Opioid use disorder has risen to epidemic proportions in the United States at an alarming rate in the past decade and is considered a leading public health concern. Women have a higher rate of acute and chronic pain conditions and are more likely to be prescribed opioids for pain management. The disproportionate incidence of opioid use, misuse, and progression to heroin and injectable drug use among reproductive age women is associated with increased morbidity and mortality. Of particular concern are the unique health risks opioid-dependent women face including immune system alterations, endocrinopathies, diminished fertility, psychosocial isolation, interpersonal violence, and unintentional overdose. Opioid use in pregnancy is associated with negative maternal and neonatal consequences and requires comprehensive, multidisciplinary services for the co-occurring medical, mental health, infectious disease, social stressors, and legal issues. Neonatal abstinence syndrome is linked to a cluster of physiological withdrawal symptoms and considered the primary adverse outcome of opioid exposure in newborns. Maternal medication-assisted treatment with methadone or buprenorphine to decrease the negative effects of neonatal withdrawal is the standard of care for opioid use disorders in pregnancy. The complexity of services required for maternal opioid use disorders requires collaborative and multidisciplinary management strategies to optimize maternal and neonatal outcomes.

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Nearly four percent of the global population consumes cannabis with the highest prevalence among young people. Proponents of its use boast a myriad of benefits, including relief of pain, depression, anxiety, and insomnia. Pharmacologic research on cannabidiol (CBD) first occurred in the late 1970s, and more recently has garnered expanded focus due to mounting consumption despite a dearth of evidence in health efficacies. Tetrahydrocannabinol (THC) is deemed to be the intoxicating component of the flowering plant, lending to psychoactive outcomes, including euphoria and psychosis. Conversely, CBD is not thought to be psychotropic in nature. While there are a number of considerations regarding the utilization of CBD, emphasis is placed on the fact that medical-use indication is limited to its anti-seizure effects. In addition, high-grade evidence-based research data regarding the use of CBD for other medical diseases is deficient. Negative health consequences for consumers who may be unaware that inaccurate labeling and dose variability across the product backdrop is problematic. All things considered, counsel against the use of CBD products may be a judicious clinical approach.