The perils of opioid prescribing during pregnancy.
Chronic opioid therapy during pregnancy is perilous, but not simply because of neonatal effects: it is perilous because women are at particular risk for misprescription, misuse, dependence, overdose, and death. Opioids may be teratogens and should be avoided in the periconception period. Accidental childhood poisoning and purposeful teen experimentation are increased with opioid prescriptions in the home. Risks to pregnancy span the pre- and periconception period; neonatal risk following in utero opioid exposure is well documented. When the authors' patients request opioids for chronic pain, they care for them in a comprehensive and compassionate matter, which often will require therapeutic approaches other than chronic opioid therapy.
Fletcher Allen Health Care and the University of Vermont, 111 Colchester Avenue, Burlington, VT 05401, USA. Electronic address: Marjorie.meyer@uvm.edu.
Marjorie
M
Meyer
D000701:Analgesics, Opioid / Q000008:administration & dosage*; D059350:Chronic Pain / Q000188:drug therapy*; D000013:Congenital Abnormalities; D062787:Drug Overdose / Q000517:prevention & control; D005260:Female; D006801:Humans; D009357:Neonatal Abstinence Syndrome / Q000517:prevention & control*; D009293:Opioid-Related Disorders / Q000517:prevention & control*; D018743:Perinatal Care; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced*; D011256:Pregnancy Outcome; D018570:Risk Assessment
D000701:Analgesics, Opioid
Chronic pain; Neonatal abstinence; Opioids; Pregnancy; Teratogens