Substance-abuse
Issue Background

Substance Use Disorders in Pregnancy

Update: In response to the opioid epidemic, Congress passed and President Obama signed into law the Comprehensive Addiction Recovery Act (CARA).  CARA is a sweeping law that, among other things, will allow nurse practitioners and physician assistants to prescribe buprenorphine for opioid addiction. AWHONN has long supported this policy change and applauds lawmakers for including it in CARA. For more information, visit the Coalition to Stop Opioid Overdose, of which AWHONN is a member

A growing number of women in the United States are using prescription or illicit opioids when they realize they are pregnant.  Other women may be prescribed an opioid pain reliever during pregnancy. Prescription opioids are among the most effective medications for the treatment of pain. However, regular or long term use of opioids can lead to physical dependence and in some cases, addiction. In utero exposure to opioids can cause the newborn to experience withdrawal symptoms after birth ranging from blotchy skin and sneezing, to respiratory complications, low birth weight, prematurity, feeding difficulties, extreme irritability, and seizures.

In utero exposure to opioids can cause the newborn to experience withdrawal symptoms after birth ranging from blotchy skin and sneezing, to respiratory complications, low birth weight, prematurity, feeding difficulties, extreme irritability, and seizures. While the rate of NAS nearly tripled between 2000 and 2009, there are many gaps in knowledge regarding what medications are safe during pregnancy and best practices for the treatment of both substance use disorders and NAS.