Women receiving opioids to relieve the pain of vaginal birth have an increased risk of becoming dependent, overdosing or dying. And this, regardless of the dose they receive.
- In women who have given birth vaginally without complications, the prescription of opioids increases the risk of serious events related to their intake, such as overdose, addiction and death.
- This risk is present regardless of the dose of analgesic prescribed, which should prompt clinical care providers to consider considering other alternatives before prescribing opioids to women who have recently given birth.
In the United States, the use and consumption of opioids is a major public health problem. Originally prescribed to relieve certain cancer patients, these powerful morphine-derived drugs have been diverted from their original purpose and commonly used as drugs.
Despite recent measures to restrict their access and force pharmaceutical companies to take their responsibilities, nearly 200 Americans die every day following an overdose of these painkillers. 72,000 people died in 2017 across the Atlantic, more than from firearms and road accidents combined.
The use of these opioids is all the more controversial today as it has been proven that a single dose can trigger a strong addiction. A new study, conducted by researchers at Vanderbilt University Medical Center and published in the journal Women’s Health Issues brings new evidence of this danger. According to the authors, mothers receiving opioids after an uncomplicated vaginal birth face an increased risk of serious opioid-related events. And this, regardless of the dose of opioids they were administered.
No opioid intake, even minimal, is without risk
The study involved approximately 147,000 women followed between 2007 and 2014, who gave birth and received one or more opioid prescriptions before delivery.
The study found that receiving an outpatient prescription for opioids within four days of vaginal delivery was associated with an increased risk of developing a serious opioid-related event. This includes risk of overdose, risk of addiction and risk of death.
The results also show that even women who were prescribed less than 100 MME (milligram equivalent of morphine) – which is roughly equivalent to 20 hydrocodone pills or 13 oxycodone pills (5 mg dose) – had faced a 52% increased risk of a serious opioid-related event compared to those who did not fill a prescription. “We wanted to answer the question of whether low-dose prescriptions were completely safe, and it turns out that even low-dose prescriptions carry some increased risk of poor outcomes”says Andrew Wiese, assistant professor of health policy in the division of pharmacoepidemiology.
According to the results, many of the opioid-related events occur after the traditional 42-day postpartum period.
For Professor Wiese, the main conclusion to draw from this study is that it is essential for clinicians, and in particular those in the field of obstetrics and gynecology, to weigh the pros and cons before prescribing opioids. women after vaginal delivery. “Our observation that there is no such thing as a ‘safe’ dose of opioids raises serious concerns and should really compel researchers and clinical care providers to take a hard look at our routine opioid prescribing practices for vaginal births. without complications, even at low doses, in Tennessee and beyond”he concludes.
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