Opioid use disorder and pregnancy

July 28, 2021

Opioids are a class of drugs used to reduce pain. They affect the body’s nervous system. Opioids release chemicals in the brain that make you feel pleasure and pain relief. Sometimes they are prescribed by a health care provider for pain relief, and sometimes they are taken illegally as street drugs.

Types of opioids include:

Prescription opioids. These medicines can be prescribed by providers to treat intense pain, such as after an injury or surgery. Examples include oxycodone (OxyContin), hydrocodone (Vicodin), morphine and methadone.

Fentanyl. This is a synthetic opioid that is much more powerful than other opioids. It can be prescribed by a provider for severe pain, such as for patients with advanced cancer. But fentanyl is sometimes made illegally as a street drug.

Heroin. This is an illegal opioid. Every day, nearly 40 people in the U.S. die from an overdose involving heroin.

What is an opioid use disorder?

Most people who take prescription opioids can stop using them without getting addicted to them. But repeated opioid use can cause changes in your brain and a powerful urge to continue using opioids, which can make you dependent on them. This can happen when you take opioids as street drugs, when you use prescription opioids in a different way than your provider directed, or even when you use them as directed by your provider.

Opioid use disorder is a pattern of opioid use that makes it hard for you to stop using them, even when it causes problems in your life. You may have an opioid use disorder if you:

  • Take more opioids than your provider says you can take
  • Have cravings (a strong desire) for opioids
  • Feel like you can’t stop taking opioids
  • Need more opioids to get the same effect
  • Have problems at home, work or school caused by taking opioids
  • Spend time and effort trying to get opioids
  • Feel sick when you stop using opioids or reduce the amount you take

Opioid use disorder is a chronic disease. It can be treated by a provider to help you regain control of your health and your life.

Opioid use and pregnancy

Opioid use disorder during pregnancy can cause serious problems for you and your baby. It can even cause death in a pregnant person. If you have an opioid use disorder, you may have trouble taking care of yourself during pregnancy. Opioid use disorder may also increase the risk of problems such as:

Should you avoid opioids if you can get pregnant?

Many pregnancies are unplanned. So if you are taking opioids, they could affect your baby before you even know you are pregnant. Talk to your provider if you’re taking opioids and can get pregnant. Your provider may want to discuss safer medication options, or treatment if you have an opioid use disorder. You can also talk to your provider about contraception options to help avoid unplanned pregnancy when using opioids.

What if you’re pregnant and have pain that needs treatment?

Pregnancy shouldn’t be a reason to avoid treating serious pain. The American College of Obstetricians and Gynecologists (ACOG) says that opioids can be safe during pregnancy when taken under a provider’s care, but still may cause NAS. If you’re pregnant or planning a pregnancy and you have pain, talk to your provider about the safest medications and treatments for you. Your provider may try to avoid or limit the use of opioids. If you need to be prescribed opioids during pregnancy, your provider may tell you to use them for the shortest time possible. It’s important to follow your provider’s instructions if you need to take these medications.

How to get help

If you are pregnant or can get pregnant and you think you may have an opioid use disorder, talk to your provider right away. Your provider may prescribe an opioid medication such as methadone or buprenorphine and recommend counseling. When this treatment is managed by your provider, it can help reduce withdrawal symptoms and cravings for opioids. Withdrawal symptoms are very uncomfortable symptoms that can happen when you are taking opioids regularly and then stop. This type of treatment can reduce the risk of relapse (using opioids again) and help you have a healthier pregnancy. It can also help you better care for yourself and your baby.

Don’t stop taking an opioid without talking to your provider first. Quitting suddenly can cause serious problems for your baby.

You can find help and treatment resources by visiting the Substance Abuse and Mental Health Services Administration (SAMSHA) website or by calling the helpline at 1-800-662-HELP (4357).

These support groups can also be helpful for people with opioid use disorder:

Learn more about opioid use during pregnancy