Opioid Use in Pregnancy

According to the research, the prevalence of low back and pelvic pain during pregnancy ranges from 68 to 72% and is an indication (for most physicians) for the prescription of opioids. Also reported was muscle pain, joint pain, and migraine. Research shows that Americans consume more than 99% of the world’s hydrocodone AND the use of opioids during pregnancy has increased in the last decade!

 

So what are opioids? Well, they are a type of prescription medication used in pain control. You may have heard of names like: Oxycodone (OxyContin®, Percoset®), Hydrocodone and codeine (Vicodin®), Fentanyl (Actiq®, Druagesic®, Sublimaze®), Morphine (Kadian®, Avinza®), Tramadol (ConZip®, Ryzolt®, Ultram®) or Methadone.

Most prescription opioids are currently classified by the Food and Drug Administration under category C for use in pregnancy, indicating evidence of potential harm to the fetus from animal studies AND THE ABSENCE of well-controlled human studies. One exception is oxycodone, which is currently classified in category B, indicating no evidence of harm to the fetus from animal studies and the absence of well-controlled human studies. Please note that none of these drugs have been tested on anything other than animals…

Side effects: altered fetal growth, low birth weights, pre-term labor, neonatal withdrawal or dependency,

An article published in 2017 by Medscape stated, “Opioid use during pregnancy has escalated, in parallel with the opioid epidemic in the general population… Medication-assisted treatment remains the preferred treatment because withdrawal is associated with high relapse rates and poorer outcomes.”

NOW… we all know that new moms may battle with lack of sleep, increased anxiety, post partum depression, pain due to the child birth process as well as the general changes associated with dealing with a new baby at home AND it has been stated that: “Women with opioid use disorder are dealing with all those things in addition to the challenges of their addiction, which — without treatment and support — can often lead to relapse.”

So what is the purpose of this post? You may ask. This conversation is way to deep to even scratch the surface with a blog post but it brings up a very interesting topic regarding changes in society and the use of medication as a solution regarding pain. What is pain? In an article by world renowned clinical scientist, Lorimer Mosley, written in 2016,  “Pain scientists are reasonably agreed that pain is an unpleasant feeling in our body that makes us want to stop and change our behavior. We now think of pain as a complex and highly sophisticated protective mechanism…Pain is only one mechanism by which we are protected.”

That being said, medication is NOT the only way. It may be a seemingly quick solution, but a temporary one and one that can have negative long term consequences, not only including addiction but including negative effects on other systems within our bodies.

What we need to do is look at pain differently. Change certain behaviors, including movement behaviors and begin to adopt new strategies within our lives so that we can continue to function whether it be for work, play, socializing, or just performing daily tasks. In some cases this may be simple. In others, especially those where persons have not engaged in much movement or activity for long periods, it may not be, but we owe it to ourselves to to try.

Most of you reading this have a vehicle. You perform the necessary maintenance to ensure that your money lasts. That your vehicle will endure and continue to ensure you and your family’s safety when in it. The same way that we maintain a vehicle we need to maintain our bodies. We only get one! Our nutrition, our activities, our life in general needs to be such that this machine we have called a body can endure as well.

So while there is definitely a place for medicine, let’s seek to move more, move better and enjoy moving, both for ourselves and our loved ones. For the moms reading this who may be in pain, there are solutions that can be utilized to address your mobility issues, whether this is during your pregnancy or after. Whether it is carrying the baby during pregnancy or after, carrying those car seats and strollers or bending over to lace those babies in those cribs. Let’s get you moving today!

Reference:
1. UT Southwestern Medical Center: An honest discussion about opioid use and pregnancy. March 28, 2017 by Robyn Horsager-Boehrer, MD
2. Guidelines on Opioid Use in Pregnancy Released by ACOG – Medscape – Jul 25, 2017.
3. Obstet Gynecol. Published online July 25, 2017. Abstract
4. Journal of Pediartic Genetics. 2015 June; 4(2): 56-70. Prescription Opioids in Pregnancy and Birth Outcomes: A review of the Literature. Mahsa M. Yazdy, Rishi J. Desai and Susan B. Brogly

 

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