Recent trends in treatment admissions for prescription opioid abuse during pregnancy.

Prescription opioid abuse is a significant and costly public health problem among pregnant women in the United States. We investigated recent trends in substance abuse treatment admissions for prescription opioids during pregnancy using the Treatment Episodes Data Set. From 1992 to 2012 the overall proportion of pregnant admissions remained stable at 4%; however, admissions of pregnant women reporting prescription opioid abuse increased substantially from 2% to 28% especially in the south. Demographic characteristics of pregnant opioid admissions changed from 1992 to 2012 with younger, unmarried White non-Hispanic women, criminal justice referrals, and those with a psychiatric co-morbidity becoming more common (p<0.01). About a third received medication assisted therapy despite this being the standard of care for opioid abuse in pregnancy. While substance abuse treatment centers have increased treatment volume to address the increase in prescription opioid dependence among pregnant women, targeting certain risk groups and increasing utilization of medication assisted therapy should be emphasized.

[1]  J. McAllister,et al.  Neonatal Abstinence Syndrome and Associated Health Care Expenditures , 2012 .

[2]  H. Jones,et al.  Methadone and Buprenorphine for the Management of Opioid Dependence in Pregnancy , 2012, Drugs.

[3]  Leonard J. Paulozzi,et al.  Vital signs: overdoses of prescription opioid pain relievers---United States, 1999--2008. , 2011, MMWR. Morbidity and mortality weekly report.

[4]  Kenneth E. Carlson,et al.  Geographic variation in opioid prescribing in the U.S. , 2012, The journal of pain : official journal of the American Pain Society.

[5]  M. Hudak,et al.  Neonatal Drug Withdrawal , 2012, Pediatrics.

[6]  ScienceDirect Journal of pain : official journal of the American Pain Society. , 2000 .

[7]  J. McAllister,et al.  Neonatal abstinence syndrome and associated health care expenditures: United States, 2000-2009. , 2012, JAMA.

[8]  C. Thomas,et al.  Medication-assisted treatment with methadone: assessing the evidence. , 2014, Psychiatric services.

[9]  H. Pollack,et al.  Methamphetamine Use Among Pregnant Women , 2009, Obstetrics and gynecology.

[10]  J. Califano,et al.  Estimating the costs of substance abuse to the Medicaid hospital care program. , 1995, American journal of public health.

[11]  C. Rose,et al.  Current trends in narcotic use in pregnancy and neonatal outcomes. , 2011, American journal of obstetrics and gynecology.

[12]  K. Thau,et al.  Lessons learned from a comparison of evidence‐based research in pregnant opioid‐dependent women , 2013, Human psychopharmacology.

[13]  L. Finnegan,et al.  Prevention and Treatment Issues for Pregnant Cocaine‐Dependent Women and Their Infants , 1998, Annals of the New York Academy of Sciences.

[14]  G. Dildy,et al.  Universal screening for substance abuse at the time of parturition. , 2008, American journal of obstetrics and gynecology.

[15]  M. Terplan,et al.  Trends in Drug-exposed Deliveries From 2002 to 2009 , 2015 .

[16]  A. Saxon,et al.  Methadone and Buprenorphine: The Place of Opiate Replacement Therapies , 2016 .

[17]  M. Behnke,et al.  Prenatal Substance Abuse: Short- and Long-term Effects on the Exposed Fetus , 2013, Pediatrics.

[18]  J. Inciardi,et al.  Prescription Drug Abuse & Diversion: Role of the Pain Clinic , 2010, Journal of drug issues.

[19]  Jeffrey Roth,et al.  Prevalence of Prescription and Illicit Drugs in Pregnancy‐Associated Non‐natural Deaths of Florida Mothers, 1999–2005 , 2013, Journal of forensic sciences.

[20]  J. Gfroerer,et al.  Substance Use Among Women: Associations with Pregnancy, Parenting, and Race/Ethnicity , 2009, Maternal and Child Health Journal.

[21]  R. Newman,et al.  Results of 313 consecutive live births of infants delivered to patients in the New York City Methadone Maintenance Treatment Program. , 1975, American journal of obstetrics and gynecology.

[22]  Hsiao-ye Yi,et al.  Prevalence of Hospitalized Live Births Affected by Alcohol and Drugs and Parturient Women Diagnosed with Substance Abuse at Liveborn Delivery: United States, 1999–2008 , 2013, Maternal and Child Health Journal.

[23]  M. Terplan,et al.  Trends in injection drug use among pregnant women admitted into drug treatment: 1994-2006. , 2010, Journal of women's health.

[24]  Stephan Arndt,et al.  Demographic and Substance Abuse Trends Among Pregnant and Non-Pregnant Women: Eleven Years of Treatment Admission Data , 2012, Maternal and Child Health Journal.

[25]  R. Frances Committee Opinion no. 524: Opioid Abuse, Dependence, and Addiction in Pregnancy , 2013 .

[26]  H. Jones,et al.  Methadone maintenance vs. methadone taper during pregnancy: maternal and neonatal outcomes. , 2008, The American journal on addictions.

[27]  R P Mattick,et al.  Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. , 2009, The Cochrane database of systematic reviews.