• Posted June 17, 2024

Help for Women Battling ADHD & Opioid Addiction in Pregnancy

Opioid overdoses in pregnant women are at an all-time high in the United States, and researchers think they’ve figured out one way to counter this phenomenon.

Attention deficit-hyperactivity disorder (ADHD) is strongly tied to substance use disorders, which means some women who become pregnant are taking ADHD medications while receiving treatment for opioid addiction.

Researchers found that women who keep taking their ADHD medications during pregnancy are more likely to adhere to addiction treatment and less likely to overdose.

“Treatment of ADHD is a huge knowledge gap in obstetrics and even more so in patients with substance use disorder,” said researcher Dr. Jeannie Kelly, an associate professor of obstetrics & gynecology at Washington University School of Medicine in St. Louis.

“In obstetrics, a knowledge gap frequently leads to reluctance to treat because of unknown risks to the fetus,” Kelly said. “However, it’s also really important to discuss the risks of not treating, because untreated disease also can have huge implications for mom’s and baby’s health.”

Overdose death rates doubled among pregnant and postpartum women in recent years, rising to about 6 deaths per 100,000 in 2021 from 3 deaths per 100,000 in 2018, researchers said in background notes.

In fact, opioid OD now accounts for about 1 in 10 of all pregnancy-related deaths, researchers said.

Nearly 1 in 4 people diagnosed with ADHD also has a substance use disorder, but there’s little research indicating how both conditions should be safely managed during pregnancy, researchers said.

“It’s very common for pregnant patients to ask their doctors, ‘Is this medication safe?’” said researcher Dr. Tiffani Berkel, a psychiatry resident at Washington University. “The physicians have to say, ‘We don’t know.’ That’s not very reassuring to a pregnant person. They have to do this risk-benefit analysis themselves.”

For the study, researchers evaluated data for 168 pregnant patients who were prescribed methadone or buprenorphine to treat their opioid addiction.

Women who continued with their ADHD medication despite pregnancy stayed roughly two months longer on buprenorphine therapy than patients who stopped taking ADHD meds, researchers found.

There also were fewer ER visits related to opioid addiction. About 41% of patients who remained on ADHD meds went to the ER, compared with 54% of those who stopped.

One possible explanation is that ADHD drugs help control impulsive behavior, which might help patients better manage their addiction treatment.

The new study was published June 11 in the journal Nature Mental Health.

More information

Massachusetts General Hospital has more on ADHD and pregnancy.

SOURCE: Washington University, news release, June 13, 2024