February 05, 2015
The number of reproductive-age women taking prescription painkillers is on the rise and federal health officials are warning of potential birth defects.
A study released by the Centers of Disease Control (CDC) found that one-third of women, aged 15 to 44, on private insurance received an opioid pain medication between 2008 and 2012. More than one-quarter of women in the same age range on Medicaid received an opiod. Commonly prescribed drugs in this category include oxycodone, hydrocodone and codeine, and are intended to treat severe pain, according to the U.S. National Library of Medicine.
“The woman has developed, often when they become addicted, a relationship to the drug that’s more important than a relationship with anyone else, including the baby.” -- Dr. Ken Thompson, medical director, Caron Treatment Centers
Though specific data is not available regarding the number of pregnant women using or abusing opioid drugs, named so for their derivation from or synthetic reproduction of opium poppy resin, the CDC says many women on the drugs may not be aware of their pregnancy in its early stages.
“Many women of reproductive age are taking these medicines and may not know they are pregnant and therefore may be unknowingly exposing their unborn child,” CDC Director Tom Frieden said, adding that use while carrying a child can result in birth defects, including congenital heart defects and neonatal abstinence syndrome (NAS), wherein the baby becomes addicted to the drug along with the mother.
Dr. Ken Thompson, medical director of the Reading, Pa.-area Caron Treatment Centers, said a newborn going through withdrawal symptoms as a result of NAS “tugs on the heartstrings.”
“The woman has developed, often when they become addicted, a relationship to the drug that’s more important than a relationship with anyone else, including the baby,” Thompson said. “The baby can really feel a detachment from mom.”
Though the CDC indicates a rise among women using prescription pain pills, Thompson said this trend parallels the increased use of opiates in everybody - from adolescents to adults, across gender, racial and income lines.
“Women who are of childbearing age aren’t necessarily protected in any way,” he said.
Indeed, the widespread use of prescription pills has grown to “epidemic proportions,” Thompson said.
The Drug Enforcement Agency (DEA) estimates almost 7 million Americans abuse controlled-substance prescription painkillers. Between 2004 and 2009, the number of ER visits linked to nonmedical use of prescription pain relievers doubled. By 2012, drug overdose was the leading cause of injury death, taking the No. 1 spot over motor-vehicle accidents. And as of 2014, most overdose deaths in the United States were not caused by cocaine or heroin, but by opioid painkillers.
Epidemic proportions, indeed.
In the last two decades, rate of death by opioid overdose has increased by 470 percent in Pennsylvania, rising from 2.7 to 15.4 per thousand from 1990 to 2011. Philadelphia nearly doubles the statewide average of death from accidental overdose, as well, according to a 2014 report prepared by The Center for Rural Pennsylvania.
Thompson has been working with Caron for the last seven years, and in the addiction-medicine field for more than 20. He said the treatment center has seen a “significant increase” of patients seeking treatment for prescription-pill addiction, especially among those ages 19 to 25.
He attributes this fatal escalation to, namely, a collective consciousness. He says that, unlike other countries around the world, there’s a “general philosophy” in the United States that people shouldn’t be in pain, and that doctors need to medicate pain.
Constituting less than 5 percent of the world’s population, Americans consume nearly all - 99 percent - of the global hydrocodone supply, and 80 percent of the global opioid supply.
“We’re the biggest users of it,” Thompson said. “That’s how we’re taught, permissiveness.”
Thompson blames the medical field for the resurgence of opioid addiction, too. Many doctors’ income is based off productivity; writing a prescription both pleases the patient by quickly alleviating pain and takes significantly less time than diagnosing the underlying causes of intense pain, which Thompson said is often tied to psychological or spiritual malaise.
“For the women, the issue is people are underestimating some of the risks of giving a fertile person an opiate who becomes pregnant,” he said.
Much like the causes behind this growing epidemic are multifaceted and interdisciplinary, so are the solutions. While state and federal agencies have thrown legislation and incarceration in the face of addicts, professionals in the addiction field agree that taking away a drug doesn’t take away the need for a drug. Rather, a well-rounded attack, including psychological treatment addressing the root causes of addiction, education and legislation would better eliminate the epidemic.
But for women, deliverance may be farther off. Though more women are seeking comfort in the drug, closing the gender gap among users, fewer women seek treatment than men.
“Women tend to have the task of taking care of children as single moms, and therefore makes them less likely to want to leave the children...” Thompson said. “...even though they may have a severe addiction, and the addiction has become overtly more important than the children.”