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Substances range from nicotine or alcohol to cocaine, a study of US women has showed.

In the study, researchers found that approximately one in every 50 women aged 18 to 44 reported using an opioid pain reliever that was not prescribed or used only for the experience or feeling it caused, or heroin.

Nearly 11 percent of these women reported only using the opioid.

The most commonly used additional substances included cigarettes (56.2 percent), binge drinking (49.5 percent) and marijuana (32.4 percent).

Prevalence of other substances including non-prescribed tranquilisers or sedatives (22.2 percent) and cocaine (9.4 percent) was also high.

"Using multiple substances - some legal, some illegal - alongside opioids is the norm, not the exception, for reproductive-age women," said lead author Marian Jarlenski, Assistant Professor at University of Pittsburgh in the US.

The findings, published online in the American Journal of Public Health, suggests that public health efforts aimed at fighting the opioid epidemic should include interventions that address concurrent use of multiple substances among reproductive-age women.

"Since the increase in opioid use among women has been accompanied by an increase in adverse pregnancy and birth outcomes, including neonatal abstinence syndrome, reproductive-age women should be of particular concern in public health efforts to combat the opioid epidemic," Jarlenski added.