The Centers for Disease Control and Prevention notes that use of opioids in pregnant women can lead to birth defects, suggesting that alternatives for pain management of severe pain should be considered. In addition, more thought needs to be given about the wisdom of providing opioids to women who are of childbearing age and not using birth control. However, a study published in Morbidity and Mortality Weekly Report found that opioids are prescribed to over 17% of such women. Among women who were on contraceptives or infertile, that figure was 27.3%. Overall, 20% of women of reproductive age had been prescribed opioids. Lead author Brian Gallagher concluded that “although opioid prescribing is lowest for women who are pregnant, without further study it is not clear that all prescribing for these women remains best practice.” Urgent care clinicians are advised to weigh female patients’ childbearing potential when making decisions on pain management. (For more updates on responsible pain management in urgent care, visit the Acute Pain Resource Center on the JUCM website.)

Should Reproductive-Age Women Receive Opioids?
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