Recently the U.S. Surgeon General sent a letter to all doctors in the U.S. to enlist their assistance in solving an urgent health care crisis facing our country, the opioid addiction epidemic.
North Carolina has experienced a sharp rise in opioid use (prescription opioids and heroin), including among women of childbearing age. One result of this increased use is an increase in newborns being treated for neonatal abstinence syndrome (NAS) as a consequence of their opioid exposure in utero and subsequent withdrawal symptoms. North Carolina has experienced a 511% increase of NAS. When a pregnant woman has an opioid use disorder, the best outcomes for mother and infant are achieved when the mother is involved in a comprehensive medication-assisted treatment program, such as methadone or buprenorphine.
There are different experiences that lead to opioid exposed pregnancies. These include: women who are in active addiction who may or may not be receiving her opioids through medical means; women in recovery who are enrolled in a medication assisted treatment program receiving methadone or buprenorphine, taking as prescribed; and women who experience chronic pain and are taking opioids as prescribed. Each of these groups of women comes into contact with many professionals who often have misinformation or no information about opioids, pregnancy, and best practices in addressing the convergence of the two.
North Carolina is fortunate to have the NC Pregnancy & Opioid Exposure Project (NCPOEP) to help provide guidance and information on the subject. NCPOEP developed the document–Pregnancy and Opioid Exposure: Guidance for North Carolina. This comprehensive document is designed for diverse professionals who serve women and their families and need information on the topic of pregnancy and opioid exposure. This resource and other information can be found at the NCPOEP website. This site provides access to information tailored for women seeking information about their pregnancy, specific guidance information for professionals working with women and their children, and a wealth of information regarding resources.
Jones., H.,Finnegan, L., Kaltenbach, K. (2012). Methadone and buprenorphine for the management of opioid dependence in pregnancy. Drugs, 72(6):747-57.
Modarai., F. (2013). Relationship of opioid prescription sales and overdoses, North Carolina. Drug Alcohol Depend. Sep 1;132(1-2):81-6.
North Carolina State Center for Health Statistics. (2014). Injury epidemiology and surveillance unit: Analysis of data of infants diagnosed with drug withdrawal from 2004 to 2012.