Prevalence of Polysubstance Use of Opioids in Pregnant Women and Medication-Assisted Treatment: Evidence from the United States Treatment Episode Data Set

OBJECTIVES:

Prenatal polysubstance use (PSU) that involves the use of opioids is associated with adverse gestational outcomes. Limited research, however, exists on prenatal opioid related PSU and potential treatments as studies have focused on monosubstance use (MSU). The purpose of this study was to (1) examine associations between PSU and prenatal medication-assisted treatment (MAT) receipt among women with opioid use disorder (OUD) across different US regions; and (2) assess regional differences in factors that influence MAT receipt during pregnancy in this group of women.

METHODS:

We used data from the 2015-2019 Treatment Episode Data Set (TEDS) system which included 28,966 pregnant women living in the US who had OUD and no history of prior treatment episodes. Descriptive statistics analyses of the sample characteristics, chi-squared tests and logistic regression were conducted to assess associations between MAT receipt and PSU, sociodemographic, and treatment characteristics across different US regions.

RESULTS:

Nearly 17.2% of the pregnant women were involved in PSU across all US regions. Pregnant women with PSU had higher odds (AOR=3.38, 95% CI 3.10, 3.67) of receiving MAT relative to their MSU counterparts. Pregnant women with dependent living arrangements, arrested once 30 days prior to discharge, and with more than one year in length of stay at the treatment facilities had increased odds of receiving MAT across all US regions. Overall, pregnant women working full-time, experiencing homelessness, being married, referred to a treatment center for reasons other than self-referral had a lower likelihood of MAT receipt.

CONCLUSIONS:

This study provides evidence of an increased use of PSU during pregnancy among women with OUD. Healthcare professionals and public health officials need to enhance or enact policies that target populations at risk (e.g., homeless, those working full time, etc.) for not receiving the necessary treatment for substance abuse such as OUD, regardless of the US region.