Opioid Use Disorder Documented at Delivery Hospitalization - United States, 1999-2014
Sarah C Haight, Jean Y Ko, Van T Tong, Michele K Bohm, William M Callaghan, Sarah C Haight, Jean Y Ko, Van T Tong, Michele K Bohm, William M Callaghan
Abstract
Opioid use by pregnant women represents a significant public health concern given the association of opioid exposure and adverse maternal and neonatal outcomes, including preterm labor, stillbirth, neonatal abstinence syndrome, and maternal mortality (1,2). State-level actions are critical to curbing the opioid epidemic through programs and policies to reduce use of prescription opioids and illegal opioids including heroin and illicitly manufactured fentanyl, both of which contribute to the epidemic (3). Hospital discharge data from the 1999-2014 Healthcare Cost and Utilization Project (HCUP) were analyzed to describe U.S. national and state-specific trends in opioid use disorder documented at delivery hospitalization. Nationally, the prevalence of opioid use disorder more than quadrupled during 1999-2014 (from 1.5 per 1,000 delivery hospitalizations to 6.5; p<0.05). Increasing trends over time were observed in all 28 states with available data (p<0.05). In 2014, prevalence ranged from 0.7 in the District of Columbia (DC) to 48.6 in Vermont. Continued national, state, and provider efforts to prevent, monitor, and treat opioid use disorder among reproductive-aged and pregnant women are needed. Efforts might include improved access to data in Prescription Drug Monitoring Programs, increased substance abuse screening, use of medication-assisted therapy, and substance abuse treatment referrals.
Conflict of interest statement
No conflicts of interest were reported.
Figures
References
- Patrick SW, Davis MM, Lehmann CU, Cooper WO. Increasing incidence and geographic distribution of neonatal abstinence syndrome: United States 2009 to 2012. J Perinatol 2015;35:650–5. 10.1038/jp.2015.36
- Maeda A, Bateman BT, Clancy CR, Creanga AA, Leffert LR. Opioid abuse and dependence during pregnancy: temporal trends and obstetrical outcomes. Anesthesiology 2014;121:1158–65. 10.1097/ALN.0000000000000472
- Cicero TJ, Ellis MS, Kasper ZA. Increased use of heroin as an initiating opioid of abuse. Addict Behav 2017;74:63–6. 10.1016/j.addbeh.2017.05.030
- Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project (HCUP). HCUP-US databases. Rockville, MD: Agency for Healthcare Research and Quality; 2018.
- Ko JY, Patrick SW, Tong VT, Patel R, Lind JN, Barfield WD. Incidence of neonatal abstinence syndrome—28 States, 1999–2013. MMWR Morb Mortal Wkly Rep 2016;65:799–802. 10.15585/mmwr.mm6531a2
- Substance Abuse and Mental Health Services Administration. A collaborative approach to the treatment of pregnant women with opioid use disorders. HHS publication no. (SMA) 16–4978. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2016.
- Paulozzi LJ, Mack KA, Hockenberry JM. Vital signs: variation among states in prescribing of opioid pain relievers and benzodiazepines—United States, 2012. MMWR Morb Mortal Wkly Rep 2014;63:563–8.
- Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain—United States, 2016. JAMA 2016;315:1624–45. 10.1001/jama.2016.1464
- American College of Obstetricians and Gynecologists; American Society of Addiction Medicine. ACOG committee opinion no. 711: opioid use and opioid use disorder in pregnancy. Washington, DC: American College of Obstetricians and Gynecologists; Rockville, MD: American Society of Addiction Medicine; 2017.
- Guttmacher Institute. Substance use during pregnancy—state laws and policies report. Washington, DC: Guttmacher Institute; 2018.
Source: PubMed