Katy B Kozhimannil1, Amy J Graves2, Robert Levy3, Stephen W Patrick4. 1. Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota. Electronic address: kbk@umn.edu. 2. Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota. 3. Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota. 4. Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee; Department of Health Policy, Vanderbilt Center for Health Services Research, Vanderbilt University School of Medicine, Nashville, Tennessee.
Abstract
OBJECTIVES: Nonmedical use of opioids during pregnancy is associated with adverse outcomes for women and infants, making it a prominent target for prevention and identification. Using a nationally representative sample, we determined characteristics of U.S. pregnant women who reported prescription opioid misuse in the past year or during the past month. METHODS: We used data from the National Survey on Drug Use and Health (2005-2014) in a retrospective analysis. The sample included 8,721 (weighted n = 23,855,041) noninstitutionalized women, ages 12 to 44, who reported being pregnant when surveyed. Outcomes were nonmedical use of prescription opioid medications during the past 12 months and during the past 30 days. Multivariable logistic regression models were created to determine correlates of nonmedical opioid use after accounting for potential confounding variables. RESULTS: Among pregnant women in the United States, 5.1% reported nonmedical opioid use in the past year. In adjusted models, depression or anxiety in the past year was strongly associated with past year nonmedical use (adjusted odd ratio [AOR], 2.15; 95% CI, 1.52-3.04), as were past year use of alcohol (AOR, 1.56; 95% CI, 1.11-2.17), tobacco (AOR, 1.72; 95% CI, 1.17-2.53), and marijuana (AOR, 3.44; 95% CI, 2.47-4.81). Additionally, 0.9% of U.S. pregnant women reported nonmedical opioid use in the past month. Past year depression or anxiety and past month use of alcohol, tobacco, and marijuana each independently predicted past month nonmedical use. CONCLUSIONS: Characteristics associated with nonmedical opioid use by pregnant women reveal populations with mental illness and co-occurring substance use. Policy and prevention efforts to improve screening and treatment could focus on the at-risk populations identified in this study.
OBJECTIVES: Nonmedical use of opioids during pregnancy is associated with adverse outcomes for women and infants, making it a prominent target for prevention and identification. Using a nationally representative sample, we determined characteristics of U.S. pregnant women who reported prescription opioid misuse in the past year or during the past month. METHODS: We used data from the National Survey on Drug Use and Health (2005-2014) in a retrospective analysis. The sample included 8,721 (weighted n = 23,855,041) noninstitutionalized women, ages 12 to 44, who reported being pregnant when surveyed. Outcomes were nonmedical use of prescription opioid medications during the past 12 months and during the past 30 days. Multivariable logistic regression models were created to determine correlates of nonmedical opioid use after accounting for potential confounding variables. RESULTS: Among pregnant women in the United States, 5.1% reported nonmedical opioid use in the past year. In adjusted models, depression or anxiety in the past year was strongly associated with past year nonmedical use (adjusted odd ratio [AOR], 2.15; 95% CI, 1.52-3.04), as were past year use of alcohol (AOR, 1.56; 95% CI, 1.11-2.17), tobacco (AOR, 1.72; 95% CI, 1.17-2.53), and marijuana (AOR, 3.44; 95% CI, 2.47-4.81). Additionally, 0.9% of U.S. pregnant women reported nonmedical opioid use in the past month. Past year depression or anxiety and past month use of alcohol, tobacco, and marijuana each independently predicted past month nonmedical use. CONCLUSIONS: Characteristics associated with nonmedical opioid use by pregnant women reveal populations with mental illness and co-occurring substance use. Policy and prevention efforts to improve screening and treatment could focus on the at-risk populations identified in this study.
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