February 4, 2015
CDC: Concerns Raised By High Opioid Use Among Reproductive-Age Women

Atlanta—Although opioid medications have been linked to birth defects and other adverse pregnancy outcomes, use of the painkillers remains high among women aged 15-44 years, according to new research from the CDC.

In fact, more than a fourth of privately insured and more than one-third of Medicaid-enrolled women of childbearing age filled a prescription for an opioid from an outpatient pharmacy each year from 2008 to 2012, according to the CDC. The agency is calling for “more targeted interventions and communications strategies to reduce unnecessary prescribing and use of opioid-containing medications, particularly among women who might become pregnant.”

The first few weeks of pregnancy are a critical period for organ formation and for development of birth defects, according to the article published recently in the Morbidity and Mortality Weekly Report. Opioid exposure in pregnancy can increase risk for adverse pregnancy outcomes, including neonatal abstinence syndrome and birth defects such as neural tube defects, gastroschisis, and congenital heart defects.

“Given that many pregnancies are not recognized until well after the first few weeks and half of all U.S. pregnancies are unplanned, all women who might become pregnant are at risk,” according to the researchers from the CDC’s Division of Birth Defects and Developmental Disabilities.

“This is a significant public health concern given evidence of adverse pregnancy outcomes with opioid exposure, the likelihood of exposures occurring among unrecognized or unintended pregnancies, and healthcare provider concerns about using other pain medications during early pregnancy,” they add.

The most commonly prescribed opioids during 2008–2012 were hydrocodone—reported reported by an average of 17.5% of privately insured and 25.0% of Medicaid-enrolled women each year—codeine (6.9% and 9.4%), and oxycodone (5.5% and 13.0%).

According to the report, the consistently higher frequency of opioid prescribing to Medicaid-enrolled women is concerning because half of all U.S. births occur in that group.

In terms of region, opioid prescription rates were highest among reproductive-aged women residing in the South and lowest in the Northeast. In addition, among the Medicaid recipients, opioid prescriptions were nearly 1.5 times higher among non-Hispanic white reproductive-aged women than among non-Hispanic black or Hispanic women.

“Many women need to take opioid-containing medications to appropriately manage their health conditions; however, in some instances safer alternative treatments are available and use of opioids is unnecessary,” according to the CDC report. “Having a better understanding of prescription opioid use just before and during early pregnancy can help inform targeted interventions to reduce unnecessary prescribing of opioids and provide evidence-based information to health care providers and women about the risks of prenatal opioid exposure.”


U.S. Pharmacist Social Connect