Analysis of Surge in Narcotic Prescriptions for Pregnant Women

The use of heroin, cocaine, and other illicit drugs has become a public health concern especially during pregnancy. Maternal substance abuse has become an issue during the crack epidemic in the 1980’s; however, there is an alarm rate of infants born addicted to heroin. More than 3.7% women have indicated the uses some form of illicit drugs during their pregnancy, as well as 1.9 % reports binge drinking (Bhuvaneswar el at., 2008; Grant el at., 2009). With this in mind, more than 375,000 infants are born to maternal substance abusers each year costing over $100,000 in medical expenses covered by the state (Reitman, 2002).

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.

Through the years, substance misuse in the United States has turned into an industrious issue influencing numerous people. In 2008, it was assessed that 17.8 million Americans beyond 18 years old where substance subordinate. Women who use medications during pregnancy can have an enduring impact on fetal. Medications can have an impact of maternal and child wellbeing, yet there are a lot of different variables, which influence it, poor social environment, nourishment, cleanliness, and sexual abuse. Regenerative interruption connected with heroin utilization has been shown in both and women and even low dosages of opiates can impede ordinary ovarian capacity and ovulation. The harm that goes hand in hand with substance utilization comes either straightforwardly from the impact of the medication itself or from issues identified with development and/or unexpected labor. The entanglements of jumbling components clamorous way of life, poor nourishment, liquor utilization and cigarette smoking influence the appraisal of the impacts of cocaine in pregnancy. In obstetric practice, 100% of pregnant women utilizing cocaine or heroin are cigarette smokers. Cigarette smoking is presumably the most well known manifestation of substance utilizes and is noteworthy corresponding considering ladies who use unlawful medications. Babies whose moms smoked in pregnancy have a tendency to have lower conception weights and diminished length, cranial and thoracic

When a woman uses heroin while pregnant, her baby is at risk for many challenging effects that will ultimately follow him or her as they grow into an adult. As heroin enters a mother’s system, the drug crosses into the child through the placenta (“Heroin Addiction”, n.d.). While a baby is in utero, a mother’s substance abuse can cause a fetus to grow at a slower rate, lead to the rupturing of the membranes surrounding the baby that results in premature labor, and cause a possible stillbirth, which means the fetus dies in the womb (“An Overview of Heroin”, n.d.). Substance abuse can also cause the placenta to separate from the uterine wall leading to dangerous heavy bleeding, which is a threat to both mother and child (“Heroin and Pregnancy,” 2015). Along with possible placenta abruption, the use of heroin can lead to the intrauterine passage of meconium (“Opioid Abuse,” 2012). After labor and delivery, the effects

Methadone maintenance therapy is the primary go to source for addicts looking to quit the street drug, heroin. Methadone on it's own has its own number of controversies within society. However add on the fact that a number of patients that attend the meth clinic that is pregnant, well this can add additional controversy and raise ethical implications as well. Ultimately the child is better off when not being subjected to harmful substances such as drugs an alcohol. However when given the choice of heroin or methadone, we will examine what the benefits of methadone maintenance therapy can provide the mother, and the fetus. Methadone clinics provide a safe form of the drug with clean needles which helps cut the spread of HIV/AIDS among the population. While the client is at the clinic it is a good time to reach out and provide the future mother with resources that may help her once her child is born. Clinicians can also take advantage of this meeting time to reach out to the mother and inform her on the benefits of attending a treatment facility to help achieve sobriety.

The National Health Institute (NIH) explains that addictive drugs such as amphetamines, cocaine, barbiturates, diazepam, and opiates consumed during pregnancy pass from mother to the fetus by crossing the placenta. This causes the baby to become addicted to these drugs along with the mother. Once born, the newborn no longer receives these drugs which then results in NAS (“Neonatal abstinence syndrome”, 2012a).

Morris, M., Seibold, C., & Webber, R. (2012, April). Drugs and having babies: An exploration of how a specialist clinic meets the needs of chemically dependent pregnant women. Midwifery, 28(2), 163-72. Retrieved from http://ebscohost.com.ezproxy.hsc.usf.edu/ehos

The Adoption Encyclopedia “ Estimates of the percentage of pregnant women using cocaine have ranged from 10% to as high as 28% in some areas.” Cocaine is one of the oldest drugs known to man. This is a powerfully addictive stimulant, and is derived from coca leaves, and this drug has been abused for thousands of years. Crack Cocaine's worst damage to the fetus is its effect on the brain. It causes the brain's of both the mother and the fetus to experience the typical surge of dopamine. Since the fetal brain is still in the process of development, it can result in serious psychological addiction, attention deficit disorders, lack of cognitive abilities and developmental problems. Also crack's effects on the fetus result in seizures. Babies that are exposed to crack are at increased risk of birth defects, which include heart deformities. Crack causes an unborn baby to have a stroke or a heart attack. Cocaine abuse by mothers during pregnancy is linked with abnormalities in the development of the heart both before and after birth. Crack Cocaine

al, 2010). By conducting an assessment on patients, the practitioner will be better able to assess for risk factors that could lead to use or abuse of the prescribed opioid. There have been numerous risk factors identified with substance abuse however, this review will look specifically at the risk factors associated with opioid use (CITE). The following risk factors will be reviewed: being prescribed opioids, being diagnosed with a mental health disorder and history of victimization. While this review looks at specific risk factors for opioid addiction, it should be noted that multiple populations have been identified as at risk for opioid addiction, specific populations are as follows: pregnant women, veterans and incarcerated individuals

(2010) explains that although methadone is used for opioid exposure especially during pregnancy, but also is linked to NAS when a fetus is exposed to methadone. With their focus of the effects of NAS on the central nervous system hyperirritability and autonomic nervous system dysfunction Jones et al. also focused on the different effects of methadone versus those of buprenorphine, which has less substantial research. The points of study included number of newborns requiring treatment for NAS, peak score on a NAS scale, amount of morphine given through out treatment, length of hospital stay and the head circumference. Overall they only found significant differences in outcomes for the total morphine required as well as the length of the neonates hospital stay. When exposed to buprenorphine prenatally the newborns required 89% less morphine during treatment and 43% less time in the hospital than those exposed to methadone (Jones et al.,

Opioid addicted babies need treatment in the hospital setting to help them through the withdrawal process. Studies are showing what medications to use to help reduce the length of hospital stay. Today, many neonates stay in the hospital much longer than years past, this is generally due to being born addicted to opioids. The United States is suffering from an epidemic of opioid abuse. When a pregnant mother is addicted to opioids these drugs cross the placenta, causing the neonates to be born addicted. According to Hall et al. (2015), this epidemic can cause opioid misuse, overdose or even death. When looking at the United States from 2005-2011, “more than 14% of pregnant women were dispensed an opioid at some time in their pregnancy”, (Hall, 2015, pg.40). Depending on the length of medication used and timing during the pregnancy will determine how a neonate will withdraw after birth. This withdrawal is becoming a common practice and is known as Neonatal Abstinence Syndrome (NAS). By 2015, this syndrome would affect one neonate in 200 births. Improvements in medications and techniques help neonates get through withdrawal. I have created a PICO to help form this paper. This paper will compare the two medications; Morphine and Buprenorphine are most commonly used to help neonates withdrawing in the

Identification of pregnant women who are addicted to opioids facilitates provision of opioid-assisted therapy with methadone. Maternal nutrition can contribute positively to the delivery of a healthy, full-term newborn of an appropriate weight. The recommended dietary allowances for most vitamins and minerals increase during pregnancy. Therefore, provision of dietary supplements to incarcerated pregnant and breastfeeding women is recommended, as is access to a nutritious diet and timely and regular meals.

In the past 20 years, prescription opioid abuse has been a rapidly growing issue in the United States. This rapid increase in abuse has led to more overdose deaths, and the increase of individuals pursuing treatment for their addiction (Brady, McCauley, & Back, 2013). The rising frequency of maternal opioid abuse affects thousands of mothers and newborns each year. According to the National Institute on Drug abuse, the use of opiates during pregnancy can result in a drug withdrawal syndrome in newborns called neonatal abstinence syndrome (NAS). Almost every drug passes from the mother's bloodstream through the placenta to the fetus. Illicit substances that cause drug dependence and addiction in the mother also cause the fetus

As of now what is known about Opiate drug usage is that pregnant women using this drug give birth to babies with neonatal abstinence syndrome. Babies being born going through withdrawal because the fetus is no longer receives the drug. It was found that neonatal abstinence syndrome is passed when the drug is in the mother's bloodstream which then passes through the placenta into the fetus. Symptoms of neonatal abstinence syndrome in babies vary depending on how much opiate was used during the pregnancy. It includes premature birth, seizures, birth defects, and developmental delays as they grow. Babies who are born full term suffer from tremors, irritability, sleep problems, high-pitched crying, tight muscle tone, poor feeding, dehydration,

Many women, including teens, abuse drugs while they are pregnant. This rate is especially high to those who are homeless, underprivileged, or live in a broken home. In order for drug abusers to even have a chance at beating their addiction they have to have support whether it’s family, friends, or boyfriend/spouse. They must also let the abuser now all the consequences to themselves and the unborn child. There are many consequences when using drugs during pregnancy such as miscarriage, health risks to baby, and health risks to the mother. And learning disabilities and brain damage to the fetus.