Medical Research: What is the background for this study?
Dr. Lind: CDC researchers published a new study estimating the proportion of women aged 15-44 years who filled a prescription for opioid pain medications. Opioids are prescribed by healthcare providers to treat moderate to severe pain. They are also found in some prescription cough medications. Opioids include medications like codeine, oxycodone, hydrocodone, or morphine. For this study, researchers used data from two large insurance claims datasets—one on Medicaid and one on private insurance—and looked at data from 2008-2012.
Medical Research: What are the main findings?
Dr. Lind: Opioid medications are widely used among women of reproductive age in the United States, regardless of insurance type. On average, more than a third (39 percent) of women aged 15-44 years enrolled in Medicaid, and more than one fourth (28 percent) of those with private insurance filled a prescription for an opioid pain medication each year during 2008-2012. Taking these medications early in pregnancy, often before women know they are pregnant, can increase the risk for some birth defects (such as spina bifida) and other poor pregnancy outcomes (such as preterm birth or low birth weight).
Medical Research: What should clinicians and patients take away from your report?
Dr. Lind: CDC encourages women to speak to their healthcare provider to determine the safest treatment for their pain. If an opioid is determined to be deemed necessary, we encourage women to ask about the lowest effective dose, shortest amount of time possible to be on treatment and to discuss effective birth control methods to decrease the likelihood of becoming pregnant while on the opioid medication. Healthcare providers should discuss the potential risks and benefits of opioid medication use with women of reproductive age, prior to prescribing.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Lind: More research is needed to understand the effects of pain management medications in pregnancy. A better understanding of opioid use just before and during early pregnancy can help inform strategies to reduce unnecessary prescribing of opioids. CDC’s Treating for Two initiative aims to fill these gaps in knowledge. Treating for Two aims to expand research and develop guidance for treating conditions during pregnancy. This information will allow women and their healthcare providers to make informed decisions about treating health conditions, like pain, during pregnancy.