PMID- 38479161 OWN - NLM STAT- MEDLINE DCOM- 20240427 LR - 20240427 IS - 1873-4758 (Electronic) IS - 0955-3959 (Linking) VI - 126 DP - 2024 Apr TI - Factors associated with receipt of medication for opioid use disorder among pregnant individuals entering treatment programs in the U.S. PG - 104342 LID - S0955-3959(24)00027-6 [pii] LID - 10.1016/j.drugpo.2024.104342 [doi] AB - BACKGROUND: Opioid use disorder (OUD) among pregnant individuals in the U.S. has been on the rise, and carries significant health risks if left untreated. Despite the effectiveness of medication for opioid use disorder (MOUD), rates of treatment utilization remain low, and access varies by state. This study seeks to expand on what is known about the utilization of MOUD by estimating annual percentages of MOUD use among treatment admissions among pregnant individuals across all 50 states and U.S. regions. The study also examines how pregnant people experiencing OUD are referred to substance use treatment programs to better understand which referral sources are most effective at linking them to MOUD. METHODS: This study estimated MOUD utilization among pregnant admissions over a 9-year period, identifying trends in the use of this treatment, using national and state level data from the Treatment Episode Dataset-Admissions (TEDS-A). The sample were pregnant females who admitted to treatment with opioids as a primary substance use problem, in all 50 states, from 2010 to 2018. The study examined the referral pathways through which pregnant individuals enter treatment, identifying variations in how they are linked with MOUD. A binary logistic regression was conducted to estimate significant sociodemographic characteristics and referral sources associated with MOUD receipt in treatment. RESULTS: Among admissions who reported both pregnancy and OUD across nine years (n= 84,492), the average percentage of MOUD use was 50.8%. Average annual MOUD use was highest in the Northeast region (63.42%), and lowest in the South (34.01%). Maine had the highest MOUD use, for an average of 81.99% across all years. Pregnant individuals who were self-referred to treatment comprised the largest percentage of admissions leading to MOUD use (62.1%), and those referred by the criminal justice system or other legal entity resulted in the lowest MOUD use across years (23.6%). Binary logistic regression results found that race, education, employment status, and referral source were significantly associated with MOUD receipt in 2018; specifically, individuals with a higher education, those were unemployed, and those who were referred to treatment by another substance use or healthcare provider or from the criminal or legal system, were significantly less likely to receive MOUD. CONCLUSION: This study estimated that an average of approximately half of admissions who were pregnant with OUD received MOUD as part of their treatment plans, and identified regional and state trends which can be further investigated to understand factors contributing to these geographical variations in MOUD access. Also notable were findings pertaining to low MOUD receipt among those referred from criminal or legal entities, warranting further investigation. These findings can lead to a better understanding of which referral sources to treatment can act as effective pathways to MOUD, and best practices to link pregnant individuals with evidence-based care. CI - Copyright (c) 2024. Published by Elsevier B.V. FAU - Curran, Laura AU - Curran L AD - Tulane University, School of Social Work, United States. Electronic address: Lcurran@tulane.edu. FAU - Manuel, Jennifer AU - Manuel J AD - University of Connecticut, School of Social Work, United States. LA - eng PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20240313 PL - Netherlands TA - Int J Drug Policy JT - The International journal on drug policy JID - 9014759 RN - 0 (Analgesics, Opioid) SB - IM MH - Humans MH - Female MH - Pregnancy MH - *Opioid-Related Disorders/drug therapy MH - Adult MH - United States MH - Young Adult MH - *Pregnancy Complications/drug therapy MH - *Opiate Substitution Treatment/statistics & numerical data MH - Referral and Consultation/statistics & numerical data MH - Adolescent MH - Analgesics, Opioid/therapeutic use OTO - NOTNLM OT - Access OT - MOUD receipt OT - Medication for opioid use disorder OT - Opioid use disorder OT - Pregnancy OT - Pregnant OT - Referral source OT - Substance use treatment COIS- Declaration of competing interest The authors declare no relevant financial or non-financial competing interests. EDAT- 2024/03/14 00:43 MHDA- 2024/04/28 07:24 CRDT- 2024/03/13 19:08 PHST- 2023/03/27 00:00 [received] PHST- 2023/12/28 00:00 [revised] PHST- 2024/01/30 00:00 [accepted] PHST- 2024/04/28 07:24 [medline] PHST- 2024/03/14 00:43 [pubmed] PHST- 2024/03/13 19:08 [entrez] AID - S0955-3959(24)00027-6 [pii] AID - 10.1016/j.drugpo.2024.104342 [doi] PST - ppublish SO - Int J Drug Policy. 2024 Apr;126:104342. doi: 10.1016/j.drugpo.2024.104342. Epub 2024 Mar 13.