic and its effects on the health of both mothers and their babies.

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Need help with substance abuse or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.