In a recent editorial, NIDA Director Dr. Nora Volkow advocates for safer opioid prescribing practices for pregnant women. Published on January 12 in the British Medical Journal, the article emphasizes event research that highlights the risks of prescribing opioids for both pregnant women and their unborn babies. The editorial underscores the importance of following good opioid prescription practices.
In the editorial, Dr. Volkow says how “attention has been focused on the large increase in the number of infants born with neonatal abstinence syndrome (NAS). In the U.S., …between 2004 and 2013 the total percentage of days spent in intensive care because of NAS increased from 0.6% to 4.0%. The rise in NAS is also likely to be a consequence of increased opioid prescriptions—estimates indicate that 14-22% of pregnant women in the U.S. receive an opioid prescription during their pregnancy—as well as an increase in the prevalence of opioid use disorders among pregnant women.”
Dr. Volkow also highlights the lack of scientific knowledge that must be respected in this critical situation. There is very little research available concerning the effects of opioids on fetal brain development. Given this lack of information, it would make more sense to play it safe as opposed to rolling the dice when so much is at stake.
Emphasizing the known association of opioids with neonatal abstinence syndrome, or NAS, implies that the drugs should only be prescribed for short-term use for pregnant women in severe pain. If long-term use is unavoidable, such as for women in need of buprenorphine or methadone maintenance therapy for heroin addiction, then careful assessment and monitoring has to be in place to minimize the risk of overdose, NAS and misuse.
