Andrea K Knittel1, Rita A Swartzwelder2, Samantha Zarnick2, Tamy Harumy Moraes Tsujimoto3, Timelie Horne2, Feng-Chang Lin3, James Edwards4, Elton Amos5, James Alexander5, John Thorp6, Hendree E Jones7. 1. Division of General Obstetrics and Gynecology, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA. Electronic address: aknittel@umich.edu. 2. University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA. 3. Department of Biostatistics, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. 4. WakeMed Maternal-Fetal Medicine, Raleigh, NC, USA. 5. North Carolina Department of Public Safety, Raleigh, NC, USA. 6. Division of General Obstetrics and Gynecology, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA. 7. UNC Horizons, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
Abstract
BACKGROUND: Although medications to treat opioid use disorder (MOUD) are the standard of care during pregnancy, there are many potential gaps in the cascade of care for pregnant people experiencing incarceration. METHODS: We conducted a retrospective cohort study of pregnant people with opioid use disorder incarcerated in a Southeastern women's prison from 2016 to 2019. The primary outcomes were access to MOUD during incarceration and continuity in the community. We used descriptive statistics to summarize aspects of our sample and logistic regression to identify predictors of MOUD receipt during incarceration. RESULTS: Of the 279 pregnant people with OUD included in the analysis, only 40.1% (n = 112) received MOUD during incarceration, including 67 (59.8%) who received methadone and 45 (40.1%) who received buprenorphine. Less than one-third of the participants were referred to a community MOUD provider (n = 83, 30%) on return to the community. Significant predictors of MOUD receipt included medium/close custody level during incarceration, incarceration during the latter portion of the study period, pre-incarceration heroin use, and receipt of pre-incarceration MOUD. CONCLUSIONS: Although prisons can serve as an important site of retention in MOUD for some pregnant people, there were substantial gaps in initiation of MOUD and retention in MOUD among pregnant people with OUD imprisoned in the Southeast during the study period.
BACKGROUND: Although medications to treat opioid use disorder (MOUD) are the standard of care during pregnancy, there are many potential gaps in the cascade of care for pregnant people experiencing incarceration. METHODS: We conducted a retrospective cohort study of pregnant people with opioid use disorder incarcerated in a Southeastern women's prison from 2016 to 2019. The primary outcomes were access to MOUD during incarceration and continuity in the community. We used descriptive statistics to summarize aspects of our sample and logistic regression to identify predictors of MOUD receipt during incarceration. RESULTS: Of the 279 pregnant people with OUD included in the analysis, only 40.1% (n = 112) received MOUD during incarceration, including 67 (59.8%) who received methadone and 45 (40.1%) who received buprenorphine. Less than one-third of the participants were referred to a community MOUD provider (n = 83, 30%) on return to the community. Significant predictors of MOUD receipt included medium/close custody level during incarceration, incarceration during the latter portion of the study period, pre-incarceration heroin use, and receipt of pre-incarceration MOUD. CONCLUSIONS: Although prisons can serve as an important site of retention in MOUD for some pregnant people, there were substantial gaps in initiation of MOUD and retention in MOUD among pregnant people with OUD imprisoned in the Southeast during the study period.
Authors: Carolyn Sufrin; Lauren Beal; Jennifer Clarke; Rachel Jones; William D Mosher Journal: Am J Public Health Date: 2019-03-21 Impact factor: 9.308
Authors: Andrea K Knittel; Samantha Zarnick; John M Thorp; Elton Amos; Hendree E Jones Journal: Drug Alcohol Depend Date: 2020-07-07 Impact factor: 4.492
Authors: Sarah C Haight; Jean Y Ko; Van T Tong; Michele K Bohm; William M Callaghan Journal: MMWR Morb Mortal Wkly Rep Date: 2018-08-10 Impact factor: 17.586