Grant: Project Grant

Canada is in the midst of an opioid crisis. With more women taking prescription opioids during pregnancy now than at any time in the past, it is important to understand how these drugs are used during pregnancy and how they affect the development of children. This information is critical to policymakers working to reduce negative effects related to prescription opioids, and to women faced with the decision of whether to take these medications during pregnancy or not. Increasing the complexity of the issue is the fact that prescription opioids are often taken together with other psychotropic medications, such as anti-depressants. The risks to mothers who use these drugs and to their infants are largely unknown. We will use powerful, comprehensive administrative data from two Canadian provinces and sophisticated statistical analysis techniques to investigate the effect of prescription opioid and psychotropic medication use during pregnancy. We will include women from the full spectrum of income, generating insight into how these medications affect mothers and their developing children over time. The project will: 1) describe patterns of prescription opioid use during pregnancy, including the specific opioid (e.g., codeine, hydromorphone), the intensity of use (total days supply and morphine equivalent), the demographics of users (age, socioeconomic status, morbidity), and information about the prescribers (e.g. specialty, location of training); and compare women who use prescription opioids to non-users to examine 2) short term outcomes (e.g., neonatal abstinence syndrome), and 3) long term outcomes (e.g., ADHD, autism) for children exposed in the womb. 4) We will also use education data to assess impacts on school readiness and test performance.