Opioid Use in Pregnancy Has Doubled—Here's What You Need to Know

Opioid use during pregnancy has more than doubled over the past decade, jumping from 0.14% in 2008 to 0.33% in 2020, according to groundbreaking new research from Oregon Health & Science University (OHSU). This alarming trend puts both mothers and babies at significantly higher risk for serious health complications.

The study, published in the Journal of Addiction Medicine, analyzed data from more than 5.5 million patients in California—making it one of the largest population-based studies to examine both maternal and infant health outcomes associated with opioid use in pregnancy over the last decade.

What Health Risks Do Mothers and Babies Face?

Pregnant individuals with opioid-related diagnoses face significantly higher risks for severe, unexpected complications. The research revealed concerning patterns for both mothers and their babies.

For mothers, opioid use during pregnancy increases the risk of several serious complications:

• Hypertension: Dangerous high blood pressure that can lead to life-threatening conditions
• Hemorrhage: Severe bleeding that may require emergency intervention
• Blood Transfusions: The need for emergency blood replacement due to excessive bleeding

Babies born to mothers with opioid-related diagnoses also face substantial health challenges. The study found these infants were at significantly higher risk for admission to neonatal intensive care units (NICUs), respiratory distress, preterm birth, and even death.

Why Are Treatment Barriers Making the Problem Worse?

"Pregnant patients already face a lot of difficulties in accessing care, but individuals with opioid-use disorders face additional barriers," said Dr. Kristin Prewitt, fellow in OHSU's section of addiction medicine and the study's co-author. "Here in Oregon, only one in four residential treatment programs offer care for pregnant persons, and some counties have no obstetric care or addiction care resources available at all."

The lack of accessible treatment creates a dangerous cycle. Many people using opioids during pregnancy hesitate to seek help due to fear of judgment, which delays critical care that could improve outcomes for both mother and baby.

"Sadly, we know many people who are using opioids while pregnant hesitate to ask for help due to the fear of judgement, and we hope to see that change," explained Dr. Jamie Lo, associate professor of obstetrics and gynecology at OHSU and the study's lead author.

What Solutions Are Being Developed?

Researchers emphasize that addressing this crisis requires a complete overhaul of how care is delivered. Instead of seeing individual providers, patients need a whole-health approach that includes addiction medicine, primary care, and pediatric health providers working together.

Oregon is already taking steps to improve care. The Oregon Perinatal Collaborative and their partner, Comagine Health, recently received long-term funding to enhance substance-use care delivery for pregnant people in both inpatient and outpatient settings. Starting this year, health systems across the state can partner with the collaborative to address care gaps and create solutions that better serve complex family needs.

Meanwhile, other states are seeing mixed results in maternal health improvements. Kansas recently received a slightly improved grade on the March of Dimes' annual maternal and infant health report card, with better scores for preterm births, infant mortality, and adequate prenatal care. However, the state still faces significant challenges, particularly severe maternal morbidity and maternal mortality rates, which actually worsened.

The research team hopes their findings will contribute to important conversations about addiction and maternal healthcare, ultimately helping create changes that improve the health and stability of families. As Dr. Prewitt noted, "Here in Oregon, we have a huge problem of family separation due to addiction, and it's because we don't have adequate access to treatment and care."