Demographic Discrepancies in Prenatal Urine Drug Screening in Washington State Surrounding Recreational Marijuana Legalization and Accessibility

Pflugeisen, Bethann M.; Mou, Jin; Drennan, Kathryn; Straub, Heather

doi:10.1007/s10995-020-03010-5

Cited by 13 publications

(13 citation statements)

References 41 publications

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“…35,36 State prenatal urine drug screening requirements have changed as a result of recreational cannabis legalization. 37 Fear of punitive action-particularly among those who have had a positive toxicology screening result during pregnancy or at the time of delivery-may have caused women to be less likely to report use when asked retrospectively. Therefore, we hypothesized that women in states where recreational cannabis is legal may have been more aware of risks of prenatal cannabis use (eg, possible involvement of child protective services, adverse health effects) than women in states that had not legalized recreational use, resulting in substantial underreporting of prenatal cannabis use.…”

Section: Discussionmentioning

confidence: 99%

“…However, women residing in states where recreational cannabis is illegal have poor or uncertain knowledge of the risks associated with cannabis use during pregnancy . State prenatal urine drug screening requirements have changed as a result of recreational cannabis legalization . Fear of punitive action—particularly among those who have had a positive toxicology screening result during pregnancy or at the time of delivery—may have caused women to be less likely to report use when asked retrospectively.…”

Section: Discussionmentioning

confidence: 99%

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Association of Recreational Cannabis Legalization With Maternal Cannabis Use in the Preconception, Prenatal, and Postpartum Periods

2021

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association of Recreational Cannabis Legalization With Maternal Cannabis Use in the Preconception, Prenatal, and Postpartum Periods

2021

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“…Perlman and colleagues have also found that Indigenous women are also far more likely to be screened than their white counterparts (aOR: 4.43, 95% CI: 1.88–10.43) (Perlman et al, 2020). These disparities persist even in areas where recreational cannabis use is legal, such as Washington State, where African American, Latinx and Asian women are screened more frequently than white women (Pflugeisen et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…Inequities beyond race and ethnicity include where someone lives, income, insurance type and maternal age and education. Women who deliver in hospitals with larger percentages of Medicaid recipients, women who are using subsidized insurance, young, unmarried and less educated mothers are more likely to be tested for substance use (Patel et al, 2021; Pflugeisen et al, 2020; Rebbe et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Experiences of child welfare social workers in addressing substance use among maltreated young mothers to prevent child maltreatment

Doig

Jasczyński

Phillips

et al. 2023

Child & Family Social Work

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Substance use during the perinatal period and while parenting can pose a significant risk to children's safety and well‐being. Mothers who have experienced child maltreatment are more likely to use substances than mothers without a history of maltreatment. This study explores how child welfare social workers experience supporting young, maltreated mothers struggling with substance use to prevent the intergenerational transmission of child maltreatment. Semi‐structured in‐depth interviews were conducted with four social workers working with young mothers with a history of maltreatment and substance use. Interpretative Phenomenological Analysis revealed two themes: (1) grappling with system challenges and (2) supporting strategies for disrupting intergenerational transmission of child maltreatment. The results highlight the need for systemic changes around support for social workers who work with young mothers who use substances and have a history of maltreatment, and substance use treatment and mental health programs themselves. Mothers need access to prenatal programs that are trauma‐informed, non‐judgemental and that support participants' basic needs and parenting skills.

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“…4,22 Yet, Black compared with White individuals are substantially more likely to undergo UDS and to have their opioids discontinued in response. [23][24][25][26] As UDS is increasingly incorporated into cancer care, 20,27,28 guidelines regarding triggers or the optimal frequency for testing are lacking. This could amplify racial biases in UDS, yet little is known about the prevalence or inequities in UDS among cancer populations.…”

Section: Introductionmentioning

confidence: 99%

Racial and Ethnic Disparities in Opioid Access and Urine Drug Screening Among Older Patients With Poor-Prognosis Cancer Near the End of Life

Enzinger

Ghosh

Keating

et al. 2023

JCO

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PURPOSE To characterize racial and ethnic disparities and trends in opioid access and urine drug screening (UDS) among patients dying of cancer, and to explore potential mechanisms. METHODS Among 318,549 non-Hispanic White (White), Black, and Hispanic Medicare decedents older than 65 years with poor-prognosis cancers, we examined 2007-2019 trends in opioid prescription fills and potency (morphine milligram equivalents [MMEs] per day [MMEDs]) near the end of life (EOL), defined as 30 days before death or hospice enrollment. We estimated the effects of race and ethnicity on opioid access, controlling for demographic and clinical factors. Models were further adjusted for socioeconomic factors including dual-eligibility status, community-level deprivation, and rurality. We similarly explored disparities in UDS. RESULTS Between 2007 and 2019, White, Black, and Hispanic decedents experienced steady declines in EOL opioid access and rapid expansion of UDS. Compared with White patients, Black and Hispanic patients were less likely to receive any opioid (Black, –4.3 percentage points, 95% CI, –4.8 to –3.6; Hispanic, –3.6 percentage points, 95% CI, –4.4 to –2.9) and long-acting opioids (Black, –3.1 percentage points, 95% CI, –3.6 to –2.8; Hispanic, –2.2 percentage points, 95% CI, –2.7 to –1.7). They also received lower daily doses (Black, –10.5 MMED, 95% CI, –12.8 to –8.2; Hispanic, –9.1 MMED, 95% CI, –12.1 to –6.1) and lower total doses (Black, –210 MMEs, 95% CI, –293 to –207; Hispanic, –179 MMEs, 95% CI, –217 to –142); Black patients were also more likely to undergo UDS (0.5 percentage points; 95% CI, 0.3 to 0.8). Disparities in EOL opioid access and UDS disproportionately affected Black men. Adjustment for socioeconomic factors did not attenuate the EOL opioid access disparities. CONCLUSION There are substantial and persistent racial and ethnic inequities in opioid access among older patients dying of cancer, which are not mediated by socioeconomic variables.

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Demographic Discrepancies in Prenatal Urine Drug Screening in Washington State Surrounding Recreational Marijuana Legalization and Accessibility

Cited by 13 publications

References 41 publications

Association of Recreational Cannabis Legalization With Maternal Cannabis Use in the Preconception, Prenatal, and Postpartum Periods

Association of Recreational Cannabis Legalization With Maternal Cannabis Use in the Preconception, Prenatal, and Postpartum Periods

Experiences of child welfare social workers in addressing substance use among maltreated young mothers to prevent child maltreatment

Racial and Ethnic Disparities in Opioid Access and Urine Drug Screening Among Older Patients With Poor-Prognosis Cancer Near the End of Life

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