Opioid use disorder affects hundreds of thousands of Americans, many of whom are women of childbearing age. If you are one of them, chances are you have questions about opioids and pregnancy.
Can opioids be taken during pregnancy? If so, what are the risks? What about opioids and breastfeeding?
In this article, we will explain the key information you should know about opioids and pregnancy, including their effects on fertility and breastfeeding.
What are Opioids?
Opioids are drugs with pain-relieving properties prescribed to treat pain that cannot be relieved by non-opioid medications. While they can be used to treat chronic pain, such as that associated with diseases like cancer, long-term use of opioids can lead to opioid dependence and addiction.
Opioid medications are available in various forms, including tablets, oral solutions, injectable solutions, suppositories, and more.
Based on their origin, opioids can be classified into three groups:
- Natural opioids (opiates), which are extracted from the poppy plant (e.g., morphine)
- Semi-synthetic opioids, such as oxycodone, which are synthesized from opiates
- Synthetic opioids, like fentanyl, which are fully human-made and devoid of opiates
The class of opioids encompasses a broad range of drugs that interact with opioid receptors in the central nervous system (CNS) and alter how the brain responds to pain. Besides prescription opioids, this drug class also includes illicit opioids like heroin.
Aside from pain relief, opioids can also induce euphoria, enhancing the potential for opioid abuse and addiction.
Side Effects of Using Opioids
The most common side effects of opioids include:
- Sedation
- Itchy skin
- Headache
- Confusion
- Constipation
- Stomach ache
- Lightheadedness
- Difficulty breathing
- Sleep disturbances
- Nausea and vomiting
Talk to your doctor if you have any side effects after using opioids. If you experience any serious side effects, such as respiratory depression, seek emergency medical care immediately.
Moreover, opioid abuse and prolonged use of opioids increase the risk of:
- Tolerance, dependence, and opioid addiction
- Liver, heart, kidney, and other organ damage
- Increased sensitivity to pain
- Chronic constipation
- Dental problems
- Opioid overdose
- Death
To reduce the risk of severe side effects, always take opioids as prescribed.
Do not increase your dosage without consulting your doctor, as this can put you at an increased risk of opioid dependence, addiction, and overdose, which can be fatal if not treated promptly. The number of opioid overdose deaths in the United States has increased by nearly 520% between 1999 and 2019.
What is Opioid Use Disorder?
Opioid use disorder (OUD) is a treatable medical condition characterized by habitual, problematic opioid use. In other words, people with OUD continue taking opioids despite the negative consequences.
Anyone who takes opioids for a prolonged period of time risks becoming physically dependent as opioids gradually alter brain chemistry. If left untreated, opioid dependence can develop into OUD, making it extremely difficult for people to control their opioid use.
Some symptoms of opioid use disorder include:
- Preoccupation with obtaining and using opioids
- Multiple unsuccessful attempts at quitting or reducing opioid use
- Continued opioid use, even after experiencing social, professional, and other problems
- Opioid abuse (i.e., taking opioids in other ways than prescribed, such as in larger doses)
- The presence of opioid withdrawal symptoms upon discontinuing or cutting back on medication
OUD doesn’t discriminate—anyone taking opioids can fall victim to it, including pregnant women.
If you suspect you might have OUD and are pregnant or planning to have a baby, contact your healthcare provider. Pregnant women with OUD are usually recommended to switch to long-acting medications used to treat OUD, such as methadone.
Do not quit opioids abruptly, as this can increase the risk of acute withdrawal symptoms, relapse, preterm birth, and fetal distress, among others.
On that note, let’s dive deeper into opioids and pregnancy and learn how they affect pregnant women and their fetuses.
Opioids and Pregnancy: How Do Opioids Affect Pregnant Women and the Fetus?
Using opioids during pregnancy can have adverse effects on both pregnant women and the fetus, increasing the risk of:
- Stillbirth
- Miscarriage
- Preterm labor
- Maternal death
- Stunted fetal growth
- Behavioral problems
- Developmental delays
- Neonatal abstinence syndrome (NAS)
- Birth defects, including congenital heart defects, gastroschisis, and neural tube defects
Most opioids are classified as Pregnancy Category C drugs by the FDA. This means that while animal studies have found that using opioids in pregnancy can potentially cause harm, no well-controlled studies on opioids and pregnancy have been carried out on humans.
Therefore, opioids can be prescribed for pain relief or OUD treatment during pregnancy, but only if their potential benefits outweigh the risks.
A study on the link between prescription opioid use during the first trimester and congenital disabilities found that prenatal opioid exposure can increase the risk of cleft lip and palate. It is also associated with negative effects on the baby’s cognitive, motor, and behavioral functions.
If you must use opioids during pregnancy, follow your doctor’s instructions carefully. To reduce the risks associated with opioids and pregnancy, take them for the shortest time and at the lowest dosage possible.
Using Opioids While Breastfeeding
Some opioids, such as medications used to treat OUD, can be used while breastfeeding. If you take illicit opioids or have HIV/AIDS, however, you may not be able to breastfeed. Your doctor can help you determine whether or not you should breastfeed while taking opioids.
Nonetheless, all opioids, including prescription medications and illicit drugs, can transfer to breast milk. Even though this amount is typically small, it can still lead to dangerous side effects, such as neonatal CNS depression and even death. As such, babies who are breastfed by mothers who take opioids should be carefully monitored.
If you notice the following symptoms in your baby after taking opioids and breastfeeding, seek medical help:
- Pale skin
- Drowsiness
- Constipation
- Trouble breathing
- Slow weight gain or weight loss
Most importantly, do not stop breastfeeding your baby suddenly or discontinue opioids abruptly, as this can induce acute withdrawal symptoms in babies and mothers alike. Consult with your doctor to quit opioids safely.
How Do Opioids Affect Fertility?
Opioids can negatively affect fertility in both women and men, especially when taken for a prolonged period of time or abused.
Long-term opioid use can impact the production of estrogen and progesterone in women, leading to the absence of menstrual periods, abnormal menstruation, ovarian insufficiency, and premature menopause.
Opioid use can not only lead to infertility but also make it more challenging to sustain a healthy pregnancy. Women who take opioids are less likely to conceive within one menstrual cycle and face a higher risk of pregnancy loss.
Opioids can also impair male reproduction, primarily by reducing the production of testosterone and reducing the quality of semen. They can also reduce libido and cause erectile dysfunction.
Prolonged opioid use and misuse can cause both men and women to struggle with long-term fertility problems that persist even after the medication is discontinued. If you are taking opioids, talk to your doctor to minimize the risks associated with opioids and pregnancy and increase your chances of conceiving.
Opioids and the Cause of Neonatal Abstinence Syndrome (NAS)
Opioids can cause neonatal abstinence syndrome (NAS), also known as neonatal opioid withdrawal syndrome (NOWS), a condition characterized by withdrawal symptoms in opioid-exposed newborns. Depending on the specific opioid and other individual factors, these symptoms may begin within the first few days or the first week following birth.
Opioids consumed by pregnant women can reach the baby through the placenta, which could cause them to become dependent on them while still in the womb. The risk of developing NAS for opioid-exposed babies is as high as 90%.
Upon birth, babies exposed to opioids may display mild to potentially life-threatening withdrawal symptoms, such as:
- Fever
- Tremors
- Seizures
- Diarrhea
- Twitching
- Sneezing
- Hyperirritability
- Sleep problems
- Tight muscle tone
- Feeding problems
- Difficulty breathing
- Increased sweating
- Persistent high-pitched crying
- Impaired growth and weight gain
NAS can last for up to 6 months. Though it is a treatable condition, it may persist for up to a month or longer, even when the baby receives treatment. Newborns born to pregnant women who take opioids should be closely monitored for NAS and may need to stay in the neonatal intensive care unit for a longer time than usual.
ANR Treatment for Opioid Dependence
If you are looking for a safe, fast, and effective treatment for opioid dependence, there’s no better option than Accelerated Neuro-Regulation (ANR).
Developed by Dr. Andre Waismann, this revolutionary treatment has helped close to 25,000 people around the world break the chains of opioid dependence.
The ANR treatment has a very high success rate, and it’s not without good reason. Unlike traditional approaches, ANR recognizes and treats the neurobiological causes of opioid dependence rather than its symptoms. By eradicating the root of the problem, ANR eliminates withdrawal symptoms and, subsequently, the risk of relapse.
ANR works by re-regulating the endorphin-receptor imbalance. It reverses the damage opioids cause to the brain while the patient is sedated, allowing you to avoid any discomfort associated with opioid withdrawal. The ANR procedure takes 4–6 hours, and the hospital stay for our patients lasts only 36 hours on average.
Most importantly, ANR is very safe. It is tailored to each patient individually and performed by highly trained, board-certified medical professionals in an ICU setting of accredited hospitals.
To get started with ANR, contact us today for a free consultation!
Key Takeaways
Now that we’ve looked into opioids and pregnancy, let’s go over the key points:
- Opioids are drugs with a high potential for dependence and addiction that are used to alleviate pain.
- Using opioids in pregnancy increases the risk of stillbirth, neonatal abstinence syndrome, congenital disabilities, and developmental delays, among others.
- If you must use opioids during pregnancy or breastfeeding, take them in small amounts and for as little time as possible. If nursing, check your baby for unusual symptoms like breathing problems.
Opioids and Pregnancy FAQ
It is not safe to suddenly quit taking opioids during pregnancy. Abrupt discontinuation of opioid medication can trigger acute withdrawal symptoms in you and your baby, which can be fatal. Speak to your doctor about quitting opioids during pregnancy safely.
The risks for babies born to mothers with opioid use disorder who take opioids during pregnancy include neonatal abstinence syndrome and developmental delays. Opioid exposure can also impair growth and cause congenital disabilities.
Opioid analgesics are not safe to take during pregnancy, as they can lead to neonatal abstinence syndrome, among other negative outcomes. You should only take opioids during pregnancy if you and your doctor determine that the potential benefits may offset the risks linked to opioids and pregnancy.
Taking painkillers, especially opioids, during pregnancy can affect the baby by increasing the risk of pregnancy loss, neonatal abstinence syndrome, breathing difficulties, and premature delivery.