Substance Abuse and Pregnancy

Substance abuse during pregnancy with illegal drugs such as cocaine, fentanyl, heroin, methamphetamines, club drugs, and alcohol may cause problems with low birth weights, birth defects or miscarriage. Children may be more likely to have learning and developmental disabilities. For this reason, PAMCC takes special care in treating expecting mothers.

We have experience managing expecting mothers who may be in active opioid or alcohol addiction. Our knowledge base encompasses treating pregnant and/or breast-feeding patients without harming the fetus. In the case of opioid dependence, we can treat the mother with Subutex (buprenorphine without the naloxone component) which some studies have shown to be safer to the baby.

Epidemiology

Current statistics show that approximately 5% to 8.5% of pregnant women in the United States use one or more addictive substances, with nicotine, alcohol, and marijuana being the most common. Between 2017 and 2020, drug overdose deaths among pregnant and postpartum individuals increased by 81%, making overdose a leading cause of maternal mortality.

Prevalence by Substance

Substance  Prevalence Among Pregnant Women (U.S.)
Tobacco/Nicotine 8.4% – 15.9%
Alcohol 8.4% – 14%
Marijuana/Cannabis 1.8% – 7% (as high as 15%–28% in some young, urban groups)
Illicit Drugs (General) 5.9% – 8.3%
Opioid Misuse ~0.9% (approx. 21,000 women annually)

 

Key Statistical Trends & Findings

  • Binge Drinking: Approximately 5% of pregnant women report binge drinking (4+ drinks on one occasion) in the past 30 days.
  • Polysubstance Use: Up to 50% of pregnant women who use substances report using more than one.
  • Opioid Crisis Impact: There was a five-fold increase in opioid use during pregnancy between 2000 and 2009. Cases of Neonatal Abstinence Syndrome (NAS) rose five-fold between 2004 and 2014.
  • Age Disparity: Illicit drug use is highest among pregnant teens (ages 15–17) at 20.9%, significantly higher than the 2.2% seen in adults aged 26–44.
  • Postpartum Relapse: While many women achieve abstinence during pregnancy (e.g., 96% for heavy drinking), relapse rates are high by 3 months postpartum, including 58% for smokers and 51% for alcohol users.

Health Risks & Outcomes

  • Stillbirth: Smoking tobacco or marijuana, or using illegal drugs, is associated with 2 to 3 times the risk of stillbirth.
  • Fetal Alcohol Spectrum Disorders (FASD): Estimated to affect 1% to 5% of first-grade children in some U.S. communities.
  • Mental Health: Roughly 29% of pregnant substance users experience postpartum depression, compared to 17% in the general population