Substance abuse in pregnancy is a major public health concern with risks for both mother and fetus. Four percent of pregnant women report current illicit drug use, with a much higher rate of 16% among teen pregnancies. Illicit drugs that are commonly abused include cocaine, heroin, methamphetamine and related stimulants, and prescription analgesics, anxiolytics, and hypnotics. The prevalence of opioid use during pregnancy ranges from 1% to 21%. In the past, this opioid use primarily consisted of heroin use. However, in recent years, an increase in the abuse of prescription analgesics has been observed in the United States. From 2002 to 2009 there was an increase in the rate of nonmedical use of prescription drugs by young adults (from 5.5% to 6.3%) that was fueled primarily by opioid analgesics. Such a rise may be attributed to a change in physician prescribing habits. In 1997, the amount of opioid pain relievers prescribed was equivalent to 96 mg of morphine per individual. By 2007, rates had reached 700 mg of morphine per person, an increase of 600%. Alarmingly, opioid pain relievers have recently surpassed heroin and cocaine in overdose deaths rivaling those from motor vehicle accidents, with a total of 73% of these deaths involving prescription analgesics.