Understanding the full effects of the nation’s opioid epidemic requires coordinated, long-term research involving women of reproductive age and children, according to scientists at the National Institutes of Health (NIH). In an editorial in the American Journal of Obstetrics and Gynecology, Diana W. Bianchi, MD, director of NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and Matthew W. Gillman, MD, SM, director of NIH’s Environmental influences on Child Health Outcomes (ECHO) Program, emphasize that women and children bear a substantial burden of the US opioid epidemic. They write that misuse of opioids before and during pregnancy can raise the risk of health consequences for both woman and child, potentially leading to intergenerational cycles of opioid overuse.

Opioid exposure during pregnancy is known to cause neonatal opioid withdrawal syndrome, or neonatal abstinence syndrome, which can make newborns irritable and inconsolable and have trouble eating and sleeping. These infants are also at higher risk of developing behavioral and educational problems later in life. Furthermore, many women have gynecological conditions, such as endometriosis, fibroids, ovarian cysts, and pelvic inflammatory disease, that may require lifelong use of medications like opioids to relieve chronic pain.

The authors note that coordinated, long-term research is essential to filling gaps in current knowledge about how opioids affect women and children. NIH is currently leading the HEAL (Helping to End Addiction Long-term) Initiative as part of the Department of Health and Human Services comprehensive strategy to address opioid use disorder in the United States. A component of HEAL, called Advancing Clinical Trials in Neonatal Opioid Withdrawal Syndrome (ACT NOW), specifically addresses the medical and social needs of infants who were exposed to opioids in the womb. ACT NOW is led by NICHD and ECHO and will include large-scale clinical trials conducted across the United States.