Affiliation:
1. School of Nursing, University of Maryland, Baltimore, MD, USA
2. Department of Practice, Sciences and Health Outcomes Research, School of Pharmacy, University of Maryland, Baltimore, MD, USA
3. Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, USA
Abstract
Background: Maternal misuse of prescription opioids and illicit drugs such as, heroin and non-pharmaceutical fentanyl analogs has increased in the last 2 decades and one in 5 women reported misuse of opioids. Medications for opioid use disorder (MOUD) are recommended for treating pregnant women with opioid use disorder (OUD). MOUD is effective in reducing cravings and negative outcomes, yet treatment is underutilized and varies in integration and intensity of resources across health systems. Exploring perceptions of MOUD delivery among pregnant/parenting women promises to uncover and address the underlying challenges to treatment, a perspective that may be different for providers and stakeholders. Therefore, our main purpose is to elicit patients’ experiences and perceptions of MOUD, associated access to treatment, and availability of supportive resources during pregnancy/postpartum to inform OUD treatment. Methods: Through a qualitative research approach we gathered data from individual interviews/focus group discussions for this pilot study. Pregnant and postpartum parenting women ( n = 17) responded to questions related to perceptions of MOUD, access to treatment, and availability of social and psychosocial resources. Data were collected, transcribed, and coded (by consensus) and emerging themes were analyzed using grounded theory methodology. Results: Emerging themes revealed positive uptake and perceptions of MOUD, continuing gaps in knowledge, negative impact of stigmatization, and limited access to programs and resources. Supportive relationships from family, peers, healthcare providers and child welfare staff, and co-located services were perceived as positive motivators to recovery. Conclusions: Through the unique lenses of women with lived experience, this study revealed several themes that can be transformative for women. Overall perceptions of MOUD were positive and likely to facilitate uptake and promote positive recovery outcomes. Bridging knowledge gaps will reduce anxieties, fears about neonatal opioid withdrawal syndrome and adverse maternal outcomes. Additionally, a deeper understanding of stigmatization and relationships can inform an integrated patient-centered approach to OUD treatment.
Funder
agency for healthcare research and quality
Patient-Centered Involvement in Evaluating the Effectiveness of Treatments
patient-centered outcomes research institute
Parent Project PI: C. Daniel Mullins, PhD
Reference76 articles.
1. Neonatal Abstinence Syndrome and Maternal Opioid-Related Diagnoses in the US, 2010-2017
2. Hughes A, Williams MR, Lipari RN, Bose J, Copello EAP, Kroutil LA. Prescription drug use and misuse in the United States: Results from the 2015 national survey on drug use and health. 2015. Accessed May 30, 2023. https://www.samhsa.gov/data/sites/default/files/NSDUHFFR2-2015/NSDUH-FFR2-2015.pdf
3. Collier AY, Molina RL. Maternal mortality in the United States: Updates on trends, causes, and solutions. Neoreviews. 2019;20(10):e561–e574. doi:10.1542/neo20-10-e561
4. Recent trends in treatment admissions for prescription opioid abuse during pregnancy
5. Maternal Mortality in the United States