WASHINGTON, DC (April 11, 2017) — Five percent of U.S. pregnant women reported nonmedical use of prescription opioids in the year before being surveyed, and 0.9 percent reported use within the past month, according to a study published today in Women’s Health Issues. Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, which is based at Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University.
Katy B. Kozhimannil, of the University of Minnesota School of Public Health, and her colleagues used 2005-2014 data from the National Survey on Drug Use and Health (NSDUH) and analyzed responses from 8,721 women who reported being pregnant when they completed the survey. The survey asked participants whether they used prescription opioids nonmedically, or “for the feeling it caused” within the last 30 days, or between 30 days and one year ago.
Chronic nonmedical opioid use during pregnancy is associated with an increased risk of preterm birth and other negative outcomes. The authors note that the NSDUH does not ask participants about duration or frequency of nonmedical opioid use (i.e., it does not distinguish between one-time use and heavy or chronic use). The survey also does not ask whether the opioid use occurred during pregnancy, although the study authors explain that most pregnancies cannot be detected or confirmed before 20 days, so they expect most past-month nonmedical opioid use reported occurred during pregnancy.
Depression and anxiety diagnoses within the past 12 months were more common in women who reported nonmedical prescription opioid use within the past year, the authors found, and women who reported using multiple substances (alcohol, tobacco, and marijuana) were more likely to also report nonmedical opioid use. These findings suggest that women at risk for nonmedical opioid use during pregnancy may need care for multiple conditions, and the authors note that they may also have social needs related to mental illness or substance use.
Kozhimannil and her colleagues highlight recent federal policy efforts to improve treatment access and outcomes for pregnant women with opioid dependence and their infants. However, they warn that “treatment access for pregnant women is extraordinarily limited, especially for women who are low-income or living in rural areas” and that women’s access to substance use treatment “may be hampered by costs, clinician supply shortages, and the choice of their state not to expand Medicaid.”
The study, “Nonmedical Use of Prescription Opioids among Pregnant U.S. Women,” has been published online ahead of print and will appear in the May/June issue of Women’s Health Issues.