Amphetamine and Opioid Use Among Expectant Mothers in the U.S. on the Rise

According to the findings of a study (https://ajph.aphapublications.org/doi/10.2105/AJPH.2018.304771) published in the American Journal of Public Health, the number of expectant mothers using amphetamines, particularly methamphetamine, and opioids has increased significantly in the United States over the past ten years. The results were found after the researchers analyzed and estimated the frequency of hospital deliveries related to amphetamine or opioid using the data from the National Inpatient Sample.

Amphetamine (https://pubchem.ncbi.nlm.nih.gov/compound/amphetamine#section=Top) is a powerful stimulant drug that affects the central nervous system. It is a commonly abused substance because of its pleasurable effects such as increased concentration and wakefulness, improved physical performance, and a general feeling of well-being. Opioids (https://www.drugabuse.gov/drugs-abuse/opioids), on the other hand, include drugs that are legally prescribed for pain relief, such as hydrocodone and morphine, as well as illegal drugs like heroin and other synthetic opioids.

Re: https://pixabay.com/photos/woman-pregnant-mother-female-belly-1209322/

Amphetamine and Opioid Use-Related Births

This study, which aims to assess amphetamine and opioid-related hospital deliveries in terms of incidence, clinical outcomes, and costs, scrutinized more than 47 million hospital deliveries in various hospitals all over the U.S. and found that:

• The number of newborns exposed to amphetamines doubled across the U.S. --- from 1.2 babies for each 1,000 hospital deliveries in 2008 to 2009 to 2.4 babies for each 1,000 hospital deliveries in 2014 to 2015. It is important to note that toward the end of the research period, the highest incidence of amphetamine-related hospital deliveries was in the rural West with 11.2 newborns per 1,000 were exposed to the potent stimulant drug amphetamine.

• With regard to opioid-related hospital births, the researchers found that the number of expectant mothers who were using opioid increased fourfold nationwide – from 1.5 babies for each 1,000 hospital deliveries, in 2004 to 2005, to 6.5 babies for each 1,000 hospital deliveries, in 2014 to 2015. By the culmination of the study, the highest incidence of opioid-related hospital deliveries was once again in the rural part of the country, although it is the rural Northeast this time, where 28.7 newborns per 1,000 were exposed to opioids.

From the total number of hospital births analyzed, approximately 82,254 hospital deliveries were related to the use of amphetamine drug. The number of hospital deliveries that are connected to the use of opioid, however, was about 170,164 births. Most of the expectant mothers who are drug users came from lower-income communities and relied on public health programs such as Medicaid.

Effects of Amphetamine and Opioid Use During Pregnancy

It is a well-known fact that the use of recreational drugs such as amphetamine and opioids cause harmful effects to expectant mothers and their babies. For instance, amphetamine use during pregnancy has been known to cause the following effects:

• Narrowing of the blood vessels that significantly reduces blood flow
• Miscarriage
• Early labor
• Antepartum bleeding conditions
• Fetal abnormalities
• Reduced growth and head circumference of the unborn baby
• Altered brain structure and development of the unborn baby

Opioid use during pregnancy may lead to serious consequences such as the following:

• Placental abruption
• Preterm labor
• Intrauterine passage of meconium
• Fetal growth restriction

In addition to available medical evidence and findings on amphetamine and opioid use during pregnancy, the proponents of the study discussed in this piece discovered that pregnant women who use amphetamine are 1.6 times more likely to suffer from serious maternal complications than expectant mothers who are opioid users.

Their analysis also revealed that certain pregnancy issues such as the following are more prevalent among pregnant women who use amphetamine than those who use opioids:

• Preterm deliveries
• Dangerously high blood pressure (Preeclampsia)
• Heart attacks
• Heart failure
• Blood transfusions
• Maternal morbidity and death

The researchers also noted that while the harmful effects of opioid use can be addressed by appropriate interventions (https://journals.lww.com/journaladdictionmedicine/Fulltext/2017/06000/Treating_Women_Who_Are_Pregnant_and_Parenting_for.4.aspx), there is currently no known treatment that can stop the effects of amphetamines.

Cost of Hospital Delivery Related to Amphetamines and Opioids

As regards, cost of hospital delivery, analysis of the data showed that expectant mothers who use amphetamine or opioid incur higher hospital delivery cost than other hospital deliveries. The average cost for delivery hospitalization among expectant mothers who are amphetamine users is $5,700, while the cost for pregnant women who use opioids is $5,400. Note that the delivery hospitalization cost for other hospital deliveries is at $4,600, which is 20 percent to 15 percent lower.

Takeaway

While the study is limited in the sense that it cannot establish whether or how the use of drugs can directly affect clinical outcomes or costs of care for the mothers or their newborns, its findings are crucial in recognizing the extent of the drug problem and its impact on maternal and child health in the country. Note that in the past couple of years, the majority of the attention and government efforts have been focused on addressing alcohol and opioid use (https://www.researchgate.net/publication/313863928_A_Public_Health_Response_to_Opioid_Use_in_Pregnancy) in pregnancy while practically disregarding other types of substance use.

Given these recent findings, concerned authorities are now alerted that both amphetamine and opioid are rising public health issues and that there is a need to effectively respond to the following challenges (https://ihpi.umich.edu/news/study-rise-meth-and-opioid-use-during-pregnancy):

Finding treatment to specifically address prenatal amphetamine use;

• Promotion of treatment for amphetamine use disorder similar to the existing highly reliable medical treatment for opioid use among pregnant women;

• Deterring access to precursor drugs that are utilized to make meth;

• Improving access to addiction treatment programs and services while at the same time curbing access to amphetamines particularly in the rural areas;

• Revisiting laws tend to discourage pregnant women from seeking professional help with their drug use problem (e.g. laws that criminalize drug use among expectant mothers);

• Improving the capacity of neonatal intensive care units in rural areas to better care for newborns exposed to amphetamines, opioids, and other drugs;

• Giving more resources to allow low-income and rural communities to create programs that will prevent and treat drug use during pregnancy; and

• Creating a universal screening process that can detect substance use even during early pregnancy.

Essentially, this recent study has revealed that there are still numerous areas in the fight against substance use disorder, particularly among pregnant women who are living in rural areas, that need to be addressed. Immediate action to the abovementioned challenges is significant in improving outcomes for expectant mothers and their babies.

As we at Sunshine Behavioral Health (https://www.sunshinebehavioralhealth.com/) try to keep consumers informed on the Opioid crisis, we will always be here to help.