Overdose Deaths Spike for Pregnant Women During the COVID-19 Pandemic

A study released by JAMA Tuesday found that drug overdose deaths of pregnant and recently pregnant people rose rapidly during the first year of the pandemic.  

Researchers from Columbia University reviewed 7,642 pregnancy-related deaths between 2017 and 2020 and found significant increases in overdoses attributed to fentanyl and synthetic drugs corresponding with the beginning of the COVID-19 pandemic and nationwide lockdowns. 

Using data from the restricted National Vital Statistics System mortality files, the study’s lead author, Emilie Bruzelius, MPH, observed an 81% increase in pregnancy-associated overdose deaths between 2017 and 2020. The increase far outpaced the 35% rise in overdose deaths of reproductive-age females who were not pregnant or recently pregnant at the time of death. 

The increase in overdose deaths was mainly attributed to illicit drug activity, including cocaine, methamphetamine, fentanyl, and other synthetic drugs. The data did not show that more people overdosed on prescription drugs like benzodiazepines or prescription opioids. 

“Pregnant and postpartum persons are known to face barriers to accessing drug treatment and harm reduction services, which when compounded by pandemic-associated stressors, health care shutdowns, and an increasingly volatile unregulated drug supply may have increased fatal overdose risk,” concluded the study’s author. 

Treating drug addiction and opioid use disorder (OUD) is a complex process for clinicians that was only made more complicated by pandemic restrictions. One study by the NYU Grossman School of Medicine found that nearly 90% of people with OUD don’t receive appropriate medication-assisted therapy to deal with drug cravings and withdrawals. Barriers to care spawned by a lack of proactive policy-making, underfunded treatment programs, and stigma surrounding addiction have kept patients from receiving treatment that could save them from an overdose. 

For mothers, the issue is exacerbated by additional risks associated with medication-assisted therapy during pregnancy. Using methadone while pregnant increases the risk of neonatal abstinence syndrome and pre-term birth. Instead, physicians recommend that mothers use buprenorphine which results in a lower rate of complications for children; however, doctors must get special training and a waiver to prescribe buprenorphine, making it less readily available to patients.  

Clinicians have found that patients with OUD benefit from regular follow-ups after treatment in addition to medication-assisted therapy. Recent research out of the University of Pittsburgh School of Public Health (UPMC) indicates that most patients currently lack access to this type of follow-up care for OUD. Providers have begun to address the need to boost contact with OUD patients by relying on virtual health tools and remote patient monitoring technology that can reduce the rate of relapse and prevent overdoses.