Postpartum Opioid-Related Mortality in Patients With Public Insurance

Suarez, Elizabeth A.; Huybrechts, Krista F.; Straub, Loreen; Hernández–Dı́az, Sonia; Creanga, Andreea A.; Connery, Hilary S.; Gray, Kathryn J.; Vine, Seanna; Jones, Hendrée E.; Bateman, Brian T.

doi:10.1097/aog.0000000000005115

Cited by 8 publications

(8 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Depression in pregnancy is a significant risk factor for postpartum depression (Liu et al 2022 ), underscoring the importance of screening for and treating depression during pregnancy. In addition, a study of women with public insurance found that mental health was associated with opioid overdose deaths in the postpartum period (Suarez et al 2023 ). Further research is needed to fully understand the relationship between stigma and longer-term outcomes among pregnant women with opioid use disorder.…”

Section: Discussionmentioning

confidence: 99%

Psychological distress among postpartum women who took opioids during pregnancy: the role of perceived stigma in healthcare settings

Bann,

Okoniewski,

Clarke

et al. 2023

Arch Womens Ment Health

View full text Add to dashboard Cite

This study examined the relationship between perceived stigma in healthcare settings during pregnancy and psychological distress and well-being in the postpartum period among individuals who took opioids while pregnant. Analyses included 134 birth mothers of opioid-exposed infants. At 0–1 months postpartum, perceived stigma and psychological distress were measured using the Prenatal Opioid use Perceived Stigma scale and measures from the Patient-Reported Outcome Measurement Information System (PROMIS). Food insecurity, housing instability, and Adverse Childhood Experiences (ACEs) were also assessed. Linear and generalized linear mixed-effect models were conducted to compare PROMIS scale scores and unmet needs by stigma, adjusting for site/location, age, race/ethnicity, marital status, education, public insurance, and parity. More than half of participants (54%) perceived stigma in healthcare settings. Individuals reporting stigma had higher depression, anxiety, and anger scores (p < 0.001) indicating greater psychological distress in the postpartum period compared to those reporting no stigma, after controlling for demographic characteristics. In addition, they scored significantly lower on the PROMIS meaning and purpose scale, an indicator of well-being (p = 0.002). Those reporting stigma were more likely to have food insecurity (p = 0.003), three or more ACEs (p = 0.040), verbal or physical abuse during pregnancy (p < 0.001), and less emotional support (p = 0.006) than those who did not. An association was observed between perceived stigma in the prenatal period and psychological distress in the postpartum period, providing support for stigma reduction interventions and education for healthcare providers on trauma-informed care.

show abstract

Section: Discussionmentioning

confidence: 99%

Psychological distress among postpartum women who took opioids during pregnancy: the role of perceived stigma in healthcare settings

Bann,

Okoniewski,

Clarke

et al. 2023

Arch Womens Ment Health

View full text Add to dashboard Cite

show abstract

“…We also found a lack of mandates for specialized SUD care, such as MOUD programs, which is notable given that opioid overdose is a significant cause of maternal mortality. 12 Evidence-based guidelines advise that pregnant persons with OUD should be on MOUD and avoid withdrawal. 13 Recent studies show that many carceral settings continue pre-incarceration MOUD in pregnancy, but few initiate MOUD and provide both methadone and buprenorphine.…”

Section: Discussionmentioning

confidence: 99%

State Laws on Substance Use Treatment for Incarcerated Pregnant and Postpartum People

Steely Smith,

Zielinski,

Sufrin

et al. 2023

Subst�Abuse

View full text Add to dashboard Cite

Background: Incarcerated perinatal populations report high rates of substance use in the United States (US). Despite this, substance use disorder (SUD) treatment is not routinely available in carceral settings and state policies related to the provision of substance use screening and treatment are unknown. Methods: We conducted a systematic search in WestLaw through the end of the 2020 legislative session combining the terms “pregnant” and “postpartum” with terms for incarceration and related terms. The search returned 453 statutes from 43 states. A deductive codebook of various maternal health topics was developed. Legislative texts related to SUD screening and treatment were extracted for textual analysis. Results: Of the 43 states identified as having at least 1 state statute pertaining to pregnant or postpartum incarcerated people, 7 states had statutes relevant to SUD screening and treatment. Statutes related to substance use screening, education, treatment and diversion programs, program eligibility, aftercare and release planning, and funding appropriations. Conclusions: The majority of states across the U.S. lack legislation that address SUD screening and treatment among incarcerated perinatal populations. Given the known limited access to SUD treatment for perinatal populations in custody, increasing legislative statutes could increase access to essential care.

show abstract

mentioning

confidence: 99%

“…3 Not only are postpartum individuals with OUD at increased risk of fatal opioid overdose, but they are also at increased risk of dying from other causes, including drug-and alcoholrelated causes, suicide, homicide, and other diseases. 5 In January 2023, the federal government passed the Consolidated Appropriations Act, which expanded access to OUD treatment by removing the buprenorphine DATA-Waiver requirement, also known as an X-waiver. Now any clinician with a Drug Enforcement Administration registration with Schedule III authority can prescribe buprenorphine.…”

mentioning

confidence: 99%

Buprenorphine Extended-Release Treatment for Opioid Use Disorder in the Postpartum Period

Galati,

Wenzinger,

Rogers

et al. 2023

Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

Buprenorphine extended-release (XR) is an extended-release monthly injection to treat opioid use disorder (OUD). This retrospective case series includes 15 postpartum patients who were treated with buprenorphine-XR at a single center and reports on their outcomes. The average total daily sublingual buprenorphine dose before initiation of buprenorphine-XR was 16.25 mg (SD±7.76, range 2–32 mg). Overall, 137 total doses of buprenorphine-XR were administered between May 17, 2021, and April 11, 2023. Urine toxicology test results were negative for opioids other than buprenorphine in the majority (80.0%) of patients once appropriate maintenance doses were achieved. Euphoria and intoxication were not reported. A minority of patients (20.0%) discontinued buprenorphine-XR. Although more extensive research is needed before widespread use, buprenorphine-XR may be a favorable treatment for OUD in this high-risk population.

show abstract

Postpartum Opioid-Related Mortality in Patients With Public Insurance

Abstract: Pregnant individuals with opioid use disorder have a high incidence of postpartum death due to opioid overdose, other substance-related injuries, accidents, and suicide.

Cited by 8 publications

References 27 publications

Psychological distress among postpartum women who took opioids during pregnancy: the role of perceived stigma in healthcare settings

Psychological distress among postpartum women who took opioids during pregnancy: the role of perceived stigma in healthcare settings

State Laws on Substance Use Treatment for Incarcerated Pregnant and Postpartum People

Buprenorphine Extended-Release Treatment for Opioid Use Disorder in the Postpartum Period

Contact Info

Product

Resources

About