The number of pregnant women using opioids in the United States more than quadrupled between 1999 and 2014. In 2014, 6.5 of every 1,000 hospital deliveries were to women with opioid use disorder, up from 1.5 per 1,000 deliveries in 1999. The highest increase in opioid use was among pregnant women in Vermont, West Virginia, Maine, and New Mexico. In Vermont, 48.6 of every 1,000 deliveries were to women using opioids, followed by West Virginia, with 32.1 cases per 1,000 deliveries. The lowest rate of deliveries was 0.7 per 1,000 in Washington, DC, and the second lowest was 1.2 per 1,000 in Nebraska.

Volunteer Jill Matranga soothes a newborn baby being treated for drug withdrawal in the neonatal ICU at Sutter Medical Center in Sacramento, California. Photo by Renee C. Byer / Zuma Press / Newscom.

This report, based on discharge data from the 1999-2014 Healthcare Cost and Utilization Project, a comprehensive source of U.S. hospital care data, is the first look at opioid use in pregnant women by state, although only 28 states and the District of Columbia consistently collect these types of data. The report documents increases in the number of opioid-addicted pregnant women, a likely consequence of the ongoing opioid epidemic in the United States. Preterm birth, stillbirth, and maternal death are linked to opioid use during pregnancy. Babies born to opioid users may experience withdrawal symptoms, known as neonatal abstinence syndrome.

Among the general public, the rates of naloxone administration by emergency medical services (EMS) for opioid overdoses also increased-jumping 75% from 2012 to 2016. During the same period, opioid deaths increased 80%, from 7.4 to 13.3 deaths per 100,000 people. Those most affected were 25-to-34-year-olds, followed by 45-to-54-year-olds. Younger people were more likely to use manufactured illicit fentanyl, which may account for their high death rates. These data came from 10,000 EMS agencies in 49 U.S. states and territories. Administration of naloxone by EMS is standard care for overdoses in prehospital settings for unconscious patients or those in cardiac arrest.

Using EMS data to evaluate nonfatal overdose events could assist in developing more timely emergency response practices, thereby potentially decreasing opioid deaths.-Carol Potera

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