Analysis of Surge in Narcotic Prescriptions for Pregnant Women by Abimbola Ademola-Dada
Thesis
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.
Summarize it
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 duration of a week or less (Only 2 % took opioids for a longer period). The rate of opioid prescription was lower in the Northeast and highest in the South. Increase in opioid prescription brings an issue because less that 10% of medications approved since 1980 have sufficient data to determine the fetal category of the drug. Healthcare providers and individual researching the use of opioids have shown greater concerns for the use of opioid prescription during first trimester and the role it may play in neural tube defects. Research shows that mothers with children with neural tube defects were on opioids in early pregnancy than mothers of children without congenital defects. Researchers found that opioid use by pregnant woman during her early trimester doubled the risk of neural tube defects. Some effects may not be as noticeable on the child after birth but are recognized after a few days. Neonatal abstinence syndrome (infant opioid addiction) can be notice 2-7 days after childbirth. The CDC has started a program titled “treating for two initia...
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Neonatal Abstinence Syndrome (NAS) is a group of problems a newborn experiences when exposed to addictive drugs that the mother consumes during pregnancy. NAS is a growing concern in the United States and can have significant adverse effects on newborns. Shortly after birth the infant can display many physical symptoms of withdrawal. In addition, substance abuse during pregnancy can cause premature birth, low birth weight, seizures, birth defects, Sudden Infant Death Syndrome (SIDS), and possible long-term cognitive and behavioral problems.
Every twenty-five minutes a baby is born suffering from opioid withdrawal called Neonatal Abstinence Syndrome (“National Institute on Drug Abuse”). Neonatal Abstinence Syndrome (NAS) - is a group of problems like seizures, vomiting, and diarrhea that a newborn faces when they have been exposed to addictive opiate drugs while in the mother’s womb (“Neonatal Abstinence Syndrome”). In 2012, around 21,732 babies were born with NAS (“National Institute on Drug Abuse”). Mothers who give birth to babies suffering from NAS should be penalized; the United States has laws protecting all children’s lives from any form of abuse, NAS is a form of child abuse and parents should lose all rights to their children.
Shniderman, Nancy, and Sue Hurwitz. Drugs and Birth Defects. New York: Rosen Pub. Group, 1993. Print.
Opioid’s chemical composition consist of many highly addictive substances which cause the human body to become quickly tolerant. Many opioid users become addictive to the substance because the doctors have been over prescribing. “In the United States, there were 14,800 annual prescribed opioid (PO) deaths in 2008” with the US having less restrictions (Fischer, Benedikt, et al 178). The United States have implemented more regulations so that “high levels of PO-related harms been associated with highly potent oxycodone formulas” will decrease (Fischer, Benedikt, et al 178). With the regulations, it does not change the fact that opioids are is destructive. The regulations assistance by lessening the probability of patients becoming addictive to opioid. There are numerous generations that are effected and harmed by the detrimental effects of opioids on opioid-dependent patients.
NIDA, through its clinical, epidemiological, and basic research programs, is increasing knowledge of immediate and long-term effects of drug use during pregnancy. NIDA grantees and others are designing and evaluating therapeutic programs to help mothers and their children overcome the harm caused by drugs.
Substance abuse during pregnancy can have a negative force on the health and wellness of not only the fetus, but that of the mother. The harmful effects of medications, alcohol and illegal drugs on an unborn child can be devastating and can have significant consequences to its use. Sometimes the effects can be faced and treated, and other times the outcome is a lifelong challenge. During the prenatal period, it is important that new mothers are informed of the different types of abuse, how they may affect the fetus, and the adverse conditions their child may be faced with before and after birth.
Signs of withdrawal in a NAS baby usually begin between 24 and 48 hours of life, but the sigs of withdrawal peak between 34 and 50 hours of life. Symptoms of withdrawal include crying excessively at a notably high pitch, sleepiness, hyperactive reflexes, tremors, increased muscle tone, excoriation, sweating, fever, mottling, nasal stuffiness and flaring, tachypnea, poor feeding, regurgitation, projectile vomiting, and seizures. Withdrawal is managed first nonpharmicologically (reduce external stimuli- dim lighting, quiet, tight swaddling), then with opioids until the baby is stable enough to begin to be tapered off of the opioids. The course of withdrawal can take anywhere between 4-6 weeks. A lot of information was concluded about the behavior and cognitive abilities being at risk in children of NAS than those without. However self esteem was not apparent in the
In medical school/pharmacology school, medical professionals are taught to treat severe pain with opioids. However, opioids should be prescribed with the possibility of future dependency in mind. Physicians often struggle with whether they should prescribe opioids or seek alternative methodologies. This ethical impasse has led may medical professionals to prescribe opioids out of sympathy, without regard for the possibility of addiction (Clarke). As previously stated, a way to address this is use alternative methods so that physicians will become more acquainted to not not treating pain by means of opioid
Drug abuse can be harmful due to the fact that the placenta connect the mother to the child. Therefore, everything the mother take in her body will be shared with the growing child. If the mother uses a drug the child will be affected by it. At this stage, the baby (fetus) is very delicate to drugs and cannot remove drugs successfully as the mother is able to. Consequently, all the chemical can pile up to very extreme levels in the child’s system and can also cause damages that will last a lifetime. The effect of perinatal drugs use are influenced by the stage of development of the ...
All drugs, legal or illegal, are considered to be harmful to the fetus and should be taken with caution and under the doctor’s direct orders only. Drugs can be anything as simple as a cigarette to a major substance like heroin and cocaine. Most mothers who do drugs during their pregnancy don’t think about the detrimental effects they could be causing to their baby. Any amount of these forbidden substances can leave an everlasting effect on the precious defenseless baby. Most women know that when you are pregnant your hormones vary greatly, but when a woman is pregnant it also ...
Understanding this problem begins with education about the type of drugs being abused. Opiates, or opioids, are a type of drug that relieves pain. Painkillers interact with nerve endings in the brain, stopping them from sending the message to your brain that you are in pain. Taking this medication results in lose of pain and a temporary high. If a patient takes pain pills for too long, they can begin to form a tolerance to lower doses, causing the physician to have to continually raise the amount being put into their bodies. After extended use, opiates can cause iatrogenic addiction, “most likely to occur with long-term use and/or high does of a prescription drug” (Kendal1 l75). Even though opiates have been used to treat pain in the medical field for years, research is indicating negative side effects. Some of these, interesting enou...
“I brought you into this world, and I can take you out!” A child has most likely heard that phrase at some point in their life. Although, it is not ethical or legal for a mother to “take her kid out of this world”, it does bring up a good point that it was through her body, that the child was born. One of the most important responsibilities in this world is a mother carrying a child in the womb. There are many divine processes that take place during gestation, but there are also many contributing factors from the mother that can affect the developing human. These factors may include what a woman ingests and exposes her embryo or fetus to. Sadly, alcohol use during pregnancy is an ongoing problem that can have detrimental affects on the fetus, including Fetal Alcohol Syndrome (FAS). Choosing to drink alcoholic beverages during pregnancy is a choice, a risky choice. Unfortunately some women don’t even know they are making a risky choice by consuming alcohol because it is in the early stages of pregnancy. It is common for a female to not find out they are pregnant until at least the fifth or sixth week after fertilization. In 2006, 49% of all pregnancies in the United States were reported unintended on a national survey.1 The highest rate of preventable birth defects and mental retardation is due to alcohol use.2 In this paper, I will further discuss FAS, the potential effects of binge drinking during the embryonic stage of gestation, and what actions need to be taken in order to reduce the incidences of alcohol related birth defects.
Aranella, Cheryl, MD., M.P.H. Use of Opiates to Manage Pain in the Seriously and Terminally Ill Patient. American Hospice Foundation, 2006. Web. 7 November 2011.
Chambers, C. D., Polifka, J. E., & Friedman, J. M. (2008). Drug safety in pregnant women and their babies: ignorance not bliss. Clinical Pharmacology & Therapeutics, 83(1), 181-183.
This essay covers information over the course of prenatal development. I will also discuss teratology and hazards to the prenatal development, those such as, caffeine, alcohol, nicotine, cocaine, marijuana, heroin, and opioids. Additionally, I will discuss how maternal factors such as maternal diet and nutrition, maternal age, emotional states and stress, and paternal factors, may influence prenatal development.