Pregnant drug deaths soared during pandemic

Nurse holding pregnant woman's hand.
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As the COVID-19 pandemic swept through the U.S., the number of pregnant people who died from drug overdose deaths shot up, according to a study published this week in the JAMA journal.

“Drug overdose deaths among pregnant and postpartum women more than doubled between 2017 and 2020,” said researchers from the Columbia University Mailman School of Public Health.

Overall drug overdose deaths increased by 30% in 2020, according to the U.S. Centers for Disease Control and Prevention. Last year, these deaths increased by another 15% for a total of 107,622.

“Drug overdose deaths, particularly deaths involving synthetic opioids like fentanyl, reached record highs in 2020 and 2021, likely exacerbated by social, economic, and health care disruptions associated with the COVID-19 pandemic,” said the study.

Authors explained that while the risk of fatal overdose is high for pregnant and postpartum persons, “recent national trends in pregnancy-associated overdose mortality are undercharacterized,” thus prompting their research.

In addition to the doubling of pregnancy-associated overdose deaths from 2017 to 2020, the number of those deaths reached a peak high in 2020, the first year of the pandemic.

“We’ve seen significant increases in fatal and nonfatal overdose in the general population during the pandemic,” said Emilie Bruzelius, MPH, a doctoral student in the Department of Epidemiology at Columbia Mailman School and first author of the research. “It now appears that pregnant and postpartum women are being affected as well.”

Out of 7,642 pregnancy-associated deaths occurring among pregnant and postpartum women, 1,249 were due to drug overdose, according to Columbia. By 2020, overdose mortality had increased more than 80% to a high of 11.85 per 100,000. Comparatively, the overall increase among reproductive-age women was 38%.

“For both groups, increases in overdose mortality in 2020 were more were more pronounced than increases in any other prior year,” Columbia said.

There were also large increases in pregnancy-associated overdoses involving fentanyl, methamphetamines, and cocaine with fentanyl-related deaths nearly doubling in 2020. Overdoses involving benzodiazepines, heroin, and prescription opioids were relatively stable from 2017 to 2020.

Fentanyl has become an increasing concern in recent years as it is found laced in more and more drugs.

“Pregnant and postpartum people are known to face barriers to accessing drug treatment and harm reduction services, that when compounded by pandemic-associated stressors, healthcare shutdowns, and an increasingly volatile unregulated drug supply, may have increased fatal overdose risk,” Bruzelius said.

According to the study authors, their research indicates that “enhanced strategies supporting substance use prevention, treatment, and harm reduction efforts among pregnant and postpartum people are critical and much needed,” to prevent more deaths.

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