Division of General Obstetrics and Gynecology, Department of Obstetrics and Gynecology University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States.
University of North Carolina at Chapel Hill, United States.
Drug Alcohol Depend. 2020 Sep 1;214:108159. doi: 10.1016/j.drugalcdep.2020.108159. Epub 2020 Jul 7.
Medication for opioid use disorder (MOUD) improves both maternal and neonatal outcomes for pregnant women with opioid use disorder (OUD). Although correctional policies often state that incarcerated pregnant women with OUD should receive MOUD, implementation data is scant. Our aims were to 1) quantify the extent to which pregnant women in a Southeastern prison received MOUD during their incarceration; 2) to describe the medications and doses used during incarceration and frequency of MOUD referral after incarceration; and 3) identify associations between maternal characteristics and receipt of MOUD in order to identify points of intervention for clinical policy change.
We conducted a retrospective chart review of pregnant women with OUD in a North Carolina state women's prison from 2016-2018. We collected MOUD, demographic, custody, pregnancy, and pre-incarceration substance use data. We used descriptive statistics, chi square tests, and logistic regression.
There were 179 pregnant women with OUD. During incarceration, 11.7 % received buprenorphine, 17.8 % methadone, 22.8 % oxycodone, and 47.8 % did not receive any opioid medications. Of those who received buprenorphine, methadone, and no MOUD, respectively, 65 %, 51.2 %, and 3.2 % were referred for community MOUD. Women were more likely to receive MOUD during incarceration if they had received MOUD pre-incarceration.
There was significant unmet need for MOUD and MOUD referral among pregnant women imprisoned in North Carolina from 2016-2018. Our findings suggest that the initial assessment for MOUD and referral to a community MOUD provider may represent opportunities to improve MOUD access for this population.
阿片类药物使用障碍（MOUD）药物治疗可改善患有阿片类药物使用障碍（OUD）的孕妇的母婴结局。尽管矫正政策通常规定，监禁中的患有 OUD 的孕妇应接受 MOUD，但实施数据却很少。我们的目的是：1）量化在东南监狱中监禁的患有 OUD 的孕妇接受 MOUD 的程度；2）描述在监禁期间使用的药物和剂量以及监禁后 MOUD 转介的频率；3）确定产妇特征与 MOUD 接受之间的关联，以便为临床政策改变确定干预点。
我们对北卡罗来纳州女子监狱 2016-2018 年期间患有 OUD 的孕妇进行了回顾性病历审查。我们收集了 MOUD、人口统计学、拘留、怀孕和监禁前药物使用数据。我们使用描述性统计、卡方检验和逻辑回归。
共有 179 名患有 OUD 的孕妇。在监禁期间，11.7%接受了丁丙诺啡，17.8%接受了美沙酮，22.8%接受了羟考酮，47.8%未接受任何阿片类药物治疗。在接受丁丙诺啡、美沙酮和无 MOUD 的患者中，分别有 65%、51.2%和 3.2%被转介接受社区 MOUD。如果孕妇在监禁前接受过 MOUD，则更有可能在监禁期间接受 MOUD。
2016-2018 年，北卡罗来纳州监禁的孕妇对 MOUD 和 MOUD 转介的需求存在显著未满足的情况。我们的研究结果表明，对 MOUD 的初步评估和向社区 MOUD 提供者的转介可能是改善该人群 MOUD 可及性的机会。
