New Study: Opioids Are Overprescribed After Childbirth

The days after a vaginal birth or a cesarean section birth can be painful and stressful for a new mother. Opioids are often prescribed for a short period to help moms manage the pain. In fact, childbirth is often the first exposure of many young women to an opioid drug. A new study from a community hospital in Oklahoma finds that women were frequently prescribed more opioid pills than they needed after childbirth. The study was done in 2018 and is published in the  Journal of the American Osteopathic Association.

The authors of the study warn that over prescription of opioids after childbirth is dangerous for two reasons. One is that even a short course of opioids can lead to misuse and abuse, especially for women who are vulnerable after childbirth. Other research shows that even a single five-day prescription of an opioid leads to a 10 percent chance of continued opioid use one year later.

The other problem is that unused opioids remain on a shelf in the kitchen or bathroom and can find their way into the community where they are abused. In the study, only two women said that they turned their unused pills into a pill return center or flushed them down the toilet.

Oklahoma has one of the highest rates of opioid prescriptions, opioid misuse and abuse, and overdose deaths. Research shows that abuse of opioids after childbirth has been linked to opioid addiction and a higher rate of death and disease for both babies and mothers. Part of the problem is that there are no guidelines on how many pills to prescribe after a vaginal or cesarian birth.

In this new study, researchers wanted to see if women were being given too many opioid pills after childbirth. Their hospital does about 1,200 deliveries every year. The researchers reviewed medical records to find out how many pills were given and then followed up with phone interviews at 4 to 6 weeks to find out how many pills were actually used.

Thirty-seven women were recruited and completed the study. These were the key findings:

  • 23 women who had vaginal deliveries were prescribed on average 18 pills. They had an average of 10 pills left unused.
  • 14 women who had cesarian section deliveries were prescribed an average of 22 pills. They had an average of 7 to 8 pills left unused.
  • Only two women had disposed of the unused pills.

Although this was a small pilot study, the researchers would like to see larger studies that follow-up for a longer time. A current study is looking at adding over-the-counter medications like Tylenol and Advil to post-childbirth pain prescriptions, to see if use of opioids can be reduced.

Think of this study along with the current statistic that over 2 million Americans have an opioid-use disorder. A 2019 study found that women who received an opioid prescription after childbirth, like hydrocodone or oxycodone, had about a two percent chance of developing a persistent opioid abuse disorder. Although many women do need pain medication after childbirth, this study strongly suggests that guidelines are needed to limit the number of pills prescribed.

If you need a prescription for an opioid, take it only as needed. You may be able to get by with an over-the-counter pain reliever. If you have unused pills, ask your doctor where you can return them. In Oklahoma, they increased the number of disposal sites at pediatric offices, since this is where many new moms will visit with their babies after childbirth.

Christopher Iliades
Dr. Chris Iliades is a medical doctor with 20 years of experience in clinical medicine and clinical research. Chris has been a full time medical writer and journalist since 2004. His byline appears in over 1,000 articles online including EverydayHealth, The Clinical Advisor, and Healthgrades. He has also written for print media including Cruising World Magazine, MD News, and The Johns Hopkins Children's Center Magazine. Chris lives with his wife and close to his three children and four grandchildren in the Boston area.

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