Health implications and management of women with opioid use disorder

Abstract

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.

Provision of and Barriers to Integrating Reproductive and Sexual Health Services for Reproductive-age Women in Opioid Treatment Programs

“…Adverse childhood events (ACEs)-stressful or traumatic events-are also associated with RSH health problems, including fertility issues later in life (Jacobs et al, 2015). Other health issues for women with OUD include cancers of the reproductive system and menstrual disorders (Hachey et al, 2017).…”

Antisocial Personality Disorder as a Risk Factor for Opioid Use: The Dual Mediating Roles of Antisocial Attitudes and Self-Control

“…Instead, only the potential benefits of the physiological effects may be considered, resulting in increased risk for use. Beyond potential legal ramifications of use, there also exist the numerous health consequences of acute and chronic use (Hachey et al, 2017; Katz et al, 2011; Torres et al, 2011). For example, Hachey et al (2017) report that women addicted to opioids face increased risk of immune system dysfunction, diminished fertility, and endocrinopathies, among other issues.…”

“…Beyond potential legal ramifications of use, there also exist the numerous health consequences of acute and chronic use (Hachey et al, 2017; Katz et al, 2011; Torres et al, 2011). For example, Hachey et al (2017) report that women addicted to opioids face increased risk of immune system dysfunction, diminished fertility, and endocrinopathies, among other issues. Torres et al (2011) found that chronic heroin users reported lower self-rated health and greater risk for a range of health issues (hypertension, diabetes, arthritis).…”