Opioid Use in Pregnancy Dangerous and Understudied

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Nora Volkow, the director of the National Institute on Drug Abuse (NIDA), authored an editorial for BMJ this month warning that the opioid abuse epidemic could have dangerous consequences for pregnant women. While the effects of opioid exposure on the developing brain are yet unknown, research suggests that infants may suffer from withdrawal syndrome, nervous system defects, and impaired attachment with the mother.

“The steep increase in the number of opioid prescriptions dispensed in the United States has been associated with a parallel rise in their misuse, fatal overdoses, and heroin use.”

pregnant womanRecent studies reveal that there has been a substantial increase in the number of babies born in the US suffering from drug withdrawal, or neonatal abstinence syndrome (NAS). “In the US, between 2000 and 2009, the incidence of NAS increased from 1.20 to 3.39 per 1000 live births, and between 2004 and 2013 the total percentage of days spent in intensive care because of NAS increased from 0.6% to 4.0%.

Volkow suggests that the reported increase in NAS is likely a consequence of the opioid abuse epidemic and the increasing prescription of opioids nationwide. She points out that between fourteen and twenty-two percent of women receive an opioid prescription while they are pregnant.

While there is currently not enough research on the effects of opioid on fetal development, Volkow points out that current research being done on rodents suggests that exposure is linked to defects in the central nervous system and that the disruption of the natural opioid system can disrupt the attachment between the mother and baby.

“The lack of scientific information on the effects of opioids on fetal brain development, combined with their known association with NAS, indicates that opioids should be reserved for pregnant women with severe pain that cannot be controlled through more benign means, and ideally limited to a short-term use.”

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Volkow, N. D. (2016). Opioids in pregnancy. BMJ352, i19. (Full Text)

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Justin Karter
Justin M. Karter, PhD, leads research news coverage and editorial strategy at Mad in America. He is the Acting Program Director of the PsyD in Clinical Psychology & Psychological Humanities at Boston College and part-time faculty with the Center for Psychological Humanities & Ethics. His scholarship examines historical and cultural formations of mind, subjectivity, and personhood; the roles of activist movements and lived-experience communities, including the consumer/survivor/ex-patient (C/S/X) tradition; and how mental health discourses shape institutions, practices, and identities. He works across mad studies, critical psychology, philosophy of psychology, and rights-based global mental health. Methodologically, he specializes in critical qualitative inquiry and psychotherapy process research grounded in intersubjective and phenomenological approaches. He is the President of APA Division 24 (2025-26) and serves on the Executive Board of Division 32. Previously, he was a Research Officer to the United Nations Special Rapporteur on the Right to Health. He earned his PhD in Counseling Psychology at the University of Massachusetts Boston, where his dissertation examined psychosocial disability advocacy in the global mental health movement. He also holds graduate degrees in Journalism and Community Psychology from Point Park University.

3 COMMENTS

  1. All I know is that when I looked at Nora Volkow’s fMRIs of the brains of meth addicts they looked identical to the brain scans of children on ADHD drugs.

    Anyway what the heck medical science, opium has been around for thousands of years and the effects on children of mothers using the stuff wile pregnant is unknown ??

    I don’t believe that.

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    • I know opium is a dangerous, mind altering, and addictive drug, have since I was a child. So I agree, it’s absurd the doctors don’t know this. And to be handing opioids out under different names, to trick patients into taking them, while calling them “safe,” is quite disingenuous. One does get to the point one wonders just how incredibly stupid, or unethical, today’s doctors can get. And to be handing them out to pregnant mothers is downright criminal, IMHO.

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