Opioid prescriptions after childbirth linked to increased risk of overdose, persistent use

June 08, 2020

Women who are prescribed opioids after childbirth have an increased risk of persistent opioid use or other serious opioid-related events, including overdose, in their first year postpartum, according to a new study by Vanderbilt University Medical Center researchers. This is true regardless of whether the woman had a vaginal delivery or a cesarean section.

The study, published today in Annals of Internal Medicine, followed more than 160,000 pregnant women ages 18-44 enrolled in TennCare who had no history of opioid prescriptions or opioid use disorder within 180 days before their delivery.

Alarmingly, more than half of the women who delivered vaginally and 91% of women who delivered via C-section filled at least one opioid prescription following childbirth. More than 10% of vaginal births and 24% of C-sections also involved filling a second opioid prescription in the postpartum period.

According to Sarah Osmundson, MD, MS, assistant professor of Obstetrics and Gynecology at VUMC and lead investigator for the study, increasing the number of postpartum opioid prescriptions also increased a woman's risk for experiencing a serious opioid-related event, including opioid-related death, persistent use and a diagnosis of opioid use disorder.

"This work highlights serious risks associated with opioid prescribing after childbirth, especially among women who receive multiple prescriptions," said Osmundson. "Routine prescribing after vaginal birth is still common, and it is alarming to know that this may put women at risk of long-term problems with opioids for a procedure (vaginal birth) where opioids have dubious benefit."

"While prior studies have looked at persistent opioid use after surgery, including C-sections, little attention has been paid to serious opioid-related events following vaginal childbirth, leaving physicians with limited information about the associated risks," added Carlos G. Grijalva, MD, MPH, associate professor of Health Policy and senior investigator for the study. "Current clinical guidelines do not provide clear recommendations for opioid prescribing after childbirth, so this work can help inform practice."

Because the rate of women who receive opioids after vaginal delivery is high in Tennessee and other states, the researchers recommend implementing rational opioid prescribing guidelines to reduce risk and improve outcomes for women in the postpartum period.
-end-
The project research team also included Jea Young Min, PharmD, PhD; Andrew D. Wiese, PhD, MPH; Robert E. Hawley, BS; Edward Mitchel, BS; Stephen W. Patrick, MD, MPH, MS; Lauren R. Samuels, PhD; and Marie R. Griffin, MD, MPH.

This research was supported in part by the National Institutes of Health (grants HD04348317, DA047476, DA038720 and AG043471).

Vanderbilt University Medical Center

Related Opioids Articles from Brightsurf:

One in 10 older dental patients inappropriately prescribed opioids
A new study by researchers at the University of Illinois Chicago and the University of Pittsburgh suggests that a significant proportion of older patients receiving opioids at dental visits also use psychotropic medications -- a potentially harmful combination.

Look beyond opioids to solve national substance use epidemic, study suggests
A new study published reveals that three-quarters of participants in an inpatient addiction intervention program at Oregon Health & Science University came into the hospital using more than one substance.

Placenta can indicate how body responds to opioids during pregnancy
Scientists at the University of Missouri have discovered possible biological markers that they hope could one day help identify the presence of an opioid use disorder during human pregnancy.

Research Finds Women Often Overprescribed Opioids After Childbirth
Excessive opioid prescriptions following childbirth may lead to higher rates of addiction within communities, according to a new report in The Journal of the American Osteopathic Association.

Women significantly more likely to be prescribed opioids, study shows
Women are significantly more likely to receive prescriptions of opioid analgesics.

Opioids for chronic non-cancer pain doubled in quarter century
A review of 24 years of global research has shown opioid prescribing doubled between 1991-2015, with demand most common for chronic conditions such as chronic lower back pain, finds University of Sydney-led research.

Cancer screening among women prescribed opioids
US women who take prescription opioids are no less likely to receive key cancer screenings when compared to women who are not prescribed opioids.

Parents: Turkey makes great leftovers -- opioids do not
Leftover prescription opioids pose big risks to kids, yet most parents keep their own and their child's unused painkillers even after they're no longer medically necessary for pain.

Co-addiction of meth and opioids hinders treatment
A study published in the Journal of Substance Abuse Treatment found that methamphetamine use was associated with more than twice the risk for dropping out of treatment for opioid-use disorder.

Computer game may help to predict reuse of opioids
A computer betting game can help predict the likelihood that someone recovering from opioid addiction will reuse the pain-relieving drugs, a new study shows.

Read More: Opioids News and Opioids Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.