Posts Tagged ‘opioids’

Opioids and birth defects–an update

Monday, June 26th, 2017

Prescription opioids are painkillers your health care provider may prescribe if you’ve been injured or had surgery. Prescription opioids include:pills

  • Codeine and hydrocodone (brand name Vicodin®)
  • Fentanyl (brand name Actiq®, Duragesic®, Sublimaze®)
  • Morphine (brand names Kadian®, Avinza®)
  • Oxycodone (OxyContin®, Percocet®)
  • Tramadol (brand names ConZip®, Ryzolt®, Ultram®)

Heroin also is an opioid.

Using opioids during pregnancy can cause problems for your baby, including:

  • Neonatal abstinence syndrome (also called NAS). NAS happens when a baby is exposed to a drug in the womb before birth and goes through withdrawal from the drug after birth. NAS most often is caused when a woman takes opioids during pregnancy. NAS can cause serious problems for a baby, like being born too small and having breathing problems. Even if you use an opioid exactly as your health care provider tells you to, it may cause NAS in your baby.
  • Birth defects.
  • Premature birth.
  • Preterm labor. Quitting opioids suddenly (going cold turkey) during pregnancy can cause preterm labor. Preterm labor can lead to premature birth.
  • Stillbirth.

Recently the CDC’s Treating for Two: Safer Medication Use in Pregnancy researchers reviewed a number of studies that had already been published regarding opioid use during pregnancy and birth defects. They found that the studies did show that using opioids during pregnancy may be linked to birth defects including cleft lip and cleft palate, congenital heart defects, and clubfoot. But many of the studies they looked at had problems with the way the study was done and the quality of the study.

According to the CDC, “More research is needed to understand the connections between individual types of opioids and specific birth defects. Until more is known, women of childbearing age and their healthcare providers should discuss risks and benefits when considering opioid treatment.”

If you are taking a prescription opioid, or any other medication during pregnancy remember:

  • Don’t take more medicine than your health care provider says you can take.
  • Don’t take it with alcohol or other drugs.
  • Don’t use someone else’s prescription medicine.

If you’re pregnant and need help to stop using opioids, taking drugs like methadone or buprenorphine may help you quit. These drugs can help you reduce your need for opioids in a way that’s safe for you and your baby. Talk to your health care provider to see if this kind of treatment is right for you.

If you need help to stop abusing prescription drugs, talk to your health care provider. Or contact:

Have questions? Send them to our Health Education Specialists at AskUs@marchofdimes.org.

Can your meds cause drug withdrawal in your baby?

Friday, May 15th, 2015

pillsNeonatal abstinence syndrome (NAS) is a group of conditions a newborn can have if he’s exposed to addictive street or prescription drugs before birth. If you take drugs during pregnancy, they can pass through the placenta to your baby. After birth, the baby is still dependent on the drug, however, now that the drug is no longer available, the baby experiences drug withdrawal. Today, one of the most common causes of NAS is maternal use or abuse of opioids during pregnancy.

Using these drugs during pregnancy can cause NAS:

• Opioids, including the prescription medicines codeine, hydrocodone (Vicodin®), morphine (Kadian®, Avinza®) and oxycodone (Oxycontin®, Percocet®). The street drug heroin also is an opioid.
• Barbiturates, like phennies, yellow jackets and Amytal®
• Benzodiazepines, like sleeping pills, Valium® and Xanax®

Signs and symptoms of NAS:

• Body shakes (tremors), seizures (convulsions), overactive reflexes (twitching) and tight muscle tone
• Fussiness, excessive crying or having a high-pitched cry
• Poor feeding, poor sucking or slow weight gain
• Breathing fast
• Fever, sweating or blotchy skin
• Trouble sleeping and yawning frequently
• Diarrhea or vomiting  (throwing up)
• Stuffy nose or sneezing

Signs and symptoms of NAS can be different for every baby. Symptoms may appear within a few minutes after birth or as much as two weeks later. NAS can last from 1 week to 6 months after birth.

Testing and treatment:

Your provider can see if your baby has NAS by testing his first bowel movement or urine. Your provider can also use what is called a neonatal abstinence scoring system which gives points for each NAS symptom depending on how severe it is. Treatment can include medicines to manage severe withdrawal symptoms, getting fluids through a needle into the vein, or giving higher-calorie baby formula to newborns that have trouble feeding or slow growth.

How can I prevent NAS?

If you’re pregnant and you use any of the drugs that can cause NAS, tell your health care provider right away. But don’t stop taking the drug without getting treatment from your provider first. Quitting suddenly (sometimes called cold turkey) can cause severe problems for your baby, including death.

If you’re addicted to opioids, medication-assisted treatment (also called MAT) during pregnancy can help your baby. NAS in babies may be easier to treat for babies whose moms get MAT during pregnancy. Medicines used in MAT include methadone and buprenorphine.

Even if you use a prescription drug exactly as your provider tells you to, it may cause NAS in your baby. If you are pregnant or think you may be pregnant, talk to your provider about any drug or medicine you are taking.

Our website has more information on where you can find help.

Have questions? Email us at AskUs@marchofdimes.org.

How can we prevent birth defects?

Friday, January 30th, 2015

speak to your health care providerBirth defects are common, costly, and critical.
Common: Every 4 ½ minutes in the United States, a baby is born with a birth defect.
Costly: Hospital costs for children and adults with birth defects exceeds $2.6 billion. That does not include outpatient expenses.
Critical: Birth defects cause 1 in every 5 deaths during the first year of life. They can result in lifelong challenges and disabilities.

As Birth Defects Prevention Month draws to a close, let’s recap what we know and look at steps that can be taken to prevent them.

Preconception and pregnancy planning
We know that it essential for a woman to take an active role in planning her pregnancy.  If you are thinking of having a baby or if you may want to have children sometime in the future, it is important to make a PACT: plan ahead, avoid harmful substances, choose a healthy lifestyle, and talk to your doctor. You can read more here.

Changing a few behaviors now can make a big difference when you are ready to have a baby. It is best to get any preexisting medical conditions, such as diabetes and high blood pressure, under control before pregnancy. Some medications, such as opioid-based prescription pain medications, are not safe to use when you are pregnant. All of these concerns can be discussed with your doctor during a preconception checkup.

Folic acid fortification
It is well known that taking 400 micrograms of folic acid every day can help to reduce the risk of neural tube defects or NTDs (disorders of the brain and spine). Since the US mandated folic acid fortification of enriched cereal grain products in 1998, the rates of NTDs have decreased by 35%.  That means that there are 1,300 fewer NTDs each year as a result of fortification. And that translates into an annual cost savings of approximately $508 million.

Surveillance
State surveillance systems record the number of babies born with a birth defect each year. The information gained from these surveillance systems furthers research on the causes of birth defects. The data also helps researchers to better understand which populations are at highest risk for specific birth defects. This information can then be used by public health professionals, policymakers, and health care providers to implement prevention strategies.

Research
The March of Dimes is funding research to understand the causes of birth defects and to develop new ways to prevent and treat them. Some March of Dimes grantees are studying basic biological processes of development. A more advanced look at the process of development will help reveal what can go wrong along the way. Others researchers are conducting clinical studies aimed at finding ways to prevent or treat specific birth defects.

Birth Defects Prevention Month may be coming to an end, but there is still a lot of work to do. Go to the National Birth Defects Prevention Network to learn more.

Painkillers and pregnancy don’t mix

Friday, January 23rd, 2015

pregnant2Did you know that a significant number of women of childbearing age fill prescriptions for narcotic painkillers each year? If a woman becomes pregnant while taking these medications, she is at an increased risk of having a baby with birth defects.

Opioid-based (narcotic) pain medications, such as codeine, oxycodone, hydrocodone, or morphine, are used to treat moderate to severe pain. Many women are unaware that the use of these medications during pregnancy, even when used as directed, may increase their chance to have a baby with a serious birth defect of the brain, spine, or heart. They also have an increased risk of preterm birth.  Use of opioid-based painkillers during pregnancy can also cause babies to suffer withdrawal symptoms when they are born. This is a condition known as neonatal abstinence syndrome or NAS, and it is a growing problem in U.S. birthing hospitals.

A new report from the CDC found that on average, about 28% of privately insured and 39% of Medicaid-enrolled women of child-bearing age filled a prescription for an opioid between 2008-2012.

Since half of all pregnancies are unplanned, women may be prescribed opioid-based pain medications before they know they are pregnant.  “This highlights the importance of promoting safer alternative treatments, when available for women of reproductive age. We must do what we can to protect babies from exposure to opioids,” stated Coleen A. Boyle, PhD, MSHyg, Director of CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD).

“If you are using an opioid painkiller, you should also be practicing effective birth control, “ says José F. Cordero, MD, MPH, a pediatrician, birth defects expert formerly at CDC, and member of the March of Dimes Board of Trustees. “If you decide to get pregnant or do become pregnant, tell your health care provider about all the medications you are taking, right away. You may be able to switch to a safer alternative.”

The CDC’s Treating for Two: Safer Medication Use in Pregnancy initiative offers information to women and their healthcare providers about medication use during pregnancy. Go here to get more information.

Pain killers and birth defects

Wednesday, April 13th, 2011

pill-bottlesBabies born to women who take opioid pain killers such as codeine, oxycodone or hydrocodone just before or in early pregnancy are at increased but modest risk of birth defects, according to a study conducted by the Centers for Disease Control and Prevention.

The study, recently published in the American Journal of Obstetrics and Gynecology, found 2-3 percent of mothers interviewed were treated with prescription opioid pain killers, or analgesics, just before or during early pregnancy. (The study did not examine illicit use of these medications.)

The most commonly used opioid meds reported by women were codeine and hydrocodone. Treatment with these pain killers was linked to several types of congenital heart defects as well as spina bifida, hydrocephaly, congenital glaucoma and gastroschisis, an abdominal wall defect. (The findings with some congenital heart defects also appeared in previous studies.) This study found that women who took prescription opioid medications just before or during early pregnancy had about two times the risk for having a baby with hypoplastic left heart syndrome (one of the most critical heart defects) as women who were not treated with them.

Congenital heart defects are the most common type of birth defect, affecting nearly 40,000 births in the United States each year. Many infants with congenital heart defects die in the first year of life, and infants who survive often require many surgeries, lengthy hospitalizations and a lifetime of treatment for related disabilities.

The studies lead author, Dr. Charyl S. Boussard, said , “It’s important to acknowledge that although there is an increased risk for some types of major birth defects from an exposure to opioid analgesics, that absolute risk for any individual woman is relatively modest. However, with very serious and life threatening birth defects like hypoplastic left heart syndrome, the prevention of even a small number of cases is very important.”

For more information on this study, click here.  Always talk with your health care provider if you are pregnant or planning a pregnancy and you have taken or are considering taking any medication, whether prescription, over-the-counter or herbal.