A significant increase in drug overdose deaths has been observed among currently pregnant or pregnant within the previous 12 months patients aged 10 to 44 years between January to June 2018 and July to December 2021, according to researchers at National Institute on Drug Abuse (NIDA) at the National Institutes of Health.
Takeaways
- Between January to June 2018 and July to December 2021, a notable rise in drug overdose deaths was observed among pregnant or recently pregnant patients aged 10 to 44 years, with a 3-fold increase among women aged 34 to 44 years.
- Despite available treatment for pregnant women with substance use disorders, barriers such as discrimination, stigma, penalization, and limited socioeconomic resources hinder many from accessing necessary treatment, contributing to the observed spike in overdose deaths.
- Stigma and punitive policies surrounding substance use disorders for pregnant women were identified as significant contributors to the increased overdose risk, making it harder for individuals to access life-saving treatment and resources.
- The study also investigated the impact of the COVID-19 pandemic on drug overdose rates in pregnant and postpartum women. A significant increase in drug overdose mortalities was observed during this period.
- Overdose deaths were higher in areas with limited accessibility to medical services, and counties with obstetricians and gynecologists in the 48th to 75th percentile also showed increased odds of overdose deaths.
Treatment is available for pregnant women with substance use disorders, but major barriers such as discrimination, stigma, penalization, and limited socioeconomic resources prevent many women from accessing this treatment. This has contributed to major spikes in overdose deaths, with a 3-fold increase from 2018 to 2021 observed among women aged 34 to 44 years.
“The stigma and punitive policies that burden pregnant women with substance use disorder increase overdose risk by making it harder to access life-saving treatment and resources,” said Nora Volkow, MD, NIDA director and senior author on the study.
“Reducing barriers and the stigma that surrounds addiction can open the door for pregnant individuals to seek and receive evidence-based treatment and social support to sustain their health as well as their child’s health,” Volkow added.
A significant rise in drug overdose rates was observed during the COVID-19 pandemic, but it was unclear how pregnancy-associated drug overdose mortality was impacted. To determine this association, NIDA researchers evaluated US data on causes of death before and after the onset of the COVID-19 pandemic.
Participants included 1,457 patients who died from a drug overdose at the pregnant or postpartum stage, 4,796 who died of obstetric causes, and 11,205 who died from a drug overdose without pregnancy in the previous 12 months. Rises in overdose mortality ratios were observed across nearly all racial, ethnic, age, marital status, and educational groups.
The most significant increase in drug overdose mortalities was observed among patients aged 34 to 44 years, from 4.9 per 100,000 live births in the 2018 period to 15.8 in the 2021 period. Patients who died from drug overdose rather than obstetric causes were more often aged 10 to 43 years, non-college graduates, unmarried, and died in a non-home, non-health care setting.
Areas with available medical services that may not be accessible saw increased overdose deaths in pregnant and postpartum women. Counties with obstetricians and gynecologists ranked within the 48 to 75th percentile also had increased odds of overdose deaths.
These results indicated a need to address overdose risk in pregnant and postpartum individuals. Investigators recommended further studies on disparities in drug overdose deaths and the risk of pregnancy-associated mortality.
Reference
Overdose deaths increased in pregnant and postpartum women from early 2018 to late 2021. National Institutes of Health. November 22, 2023. Accessed November 29, 2023. https://www.nih.gov/news-events/news-releases/overdose-deaths-increased-pregnant-postpartum-women-early-2018-late-2021
