Pain, Opioids, and Pregnancy: Historical Context and Medical Management

Clin Perinatol. 2019 Dec;46(4):833-847. doi: 10.1016/j.clp.2019.08.013. Epub 2019 Aug 22.

Abstract

Women are being disproportionately affected by the opioid crisis, including during pregnancy. Pain and other vulnerabilities to addiction differ between men and women. Management of opioid use disorder should be gender informed and accessible across the lifespan. During pregnancy, care teams should be multidisciplinary to include obstetrics, addiction, social work, anesthesia, pediatrics, and behavioral health. Pain management for women with opioid use disorder requires tailored approaches, including integration of trauma-informed care and addressing psychosocial needs. Thus, coordinated continued care by obstetric and addiction providers through pregnancy into postpartum is key to supporting women in recovery.

Keywords: Addiction; Gender differences; Opioid use disorder; Pain; Substance use screening; Trauma-informed care.

Publication types

  • Historical Article
  • Review

MeSH terms

  • Analgesics, Opioid / history
  • Analgesics, Opioid / therapeutic use*
  • Chronic Pain / drug therapy
  • Drug Overdose / etiology
  • Drug Overdose / prevention & control
  • Female
  • Harm Reduction
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Naloxone / therapeutic use
  • Narcotic Antagonists / therapeutic use
  • Opiate Substitution Treatment*
  • Opioid-Related Disorders / diagnosis
  • Opioid-Related Disorders / history
  • Opioid-Related Disorders / psychology
  • Opioid-Related Disorders / therapy*
  • Pain / drug therapy*
  • Pain Management
  • Patient Care Planning
  • Patient Participation
  • Postnatal Care
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Pregnancy Complications / psychology
  • Pregnancy Complications / therapy*
  • Prenatal Care
  • Prenatal Diagnosis
  • Psychological Trauma / psychology
  • Sex Factors

Substances

  • Analgesics, Opioid
  • Narcotic Antagonists
  • Naloxone