Opioid overdoses for pregnant people are at an all-time high in the United States, even as overall numbers are improving. Attention deficit hyperactivity disorder (ADHD) is highly correlated with substance use disorders, yet treatment protocols to help expecting parents manage opioid use disorders and ADHD together are essentially nonexistent.
New research from Washington University School of Medicine in St. Louis may help change that. A study published in Nature Mental Health indicates that patients with opioid use disorders and ADHD who remain on their ADHD medications during their pregnancies are far more likely to adhere to treatment for opioid use, and far less likely to overdose, than are patients who stop taking ADHD medications.
This research is a step toward developing urgently needed resources and treatment guidelines, said Kevin Xu, MD, an assistant professor of psychiatry and the study’s first author. “We have really never seen such rates of overdose among reproductive-age and pregnant people,” Xu said.
According to data from the National Institutes of Health (NIH), rates of overdose deaths doubled among pregnant and postpartum people in recent years (rising to 6.1 deaths per 100,00 in 2021, from 3.1 deaths per 100,000 in 2018). Opioid overdose accounts for about 10% of all pregnancy-related deaths. Despite research indicating that nearly one in four people diagnosed with ADHD also has a substance use disorder, there is little research available to physicians or their patients to guide how they can safely manage both conditions during pregnancy.
That lack of research struck psychiatry resident Tiffani Berkel, MD, PhD, as she was trying to advise patients navigating their pregnancies, which led her to approach Xu and propose this study.