High Rates of Opioid Prescriptions Among Women Raise Birth Defect Fears
By SABRINA TAVERNISE JAN. 22, 2015
The federal health authorities reported Thursday that nearly one-third of women of reproductive age had had an opioid painkiller prescription filled every year from 2008 to 2012. Experts said the practice carried considerable risks for birth defects.
The Centers for Disease Control and Prevention analyzed health insurance claims data from Medicaid and private insurers for women ages 15 to 44 and found that an average of 39 percent of women on Medicaid filled an opioid prescription in a pharmacy each year from 2008 to 2012, compared with 28 percent of women with private insurance.
Dr. Thomas R. Frieden, director of the C.D.C., described the numbers as “astonishing” and said they presented a substantial risk for birth defects. Women often do not know they are pregnant in the early weeks after conception, a critical time for organ formation, and could be “unknowingly exposing their unborn child” while taking the drugs.
Exposure to opioid painkillers increases the risks for major defects in the baby’s brain and spine, congenital heart defects and problems with the baby’s abdominal wall.
“These are dangerous drugs that are addictive, and we are substantially overusing them,” Dr. Frieden said.
It was not clear from the analysis which, if any, of the prescribed drugs were being abused. Addiction is a major problem in the United States, and deaths from opioid overdoses have more than tripled since the late 1990s, with rates for women rising even faster. In places where the epidemic has been most deadly, newborns have also been affected. In Scioto County in southeast Ohio, for example, about one in 10 babies are born addicted.
Opioids are the single largest cause of overdose fatalities in the nation, with
more than 16,000 deaths a year. Overdose deaths from opioids leveled off in 2012. A 2014 study found that nearly a quarter of pregnant women on Medicaid had
filled an opioid prescription in 2007. The current analysis, based on more recent data, looked at a larger sample of women of childbearing age, not just those who were pregnant, and included privately insured women.
It was unclear why Medicaid, the health insurance program for the poor, had a higher prescription rate than private insurers. Researchers speculated that it could be because of medical conditions particular to that population, or because of differences in coverage offered by Medicaid and private insurers. The most frequently prescribed opioids for both groups were oxycodone, hydrocodone and codeine.
A geographic breakdown in the private insurance data showed that the highest rates of prescribing were in the South and the lowest in the Northeast. A racial breakdown in the Medicaid data showed that whites were over one and a half times more likely to fill a prescription than blacks or Hispanics.
Prescriptions were highest in 2009, the study found, with 29 percent of privately insured women filling a prescription and 41 percent of women with Medicaid coverage filling one.
The most intense prescribing skewed older. Among Medicaid beneficiaries, those ages 40 to 44 had the highest prescription rates, and among privately insured women, the highest rates were for those 30 to 34. In both groups, women ages 15 to 19 were least likely to fill an opioid prescription.
Correction: January 26, 2015
An article on Friday about the high rates of opioid prescriptions for women of
reproductive age misstated the upper limit of the age range. The study looked at health
insurance claims data for women ages 15 to 44 — not to 55.
A version of this article appears in print on January 23, 2015, on page A18 of the New York edition with the headline: High Rates of Opioid Prescriptions Among Women Raise Birth Defect Fears.
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