Opioid Use During Pregnancy


[MUSIC] Dr. Uma M. Reddy: What happened in the 1990s, that is
really when the root of this current problem started. First of all, physicians were being told that
we are ignoring pain. That pain is the sixth vital sign. So, we started asking everyone about their
pain, and rating it from a scale from zero to ten. And then really, the prescription of pain medications
in general, a much more liberal use of pain medications. And so, I think it was a combination
of physicians but also patients. Patients also did not understand that
these medications are addictive. [MUSIC] So, C-section is the most common surgery
in the United States. 32 percent of women deliver by C-section. And it turns out,
when we prescribe, we typically prescribe short-term narcotics to help women get
through the pain after a C-section. But 93 percent of women have leftover pain
medication. They do not even know how to dispose of it, so it is left around. And
then what was really shocking was that 1 out of 300 women after a C-section
become persistent opioid users. [MUSIC] Every thirty minutes, there is a baby being born
to a woman who has used opioids and is having a withdrawal syndrome,
neonatal abstinence syndrome. And what happens is, once the baby is born,
it is not receiving through the mother, the constant dose of opioids.
So, the baby undergoes a withdrawal. So, you have tremors and hyperactivity
of the central nervous system. So, these babies need to be treated,
basically, because they are withdrawing. [MUSIC] So, we brought these people together
to really understand, what do we need to do, in terms of research, to be able to
combat this crisis. First of all, with screening. We do not screen women, we do not even ask them. But everybody at the workshop agreed, we
should ask women, in non-judgmental way. Explain to them that we ask all women
about this, just like with alcohol, cigarettes. It is a routine part of prenatal care.
And then we talked about neonatal abstinence syndrome. And really, even neonatal abstinence syndrome, there are six different scales. It’s very difficult to really treat
these babies well. And we have very little data on how these children
do, exposed to opioids in utero. So, we had a lot to talk about at the
workshop. So, we identified a lot of gaps. [MUSIC]

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