Many U.S. Women of Child-Bearing Age Use Opioid Painkillers: CDC Warns about Birth Defects
A report released earlier this year by the Centers for Disease Control and Prevention states that close to one-third of all American women of reproductive age got an opioid painkiller prescription filled each year from 2008 to 2012. This is of concern to health authorities because these medicines are known to cause serious birth defects.
The prescriptions were for popular pain-killing medications such as Vicodin, Percocet, OxyContin, Demerol and Dilaudid. (Some of these drugs also include in their formulations the over-the-counter painkiller acetaminophen.)
The CDC reviewed data from health insurance claims for Medicaid and private insurers, for women aged 15 to 44. Some 39 percent of women with Medicaid insurance had filled and opioid prescription each year from 2008 to 2012; 28 percent of women with private insurance had done so.
Opioid painkillers are usually prescribed to treat moderate to severe pain, and they’re also found in some prescription cough medicines. However, using these drugs in early pregnancy (or even just before becoming pregnant) can be dangerous. CDC Director Thomas Frieden, MD, told news media that the drugs pose a sizable risk for birth defects. He added that opioid medicines are quite addictive, as well as deadly for mothers and infants.
The CDC review found that older women tended to fill opioid prescriptions the most: among Medicaid recipients, women 40 to 44 had the highest number of filled prescriptions; among women with private insurance, those between 30 and 34 had the highest number. For both groups, women 15 to 19 had the fewest filled opioid prescriptions.
The review showed that among privately insured women, the highest rates of prescriptions were in the South and the lowest were in the Northeast. A racial breakdown of the Medicaid data showed that Caucasian women were more than one and a half times more likely to get a prescription filled than African American or Hispanic women.
The usage numbers are troubling to health authorities, especially in view of the facts that close to half of all pregnancies are unplanned, and women often don’t know that they’re pregnant in the first weeks after conception.
NBC News interviewed Dr. Neil Seligman, assistant professor of obstetrics and gynecology at the University of Rochester Medical Center in upstate New York. The doctor stated that in his practice, women often don’t come in for their first prenatal care appointment until the late first trimester, or early second trimester. By that time, the baby is no longer susceptible to birth defects, he said.
Seligman added that birth defects can occur when some medications, including opioids, are taken between the 4th and 10th weeks of pregnancy. After that, the concern of pregnant women taking opioids is about the risk of neonatal withdrawal. Meanwhile, a 2014 study found that in 2007, close to one-quarter of pregnant women on Medicaid had filled an opioid prescription.
How often withdrawal symptoms occur in babies of mothers who used prescription opioids during pregnancy is not currently well-known; however, among pregnant women using heroin (an illegal opioid drug not prescribed by doctors), 60 to 70 percent of their newborns require withdrawal treatment for an average of one month, Dr. Seligman said.
In areas where prescription opioids are most heavily used, newborn infants are paying a price. As an example, The New York Times alluded to Scioto County in southeast Ohio, where about 1 in 10 babies is born addicted to prescription opioids.
Possible Birth Defects Caused by Opioid Analgesics
Birth defects associated with prescription opioid painkillers can be serious and even life-threatening. They include the following:
- Major defects in the baby’s brain and spine, such as hydrocephaly (fluid build-up inside the brain) or spina bifida
- Gastroschisis: baby’s intestine, and possibly other abdominal organs like the stomach, come out through a hole in the fetal abdominal wall and skin, and develop on the outside, next to the navel; these organs may be irritated and inflamed, due to ongoing exposure to amniotic fluid
- Heart defects
- Glaucoma
It was not clear from the CDC’s analysis whether or not any of the prescription drugs was being abused; however, Dr. Frieden, the CDC director, added that Americans are “substantially overusing” these drugs.
Prescription Opioids Kill More Americans than Illegal Drugs
As we know, drug abuse is a big problem in the United States. Shockingly, prescription pain medications were responsible for more overdose deaths in the U.S. between 1999 and 2010 than cocaine and heroin combined. The fact is, prescription opioids are the leading cause of overdose fatalities in the country, resulting in more than 16,000 deaths a year. (Sources: CDC, The New York Times.)
Deaths from opioid overdoses have increased more than three times since the late 1990’s, and overdoses among women are rising even faster. We’ve heard plenty about the heroin epidemic and heroin overdoses, which are certainly troubling; but we’ve heard very little, if anything, about overdoses from prescription opioids, where the number of deaths is far greater: CDC statistics show that legal, prescription opioids are killing more than five times the number of Americans that illegal, street heroin kills.
Prescription opiates are being used by Americans from all socioeconomic levels; the fact that the drugs are so addictive leads many users to “shop around” for doctors who will write prescriptions for them, or even to buy them illegally on the street.
Many people who become addicted to prescription opioids, and who can’t get all the pills they want from their doctors, start injecting street heroin, as a replacement. The Washington Post cites the case of the state of Maryland, where health officials reported that in the first 7 months of 2012, a 15 percent reduction in prescription opioid overdoses was accompanied by a 41 percent increase in heroin overdoses.
Symptoms of Opioid Overdose Include:
- Decreased level of consciousness
- Heart rate and breathing slow down or stop
- “Pinpoint” pupils (pupils constrict to an extra-small dot)
- Seizures
- Muscle spasms
- Bluish lips and nail beds from insufficient oxygen in blood
Another class of prescription drugs, benzodiazepines, which are used to treat anxiety or insomnia (brand names: Xanax, Valium, Ativan, Halcion and others), is also responsible for thousands of overdose deaths in the United States every year. Benzodiazepines cause as many fatalities as cocaine and heroin combined, and about a third the number of deaths caused by prescription opioids. (Sources: CDC, Washington Post.)
By Cynthia Sanchez. A graduate of the University of Washington, Cynthia has extensive experience writing about health and wellness topics for different media.