Jennifer B Saunders1, Marian P Jarlenski2, Robert Levy3, Katy B Kozhimannil4. 1. Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota. Electronic address: saund252@umn.edu. 2. Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania. 3. Department of Family Medicine and Community Health, School of Medicine, University of Minnesota, Minneapolis, Minnesota. 4. Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota.
Abstract
BACKGROUND: Opioid misuse during pregnancy is increasingly common and is associated with preterm birth and neonatal abstinence syndrome. As such, there is increased policy attention on reducing opioid misuse and increasing detection and treatment of opioid use disorder around the time of childbirth. METHODS: We conducted a review of peer-reviewed and grey literature to identify policy strategies to address opioid misuse among pregnant women; to describe current federal and state laws that impact women before pregnancy, during pregnancy, at birth, and postpartum; and to identify gaps and challenges related to these efforts. RESULTS: We identify two gaps in current efforts: 1) limited attention to prevention of opioid misuse among reproductive-age women, and 2) lack of policies addressing opioid misuse among postpartum women. We also discuss barriers to accessing care for women who misuse opioids, including provider shortages (e.g., too few addiction medicine specialists accept pregnant women or Medicaid beneficiaries as patients), logistical barriers (e.g., lack of transportation, child care), stigma, and fear of legal consequences. CONCLUSIONS: As policymakers pursue strategies to address the opioid epidemic, the unique needs of pregnant and postpartum women and barriers to treatment should be addressed.
BACKGROUND: Opioid misuse during pregnancy is increasingly common and is associated with preterm birth and neonatal abstinence syndrome. As such, there is increased policy attention on reducing opioid misuse and increasing detection and treatment of opioid use disorder around the time of childbirth. METHODS: We conducted a review of peer-reviewed and grey literature to identify policy strategies to address opioid misuse among pregnant women; to describe current federal and state laws that impact women before pregnancy, during pregnancy, at birth, and postpartum; and to identify gaps and challenges related to these efforts. RESULTS: We identify two gaps in current efforts: 1) limited attention to prevention of opioid misuse among reproductive-age women, and 2) lack of policies addressing opioid misuse among postpartum women. We also discuss barriers to accessing care for women who misuse opioids, including provider shortages (e.g., too few addiction medicine specialists accept pregnant women or Medicaid beneficiaries as patients), logistical barriers (e.g., lack of transportation, child care), stigma, and fear of legal consequences. CONCLUSIONS: As policymakers pursue strategies to address the opioid epidemic, the unique needs of pregnant and postpartum women and barriers to treatment should be addressed.
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