The rate of opioid use in pregnancy has more than doubled over a 12-year period. A new study from Oregon Health & Science University (OHSU) analysed hospital data across California and found a sharp, troubling rise. Researchers are now calling for urgent action. Both mothers and newborns face serious risks as a result.

A Crisis Growing in Plain Sight

The study examined records from more than 5.5 million patients between 2008 and 2020. It found that opioid-related diagnoses during pregnancy rose from 0.14% to 0.33% over that period. In real terms, that is a jump from roughly 700 patients to nearly 1,200. Whilst those figures may appear small, researchers stress they are almost certainly an undercount.

“The real situation is more dire and more severe,” said Jaime Lo, associate professor of obstetrics and gynaecology at OHSU and the study’s lead author.

California was chosen deliberately. Its diverse age, racial, and ethnic population makes the findings more representative of broader US trends. What California’s hospitals are recording is likely a reasonable mirror of what is happening nationwide.

What Opioid Use in Pregnancy Actually Does to Mother and Baby

Opioid use in pregnancy carries significant health consequences for both mother and child. Complications include hypertension, respiratory distress, and preterm birth. Neonatal abstinence syndrome, or infant withdrawal, is also a documented risk. In the most severe cases, the outcome is death.

These are not rare occurrences. They are recurring consequences of untreated opioid use disorder in pregnancy. Rates continue to climb, and so do the stakes.

How the System Is Failing Pregnant Patients

Despite the scale of the problem, Lo says outcomes for pregnant patients remain consistently poor. The reason is structural. Effective care requires a multidisciplinary approach. That means medication-assisted treatment, mental health support, and coordinated obstetric and paediatric services working together. That kind of provision is far from the norm.

Patients frequently fall through the cracks. Provider stigma, unclear referral pathways, and a shortage of clinicians trained in both addiction medicine and pregnancy care all play a role. These are not individual failings. They reflect a systemic gap in how healthcare responds to opioid use disorder in pregnancy.

Localised Progress, But Still Not Enough

There are pockets of good practice. UC San Diego Health provides medication-based treatment for opioid and substance use disorder throughout the prenatal period, during delivery, and into the postpartum phase. San Diego County also has at least nine publicly funded treatment programmes for pregnant women and new mothers.

Local initiatives matter. Across San Diego County, accidental drug overdose deaths rose sharply during the pandemic, then dropped for three consecutive years. That decline shows coordinated intervention can work when properly resourced. But local effort alone is not enough.

The Data on Opioid Use in Pregnancy Likely Underestimates Today’s Reality

The OHSU study’s figures stop at 2020. The opioid crisis has deepened in many parts of the country since then. The true current rate of opioid use in pregnancy is almost certainly higher than what the data captured. Researchers are clear: this study reflects a trajectory, not a ceiling.

That trajectory points upward unless systems change. Prevention, early intervention, and stigma-free access to treatment are not optional. They are the foundation of any serious response.

Reversing the Trend Is Possible

Lo is careful not to frame the situation as hopeless. Rising rates are not irreversible. When healthcare systems invest in perinatal addiction programmes, outcomes genuinely improve. The evidence supports this.

“That’s how we can really turn this conversation around and start to see some of those numbers that are rising turn the other way,” she said.

The political will and clinical infrastructure to drive that shift are what is needed now. Opioid use disorder in pregnancy is a public health emergency. The window to act is open.

Source: axios