Analysis of Surge in Narcotic Prescriptions for Pregnant Women by Abimbola Ademola-Dada
While Mothers may need opioid due to the pain they are experiencing, Opioids should be used limitedly in pregnant patient if a Pregnancy risk category is not place on the opioid.
Increase of opioid prescriptions to pregnant women by doctors is at an all time rise. Out of 1.1million pregnant women who are in the Medicaid program nearly 23% filled an opioid prescription in 2007, which is an increase from 2000 (18.5%). The opioids that were prescribed in the past and those currently being prescribed the most include codeine and hydrocodone. The most prescribed medication was given for ...view middle of the document...
Process of creating a fetus, keeping the fetus for close to 9 months and actually delivering a healthy child can at any time take an unexpected turn. With an increase in articles discussing external effects that can be avoided to help protect the fetus will help several mothers increase the chance of having a healthier child. Websites such as the CDC in collaboration with other websites can lead to mothers that are properly informed of possible defects that can occur with their child. For a drug to receive pregnancy category research is required. However to find subjects willing to risk their child having a defect to help categories a drug is limited. There are instances where some women may not even be aware that they are pregnant. They may be on an opioid regimen and be total unaware of the damage it could cause their unborn fetus. Once realized by the physician, the mother should be tapered off and place on a pregnancy appropriate therapy of either Methadone or Buprenorphine. There are some mothers that may be addicted to the opioid therapy prior to pregnancy. These mothers require a switch of therapy and behavioral therapy to ensure safety of both the mother and child. Some mothers might be opioid naïve till pregnancy. They may need opioid therapy due them needing surgical procedure (car accident, emergency surgeries), infection, injuries or chronic diseases (such as nephropathy).
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The use of opioid during pregnancy can lead to the following possible defects such as spina bifida, a neural type defect, hydrocephaly, a build up of fluid in the brain, gastroschisis, a defect of the abdominal wall, and congenital heart defects. There are two types of mothers that should be discussed in more detail. A mother that is an addict prior to pregnancy and a mother who is opioid naïve and requires opioid regimen to alleviate pain due to unforeseen circumstances.
A mother to be addicted to painkillers prior to birth can have issues avoiding their addictions, which can lead to detrimental harm to their unborn fetus. The recommended opioid for pregnant women addicted to opioids is methadone. Methadone is safe if used properly however; it is associated with neonatal abstinence syndrome that causes the child to experience opioid withdrawal. Another medication currently studied for use in pregnant patient is buprenorphine. Research shows that buprenorphine was better than methadone at decreasing withdrawal syndrome in newborns. In the MOTHER trial, 131 addicted pregnant women resulted in the conclusion that NAS were caused by opioids and not other drugs. Nonetheless methadone is used more because more research has been done in methadone than buprenorphine. Although methadone can aid in the treatment of addiction with less side effects on the child, it is not with out an effect. Neonatal abstinence syndrome leads to an opioid withdrawal that occurs 24-36 hours but can be up to 5-7days. There are...