Medications for opioid use disorder during pregnancy: Access and continuity in a state women’s prison facility, 2016–2019

Knittel, AK; Swartzwelder, RA; Zarnick, Samantha; Tsujimoto, Tamy; Horne, Timeli; Fan, Lin; Edwards, James M.; Amos, Elton; Alexander, Jeffrey A.; Thorp, John M.; Jones, Hayley E

doi:10.1016/j.drugalcdep.2022.109308

Cited by 7 publications

(11 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The NCCIW is the only North Carolina state prison facility housing pregnant people and has a total capacity of 1776 15 . During the study period, the total daily pregnancy census ranged from 20 to 60 people and the prevalence of OUD among pregnant people was 58% 16 . Additional details about overall study are described elsewhere 16 .…”

Section: Methodsmentioning

confidence: 99%

“…16 Additional details about overall study are described elsewhere. 16 Obstetrician-gynecologists from the University of North Carolina at Chapel Hill provide prenatal services inside the prison facility. Pregnant people who labored spontaneously received intrapartum and postpartum care at the nearest hospital to NCCIW, an academically affiliated community hospital (WakeMed).…”

Section: Settingmentioning

confidence: 99%

“…Approximately one third of pregnant people had received MOUD before incarceration, with half of those continuing treatment while at NCCIW. 16 Medications for opioid use disorder were continued during the entire delivery hospitalization and was discontinued at the time of discharge to NCCIW.…”

Section: Medication Administrationmentioning

confidence: 99%

“…Maternal characteristics are described with the primary outcomes from the study. 16 Before incarceration, pregnant people who delivered during incarceration most commonly reported use of tobacco (n = 100, 80%), alcohol (n = 37, 30%), cannabis (n = 43, 34%), cocaine (n = 42, 34%), and amphetamines (n = 42, 34%). Preincarceration opioid exposure included heroin (n = 25, 20%), other opioids (n = 114, 91%), prescribed methadone (n = 14, 11%), and prescribed buprenorphine (n = 24, 19%).…”

Section: Study Samplementioning

confidence: 99%

See 3 more Smart Citations

Neonatal Outcomes after Medications for Opioid Use Disorder during Pregnancy in a State Women’s Prison Facility, 2016–2019

et al. 2023

Self Cite

View full text Add to dashboard Cite

Objective: Although medications for opioid use disorder improve both maternal and neonatal outcomes, little is known about opioid-exposed infants born during episodes of incarceration. The study sought to examine birth outcomes for infants born with opioid exposure during perinatal incarceration. Methods: Participants were identified from clinic rosters in a Southeastern women's prison (2016)(2017)(2018)(2019). Included infants born to pregnant people with opioid use disorder incarcerated in the study facility at the time of delivery. We abstracted hospital length of stay, neonatal opioid withdrawal syndrome (NOWS) severity, and discharge plan from hospital records and report descriptive statistics, analysis of variance F tests, and chi-square tests to compare outcomes by opioid exposure type. Results: There were 125 infants born after exposure to methadone (n = 34), buprenorphine (n = 15), oxycodone (n = 22), or no opioid medication (n = 54) during prenatal incarceration. Most infants exposed to methadone or buprenorphine had difficulty with eating, sleeping, or consoling (97% and 80%), and 59% and 47% were treated with medication for NOWS, respectively. The majority with prenatal opioid exposure required intervention for NOWS symptoms after their birthing parent was discharged to the prison. The average hospital length of stay was different for infants with no opioid, methadone, buprenorphine, and oxycodone exposure during incarceration (4, 15, 12, and 9 days, respectively, P < 0.001). Conclusions: Neonatal hospitalization experiences of infants with perinatal opioid exposures during maternal incarceration mirror those of similarly exposed infants born outside the context of incarceration, except for hospital length of stay. Consideration of avoiding separation of the parent-infant dyad may be needed to improve outcomes for these infants.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Settingmentioning

confidence: 99%

Section: Medication Administrationmentioning

confidence: 99%

Section: Study Samplementioning

confidence: 99%

See 2 more Smart Citations

Neonatal Outcomes after Medications for Opioid Use Disorder during Pregnancy in a State Women’s Prison Facility, 2016–2019

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…Nonetheless, innovative models of care are emerging to address these significant unmet treatment needs among people who are incarcerated, including during the highly vulnerable life-course periods of pregnancy and postpartum. For example, a recent study done in North Carolina highlighted the potential of a prison-academic partnership to bolster MOUD continuity for pregnant and postpartum people with OUD ( 11 ). Likewise, our institution houses an integrated OBGYN-Addiction program consisting of nurses and medical providers with expertise in both OBGYN and Addiction Medicine as well as support staff, behavioral health clinicians and subspecialty consultants who provide robust, recovery-oriented wrap-around services ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Incarceration status at buprenorphine initiation and OUD treatment outcomes during pregnancy

Nguyen

Shadowen

et al. 2023

Front. Psychiatry

Self Cite

View full text Add to dashboard Cite

IntroductionOpioid use disorder (OUD) is a leading cause of pregnancy-associated deaths. OUD treatment with buprenorphine (BUP) reduces overdose risk and improves perinatal outcomes. Incarceration can be a barrier to receipt of OUD treatment during pregnancy and postpartum. The objective of this study was to examine differences in BUP continuation at delivery by patients’ incarceration status at the time of BUP initiation.MethodsThis is a secondary analysis of a retrospective cohort study of pregnant patients with OUD who delivered at an academic medical center and initiated BUP between January 1, 2018, and March 30, 2020. The primary outcome was BUP continuation at delivery, abstracted from the state prescription monitoring program and electronic medical record, along with incarceration status. Bivariate analysis was used to assess the relationship between BUP continuation and incarceration status.ResultsOur sample included 76 patients, with 62% of patients incarcerated at BUP initiation (n = 47). Among the entire sample, 90.7% (n = 68) received BUP at delivery. Among patients who were incarcerated at BUP initiation, 97% remained on BUP at delivery; among patients who were not incarcerated at BUP initiation, 79% remained on BUP at delivery (p = 0.02).ConclusionIn our sample from a health system housing a care model for pregnant and parenting people with OUD with local jail outreach, BUP continuation rates at delivery were high, both for patients who were and were not incarcerated at BUP initiation. Findings are intended to inform future work to develop and evaluate evidence-based, patient-centered interventions to expand OUD treatment access for incarcerated communities.

show abstract

Neonatal abstinence syndrome and other neonatal outcomes for the infants of women experiencing incarceration: A retrospective cohort study

Bell,

Kelty,

Segal

et al. 2023

Aust J Social Issues

View full text Add to dashboard Cite

Substance use during pregnancy is associated with poor neonatal outcomes. Women incarcerated during pregnancy may have a history of substance use, and their babies may be at risk of neonatal abstinence syndrome (NAS). This study examines the incidence of NAS and other outcomes in infants born to currently or formerly incarcerated women. Infants born between 1985 and 2011 in Western Australia were divided into three mutually exclusive groups: born to women incarcerated during pregnancy (n = 708); born within 9–24 months of the mother's release from prison (n = 651); and born to women who were never incarcerated (n = 17,712). The impact of the timing of incarceration during pregnancy was also examined. Neonatal outcomes (NAS, preterm birth, low birthweight, infant mortality and admission to special care nursery) were compared using logistic regression. Infants born to currently or recently incarcerated women had higher odds of all adverse outcomes than infants in the nonexposed group. Infants born to women incarcerated during the second or third trimester (but not the month of birth) had poorer outcomes than infants born to women incarcerated during the month of birth. The findings show that babies born to currently or formerly incarcerated women are equally likely to experience adverse neonatal outcomes. Enhanced maternal healthcare must be provided during incarceration and after release.

show abstract

Medications for opioid use disorder during pregnancy: Access and continuity in a state women’s prison facility, 2016–2019

Cited by 7 publications

References 35 publications

Neonatal Outcomes after Medications for Opioid Use Disorder during Pregnancy in a State Women’s Prison Facility, 2016–2019

Neonatal Outcomes after Medications for Opioid Use Disorder during Pregnancy in a State Women’s Prison Facility, 2016–2019

Incarceration status at buprenorphine initiation and OUD treatment outcomes during pregnancy

Neonatal abstinence syndrome and other neonatal outcomes for the infants of women experiencing incarceration: A retrospective cohort study

Contact Info

Product

Resources

About