Author: Anum Shabbir, RPh (Community), MW, IMC

Reviewed by: Dr Azuka Ezeike, MBBS, FWACS, FMCOG, MSc (PH)

Introduction

Illicit drugs promise a quick escape from reality, but they come with a heavy price; addiction, health risks, and broken lives. They don’t just harm those who use them; they tear apart families and communities. The more we understand their dangers, the better we can protect ourselves and those we care about.Illicit drugs are substances that are illegal to possess, use, produce, or distribute. They are typically regulated by law due to their potential for abuse, addiction, and harmful effects on individuals and society. Some of the most common illicit drugs include cocaine, methamphetamine, heroin, and prescription opioids that are used illegally. Other dangerous drugs are lysergic acid diethylamide (LSD), magic mushrooms, and cannabis when used illegally. Synthetic drugs like 3,4-methylenedioxymethamphetamine (MDMA) and synthetic cannabinoids (spice) j have widespread use, as well as club drugs such as gamma-hydroxybutyrate (GHB), ketamine, and flunitrazepam (Rohypnol). 

These substances are often controlled under local or international drug laws, like the Controlled Substances Act in the United States or the Misuse of Drugs Act in the UK. Misusing prescription medications, even if legally obtained, can also be considered illicit when used outside prescribed guidelines.An alarming statistic was released by the World Drug Report 2019: over 5% of people worldwide have used illicit drugs, and that percentage is rising each year. As its usage grows, pregnancy-related misuse has emerged as a global public health issue, leading to social and medical issues pertaining to the health of mothers and children.[1]The use of illicit drugs during pregnancy is not only harmful to the mother but also to the unborn baby. This is because these illicit drugs can cross the placenta, causing premature separation of the placenta, premature birth, stillbirth, and abnormalities in the unborn baby.[2] These drugs also pose a greater risk to the life of a mother.This article aims to educate expectant mothers, caregivers, and general readers on the harmful outcomes of the use of illicit drugs.

Common Illicit Drugs and Their Effects on Pregnancy

Substances most commonly abused in pregnancy include 

• Cocaine
• Amphetamines
• Opioids
• Marijuana
• Ethanol
• Tobacco
• Caffeine
• Toluene-based solvents

 Risks of illicit drugs to the Mother

Research studies have shown the following effects of illicit drug use during pregnancy on the mother's health:[3.4]

Opioids (like heroin or prescription painkillers):

• Increases the chances of pregnancy problems like high blood pressure and low birth weight.
• Can lead to infections, heart issues, or diseases passed through unprotected sex.
• Can cause missed periods and unplanned pregnancies.

Benzodiazepines (like Valium):

• Increases the chance of preterm birth and low birth weight.
• May cause birth defects.
• Can make mothers feel sleepy or drowsy, especially if they’re breastfeeding.

Cannabis (marijuana):

• Can affect the mother’s thinking and memory.
• Increases the likelihood of using other drugs like alcohol or cigarettes.

Cocaine:

• Increases the risk of miscarriage and early labour.
• Can cause high blood pressure and affect the blood flow to the placenta.
• Can change how the brain works because of its impact on brain chemicals.

Amphetamines (like methamphetamine):

• Can increase stress and cause health problems, leading to low birth weight and early delivery.
• Can cause lasting changes to the mother’s brain.
• It reduces the appetite in mothers which can lead to nutritional deficiencies.
• Women who use methamphetamine often report feeling overly suspicious of others (paranoia), struggling with sadness or hopelessness (depression), and having difficulty dealing with people or feeling emotionally sensitive in social situations.

     Ecstasy (MDMA)

 Boosts mood, energy, and sensory perception but causes dehydration, heart problems, and memory issues.

    Alcohol

        Affects coordination, mood, and judgment.

    Cocaine

Gives a temporary high but can cause heart problems and high blood pressure.

   Heroin

      Causes addiction, drowsiness, and nausea.

   Marijuana

    affects mood, memory, and coordination.

Risks of illicit drugs to the baby

During pregnancy, everything a mother consumes doesn’t just stay in her body; it can also travel to her baby through the placenta, which acts as a lifeline between the mother and the baby. The placenta supplies oxygen and nutrients, but it can’t filter out harmful substances like drugs, alcohol, or nicotine.Most drugs, whether illegal substances or prescription medications are made up of small molecules that easily pass through the placenta and enter the baby’s bloodstream. Illicit drug use during pregnancy can have serious effects on a developing baby. Here's a list of potential effects on the baby:

• Growth Problems: Babies may be smaller than normal at birth.
  
  
• Low Oxygen Levels: Drugs can reduce the baby's oxygen, affecting development.
  
  
• Brain Damage: Exposure can harm the baby's brain, leading to learning and behaviour issues.
  
  
• Low Birth Weight: Babies may weigh less than expected, leading to health problems.
  
  
• Premature Birth: Drug use can cause babies to be born too early before they're fully developed.
  
  
• Stillbirth: In severe cases, drug use can lead to the baby’s death in the womb of the mother.
  
  

Studies have shown that children exposed to cocaine before birth may have long-term issues with thinking, memory, and behaviour. They might struggle with paying attention, remembering things, and organizing tasks, and could be more withdrawn, anxious, or aggressive. The specific problems a child may face depend on the type of drug used, the amount, and how long the mother used the drugs during pregnancy.[2]Expectant mothers need to avoid illicit drugs to help ensure a healthy start for their babies.

Breaking the Cycle: Seeking Help for Drug Abuse During Pregnancy

Drug abuse during pregnancy can pose serious risks to both mother and baby. But it’s never too late to seek help and make a positive change. Fear of punishment or having her baby taken away after delivery prevents a woman from confessing to drug usage outside of routine therapy. Different states have different policies for handling known cases of drug use during pregnancy; some may file charges of child abuse or take away custody of the unborn child. An accurate assessment is necessary due to the possible impact on the woman and her baby.[5]Here’s how you can break the cycle:

Preventive Management: Early Action Makes a Difference

• Recognize the Problem: Identifying drug abuse early is the first step in preventing harm.
• Seek Professional Help: Counselors and healthcare providers can guide you through safe options for managing addiction.
• Support Networks: Support groups and families can provide essential encouragement throughout the journey.

Rehabilitative Strategies: Pathways to Recovery

• Detoxification: safely removing harmful substances under medical supervision.
• Therapy & Counseling: Learn to manage cravings and emotional triggers with professional help.
• Support Systems: Building strong connections with friends, family, and community offers motivation and understanding.
• Medication-Assisted Treatment (MAT): Medications can help manage withdrawal symptoms when supervised by a doctor

Conclusion

Illicit drug use during pregnancy threatens both mother and baby, causing severe health risks. Pregnant women who use drugs are at a higher risk of infections and health problems compared to those who don’t. They need special care that includes help for their physical and mental health, managing drug use, and support during pregnancy. Doctors, counsellors, and social workers should work together to provide complete care. It’s also important to offer parenting support to help them care for their baby and prevent problems caused by drug use. Services should be easy to access. However, with the right support, through addiction counselling, antenatal programs, and healthcare interventions, women can break the cycle and ensure a healthier future for their children. Early identification of drug-related issues during pregnancy is essential for ensuring the health and safety of both the mother and the baby

References

1.Tavella, Ronan A., Victória O.M. De Abreu, Ana Luiza Muccillo-Baisch, and Flávio M.R. Da Silva Júnior. “Prevalence of Illicit Drug Use During Pregnancy: A Global Perspective.” Anais Da Academia Brasileira de Ciências 92, no. 4 (2020): e20200302. https://doi.org/10.1590/0001-3765202020200302.

2.Ross, Emily J, Devon L Graham, Kelli M Money, and Gregg D Stanwood. “Developmental Consequences of Fetal Exposure to Drugs: What We Know and What We Still Must Learn.” Neuropsychopharmacology 40, no. 1 (January 2015): 61–87. https://doi.org/10.1038/npp.2014.147.

3.Madgula, Rajashekhar Moorthy, Teodora Groshkova, and Soraya Mayet. “Illicit Drug Use in Pregnancy: Effects and Management.” Expert Review of Obstetrics & Gynecology 6, no. 2 (March 2011): 179–92. https://doi.org/10.1586/eog.10.54.

4.Forray, Ariadna. “Substance Use during Pregnancy.” F1000Research 5 (May 13, 2016): 887. https://doi.org/10.12688/f1000research.7645.1.

5.Gyarmathy, V. A., I. Giraudon, D. Hedrich, L. Montanari, B. Guarita, and L. Wiessing. “Drug Use and Pregnancy – Challenges for Public Health.” Eurosurveillance 14, no. 9 (March 5, 2009): 19142. https://doi.org/10.2807/ese.14.09.19142-en.