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Pregnant and Non-Pregnant Women with Substance Use Disorders: The Gap Between Treatment Need and Receipt

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Differences in pregnant and non-pregnant women's alcohol and drug use, substance treatment need, and treatment receipt were examined using The National Survey of Drug Use and Health (2002-2006). Treatment need and receipt were defined by either self-report or DSM-IV criteria. Pregnant women were less likely to use alcohol and drugs than non-pregnant women. Among women who use drugs, pregnant women were more likely to need treatment (odds ratio (OR) = 1.92; 95% confidence interval (CI): 1.46, 2.52), however they were not more likely to receive treatment (OR = 0.90; 95% CI: 0.54, 1.51). Overall, there is an unmet need for treatment among reproductive-aged substance users.
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... 21 Appendix Figure A1 shows the inclusion and exclusion criteria used to construct the final sample. The initial maternal sample consisted of all women with a claim for a delivery between January 1, 2006 and December 31,2009. Women were included if they were 12-55 years old, resided in one of the three selected states in the year of delivery, and had at least 1 month of Medicaid enrollment in the 12 months before and including delivery. ...
... Several studies have documented the multiple barriers to care during the perinatal period for women with SUD, 8,28-30 including stigma, lack of treatment capacity, challenges with daily treatment attendance, and logistical hurdles such as childcare and transportation. 10,31 These more recent studies documenting multiple barriers suggest that the low rates documented in our study may very well continue to exist and highlight the continued need for programmatic and policy interventions to address barriers to engaging women with SUD in personcentered care during both the prenatal period as well as in the critical months following delivery, 32 (the ''fourth trimester''), 33 when relapse rates and overdose risk increase. 6,34 Overall, only one in five women with infants affected by substance exposure attended a postpartum visit within 60 days of delivery, which is consistent with a 2019 study of women with OUD in a single state. ...
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Background: Little is known about rates of substance use disorder (SUD) treatment for women in dyads affected by substance use in the immediate postpartum period. This study's objectives were to (1) identify characteristics of mothers of infants with neonatal abstinence syndrome (NAS) and/or prenatal substance exposure (PSE) who did or did not receive SUD treatment in the first 60 days postpartum and (2) describe timing of treatment receipt. Methods: This descriptive study examined linked mother?infant dyads using Medicaid data from Louisiana, Massachusetts, and Wisconsin for 2006?2009. Dyads were included if the infant had NAS and/or PSE. Descriptive statistics on sociodemographic characteristics, prenatal SUD, mental health conditions, Medicaid enrollment, and health care utilization were reported for women who did and did not receive SUD treatment in the first 60 days postpartum. The distribution of each variable was compared using chi-square tests. The timing of first postpartum treatment in weeks since delivery was examined. Results: Among Medicaid-insured women whose infants had in utero substance exposure, 15% received any postpartum SUD treatment. Fewer than half were diagnosed with SUD prenatally. Of those who received postpartum SUD treatment, 68% had received prenatal treatment. No association was observed between postpartum SUD treatment receipt and months of Medicaid enrollment in the year before delivery, prenatal visits, or postpartum visit attendance. Conclusions: Most women who likely need postpartum SUD treatment did not receive it and multipronged solutions are needed. These findings provide a useful baseline for evaluations of policies aimed at improving maternal health.
... Overall, the present results highlight the need for continued screening and improved education and treatment for those continuing to use substances during pregnancy. Pregnant women are less likely than their non-pregnant counterparts to receive substance use treatment (Terplan et al. 2012). This may be due to the limited substance use interventions available (O'Connor and Whaley 2003). ...
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Purpose Given the health consequences, perinatal substance use is a significant public health concern, especially as substance use rates increase among women; ongoing data regarding the rates of substance use across trimesters of pregnancy is needed. Methods The present study utilized cross-sectional population-based data from the National Survey of Drug Use and Health (NSDUH) between 2009 and 2019. We aimed to explore both licit and illicit substance use assessed within each trimester among women endorsing past-year substance use. The NSDUH sample included 8,530 pregnant women. Results Perinatal substance use was less prevalent among women in later trimesters; however, past-month substance use was observed for all substances across trimesters. The prevalence of past-month licit substance use among pregnant women ranged from 5.77 to 22.50% and past-month illicit substance use ranged from 4.67 to 14.81%. In the second trimester, lower odds of past-month substance use were observed across tobacco, alcohol, and marijuana (odds ratios [ORs] ranging from 0.29 to 0.47), when compared to the first trimester. A similar lower rate of past-month substance use was observed in the third trimester compared to the first trimester, across tobacco, alcohol, and marijuana use, as well as cocaine, prescription pain medication, and tranquilizer use (ORs ranging from 0.02 to 0.42). The likelihood of polysubstance use was lower among women in the second and third trimesters compared to the first trimester (ORs ranging from 0.09 to 0.46). Conclusion Findings indicate that a minority of women continue to use substances across all trimesters. This is especially true among women using licit substances and marijuana. These results highlight the need for improved interventions and improved access to treatment for these women.
... Womenspecific barriers are also observed, including feelings of guilt, shame, and responsibility towards their children [60,61]. Furthermore, lower rates of women than men receive AUD treatment [55,62], with pregnant women being less likely to receive AUD treatment than non-pregnant women [63]. ...
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