Department of Family and Community Medicine, Meharry Medical College, Nashville, Tennessee, USA.
Department of Health Behavior & Society, University of Kentucky, Lexington, Kentucky, USA.
Am J Addict. 2022 Sep;31(5):441-446. doi: 10.1111/ajad.13299. Epub 2022 May 9.
America's opioid epidemic has spawned an epidemic of neonatal abstinence syndrome (NAS). Studies have not tested approaches to promoting contraceptive services for women with opioid use disorder (OUD) along with treatment for this disorder. This pilot study examined the promotion of medication for OUD (MOUD) treatment and contraception use, primarily long-acting reversible contraception (LARC), for women with OUD.
In Appalachia, a peer-delivered contraception and MOUD promotion intervention was delivered to a sample of 30 women with OUD. Primary outcomes were attendance of initial appointments to receive MOUD and counseling about contraceptive options. Peer recovery coaches also offered to help the women schedule appointments and attend the appointment with them or give them a ride if necessary and requested by the patients.
Two-thirds experienced all seven symptoms of opioid dependence. Within 30 days of a brief counseling session, over one-half of the women (56.7%) were referred to MOUD, with all of them initiating treatment within 30 days. Just under one-half of the women (46.7%) were referred to a contraception consultation, with 85.7% of those receiving a LARC implant.
Study findings indicate the potential efficacy of a single-session, peer-delivered counseling intervention for linking women with OUD and at high risk of unintended pregnancy to MOUD and to services that provide women with highly reliable contraceptives.
This study is unique in exploring the efficacy of linking high-risk opioid-using women to contraceptive options and treatment for MOUD to prevent NAS.
美国的阿片类药物泛滥已引发新生儿戒断综合征（NAS）泛滥。研究尚未检验过为患有阿片类药物使用障碍（OUD）的女性提供避孕服务以及治疗这种疾病的方法。这项试点研究检验了为患有 OUD 的女性提供促进 OUD 药物治疗（MOUD）和避孕措施（主要是长效可逆避孕法，LARC）的方法。
在阿巴拉契亚地区，为 30 名患有 OUD 的女性提供了由同伴提供的避孕和 MOUD 促进干预措施。主要结局是参加 MOUD 初始预约和咨询避孕选择的情况。同伴康复教练还主动提出帮助女性安排预约并陪她们参加预约，或者在患者要求的情况下开车送她们去。
三分之二的女性经历了所有七种阿片类药物依赖症状。在简短的咨询课程后 30 天内，超过一半的女性（56.7%）被转介到 MOUD，其中所有人都在 30 天内开始治疗。略低于一半的女性（46.7%）被转介到避孕咨询，其中 85.7%的人接受了 LARC 植入。
研究结果表明，单次、同伴提供的咨询干预措施有潜力将患有 OUD 且有高意外怀孕风险的女性与 MOUD 以及为女性提供高度可靠避孕措施的服务联系起来。
这项研究独特之处在于探索了将高危阿片类药物使用者女性与避孕选择和 MOUD 治疗联系起来以预防 NAS 的疗效。
