Zoe King1, Camille Kramer2, Carl Latkin3, Carolyn Sufrin4. 1. Duke University, Trinity College of Arts & Sciences, 117 Physics Building, 120 Science Dr., Durham, NC 27708, United States. Electronic address: zoe.king@duke.edu. 2. Johns Hopkins University School of Medicine, Department of Gynecology and Obstetrics, Johns Hopkins Bayview Hospital, 4940 Eastern Ave, A121, Baltimore, MD 21224, United States. Electronic address: ckramer@jhu.edu. 3. Johns Hopkins University Bloomberg School of Public Health, Department of Health, Behavior and Society, 642 N Broadway, Baltimore, MD 21205, United States. Electronic address: carl_latkin@jhu.edu. 4. Johns Hopkins University School of Medicine, Department of Gynecology and Obstetrics, Johns Hopkins Bayview Hospital, 4940 Eastern Ave, A121, Baltimore, MD 21224, United States; Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 24 N. Broadway, Hampton House 737, Baltimore, MD 21205, United States. Electronic address: csufrin1@jhmi.edu.
Abstract
BACKGROUND AND AIMS: Many jail facilities provide limited access to medications for opioid use disorder (MOUD) for pregnant people with opioid use disorder (OUD), despite it being the standard of care. We aim to explore the perspectives of opioid treatment providers (OTPs) on access to MOUD for pregnant people while incarcerated and postincarceration. METHODS: We conducted 16 semistructured phone interviews with providers and administrators representing 16 unique OTPs in various U.S. states with high maternal opioid use rates. We developed the interview guide using the Consolidated Framework for Implementation Research, and we analyzed interview transcripts using a direct content analysis. RESULTS: Nine participants reported having an arrangement with a carceral facility to provide care for pregnant people with OUD; however, others described how their local jail offered no OUD treatment for incarcerated pregnant people. Even if participants' clinics had arrangements to provide MOUD in a jail, most participants described significant barriers to continuity of care between jails and community providers as patients transition between jails and community settings. OTPs described their belief of how postincarceration, pregnant people experience barriers to OUD care such as lack of access to childcare, preparing for the baby, feeling unwell, in addition to the barriers that nonpregnant patients experience, such as transportation, housing, and financing. CONCLUSIONS: OTPs perceive that pregnant people with OUD experience significant barriers to accessing treatment while incarcerated and in community settings due to discrimination, difficulties in continuity of care, and lack of treatment access while incarcerated. The implementation of evidence-based MOUD treatment for pregnant people in jail and continuation of treatment upon release is crucial to reduce health disparities.
BACKGROUND AND AIMS: Many jail facilities provide limited access to medications for opioid use disorder (MOUD) for pregnant people with opioid use disorder (OUD), despite it being the standard of care. We aim to explore the perspectives of opioid treatment providers (OTPs) on access to MOUD for pregnant people while incarcerated and postincarceration. METHODS: We conducted 16 semistructured phone interviews with providers and administrators representing 16 unique OTPs in various U.S. states with high maternal opioid use rates. We developed the interview guide using the Consolidated Framework for Implementation Research, and we analyzed interview transcripts using a direct content analysis. RESULTS: Nine participants reported having an arrangement with a carceral facility to provide care for pregnant people with OUD; however, others described how their local jail offered no OUD treatment for incarcerated pregnant people. Even if participants' clinics had arrangements to provide MOUD in a jail, most participants described significant barriers to continuity of care between jails and community providers as patients transition between jails and community settings. OTPs described their belief of how postincarceration, pregnant people experience barriers to OUD care such as lack of access to childcare, preparing for the baby, feeling unwell, in addition to the barriers that nonpregnant patients experience, such as transportation, housing, and financing. CONCLUSIONS: OTPs perceive that pregnant people with OUD experience significant barriers to accessing treatment while incarcerated and in community settings due to discrimination, difficulties in continuity of care, and lack of treatment access while incarcerated. The implementation of evidence-based MOUD treatment for pregnant people in jail and continuation of treatment upon release is crucial to reduce health disparities.
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