Study finds large disparities in use of medications for opioid use disorder in pregnancy

Study finds large disparities in use of medications for opioid use disorder in pregnancy

Publication date: May 28, 2020

Black non-Hispanic and Hispanic women with opioid use disorder (OUD) are significantly less likely to receive or to consistently use any medication to treat their opioid use disorder during pregnancy than their white non-Hispanic counterparts, according to a new study from Massachusetts General Hospital (MGH).

Based on a population-level sample of women with OUD in the State of Massachusetts, the researchers found racial and ethnic disparities in the range of 60 to 75 percent, despite the fact use of the medications such as methadone and buprenorphine is associated with improvement in outcomes of both mothers and infants.

“We found evidence of striking racial and ethnic differences in terms of medication receipt, continuation of medication use, and type of medication received by pregnant women with OUD,” said Davida Schiff, MD, with the Division of General Academic Pediatrics, MassGeneral Hospital for Children, and lead author of the study, published in JAMA Network Open.

The retrospective study by led by the MGH team and collaborators at the Massachusetts Department of Public Health is the first to explore racial/ethnic differences in the use of medication for OUD during pregnancy.

Dr. Monica Bharel, MD, MPH, Commissioner of the Massachusetts Department of Public Health (DPH) and co-author of the study, remarked that “data from our innovative Public Health Data Warehouse has enabled us to gain a deeper understanding of the opioid crisis and document inequities in treatment during pregnancy.

And while pregnancy provides a motivational opportunity for women with OUD to initiate treatment and increase their engagement with health care services, the MGH study suggests that for all women, consistent use of medications during pregnancy in the second and third trimesters was low, at only 38 percent.

“Even in a state like Massachusetts which has a well-funded addiction treatment system and universal insurance coverage in pregnancy, we identified significant racial and ethnic disparities, suggesting that individual and systemic factors are discouraging women from receiving addiction treatment,” says Schiff, a pediatrician and medical director of the HOPE Clinic at MGH that cares for women and families with substance use disorders.

Concepts Keywords
Addiction Psychoactive drugs
Alcoholism Drug rehabilitation
Australia Opioids
Birth Weight Behavioral therapy
Buprenorphine RTT
Cohort Euphoriants
Counterparts Morphinans
DM Substance dependence
Harvard Methadone
Healthcare Massachusetts General Hospital
Hispanic Buprenorphine
Hospital
Insurance
JAMA
John Kelly
Massachusetts
Massachusetts General Hospital
Methadone
MGH
MSc
Opioid
Opioids
Overdose
Pediatrician
Pediatrics
PhD
Pittsburgh
Pregnancy
Prenatal Care
Preterm Birth
Public Policy
Racial Discrimination
Relapse
Sabrina
ScD
Stigma
Sydney
Teaching Hospital
United States

Semantics

Type Source Name
drug DRUGBANK Methadone
drug DRUGBANK Buprenorphine
drug DRUGBANK Methylphenidate
drug DRUGBANK Tropicamide
disease MESH pregnancy outcomes
disease MESH preterm birth
disease MESH low birth weight
disease MESH relapse
disease MESH substance use disorders
disease MESH communities
disease MESH Alcohol Abuse
pathway KEGG Alcoholism
disease MESH Kidney Diseases

Original Article

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