Abuse and misuse of opioid painkillers has been on the rise nationally, and pregnant women are getting hooked into the epidemic.

A University of Minnesota study released Friday found that 2.3 percent of women ages 18 to 44 and 0.8 percent of pregnant women had taken opioids for nonmedical reasons in the 30 days before completing a national drug use survey.

"About 1.4 million reproductive-age women and 50,000 pregnant women reported recent use of opioids for nonmedical reasons, and this has profound public health implications," said Katy Kozhimannil, a U associate professor of public health who co-authored the study in the journal Drug and Alcohol Dependence.

Kozhimannil's report, based on responses between 2005 and 2014 to the National Survey on Drug Use and Health, follows last week's guidance from the American Academy of Pediatrics on how to confront the problem of pregnant women addicted to opioids.

While opioid exposure can harm fetuses — causing them to suffer addictions and withdrawal symptoms after birth — the academy recommended a sympathetic public health response in dealing with pregnant addicts rather than a punitive one.

Part of the public health problem is that addiction itself leads to more unplanned pregnancies. The Pediatrics report noted that as many as 47 percent of all pregnancies are unplanned, but that 85 percent of pregnancies are unplanned in women addicted to opioids.

Kozhimannil's study didn't assess whether pregnant women who had used opioids in the prior 30 days had also used them before pregnancy. But it did examine the sources of their pills — with 46 percent of pregnant women saying they got their opioids from doctors or other providers.

"This clearly identifies an area for intervention," she said.

Her study recommended training for doctors on opioid risks and alternatives for pain management. It also advocated for tailored treatment of addictions in pregnant women and the expanded use of opioid replacement drugs such as methadone or buprenorphine.

Replacement therapy is particularly important when considering that cutting off a pregnant addict from opioids can cause preterm birth and fetal distress or death.

Jeremy Olson • 612-673-7744