Overdose is the leading cause of maternal death in the United States — killing more new and expectant mothers than any traditional obstetric complication. It's a crisis that has grown quietly in the shadows of the opioid epidemic, often undiscussed because of stigma around substance use in pregnancy.
In Colorado, it reached a devastating peak. Between 2016 and 2020, **33 women** who were pregnant or had recently given birth died from accidental overdoses — more than died from infection, high blood pressure, or bleeding combined.
Then something changed.
New data from the **Colorado Department of Public Health** shows that maternal overdose deaths fell from **20 in 2022 to just 8 in 2023** — a **60% drop in a single year**. Experts believe the key factor is a pioneering programme that does something remarkably direct: put naloxone, the overdose-reversing medication, into the hands of new mothers before they leave hospital.
**The Invisible Crisis**
Overdose deaths in pregnancy and the postpartum period are particularly hidden. They almost never happen in hospitals — they happen at home, in cars, in public places, far from medical care. For years, the Colorado Maternal Mortality Review Committee reviewed case after case where a simple intervention could have saved a life.
Dr. Mishka Terplan, a perinatal addiction medicine physician who served on the committee, describes the pattern: 'In almost all circumstances, the review committee determined that if naloxone had been present, there was a good chance the mother would have survived.'
The problem wasn't that naloxone didn't exist. It was that it wasn't in the right hands at the right moment.
**The MOMs Initiative**
In 2023, **The Naloxone Project**, a nonprofit organisation, launched the **Maternal Overdose Matters Initiative (MOMs)** — a programme distributing naloxone directly to pregnant and postpartum mothers and their family members at the point of discharge from birthing hospitals.
The scale is remarkable: the programme operates across **all 48 birthing hospitals** in Colorado. Every mother leaving those hospitals — not just those identified as high-risk — is offered naloxone and training in how to use it.
This universal approach is deliberate. Substance use disorder affects all demographics, and identifying 'high-risk' patients has historically been subject to bias and stigma. By making naloxone standard issue — like a car seat, or a follow-up appointment — the initiative removes judgement from the equation.
**60% Drop in a Single Year**
The results have been striking. Maternal overdose deaths fell from 20 to 8 between 2022 and 2023. While no single factor can fully explain a change of that magnitude, the timing aligns closely with the MOMs programme launch, and experts are cautiously optimistic.
The drop means **12 more mothers** were alive at the end of 2023 compared to the year before — 12 more families intact, 12 more women who survived a crisis moment and had the chance to recover and rebuild.
**A Model That Can Scale**
What makes the MOMs initiative particularly powerful is how replicable it is. Naloxone is inexpensive, easy to administer, and requires no prescription. The distribution protocol can be implemented by any hospital with minimal training.
Nationally, overdose is the number one cause of maternal mortality. Every US state has birthing hospitals. If the Colorado model can be replicated — and early results suggest it should be — the impact could be measured in hundreds of lives saved per year.
There's also a broader lesson here about where public health interventions work best: **not in crisis, but before it**. Not after an overdose is called in, but at the moment a new mother walks out of hospital — equipped, informed, and with a life-saving tool in her bag.
That's exactly what MOMs is doing. And in Colorado, the numbers say it's working. 💉
*Sources: Colorado Department of Public Health and Environment · The Naloxone Project / Maternal Overdose Matters Initiative (MOMs) · Dr. Mishka Terplan, University of Colorado Anschutz Medical Campus · The Conversation, 2026*
