School of Nursing, University of Maryland, Baltimore, MD, USA.
Department of Practice, Sciences and Health Outcomes Research, School of Pharmacy, University of Maryland, Baltimore, MD, USA.
Subst Use Addctn J. 2024 Jul;45(3):367-377. doi: 10.1177/29767342231221055. Epub 2024 Jan 22.
Maternal misuse of prescription opioids and illicit drugs such as, heroin and non-pharmaceutical fentanyl analogs has increased in the last 2 decades and one in 5 women reported misuse of opioids. Medications for opioid use disorder (MOUD) are recommended for treating pregnant women with opioid use disorder (OUD). MOUD is effective in reducing cravings and negative outcomes, yet treatment is underutilized and varies in integration and intensity of resources across health systems. Exploring perceptions of MOUD delivery among pregnant/parenting women promises to uncover and address the underlying challenges to treatment, a perspective that may be different for providers and stakeholders. Therefore, our main purpose is to elicit patients' experiences and perceptions of MOUD, associated access to treatment, and availability of supportive resources during pregnancy/postpartum to inform OUD treatment.
Through a qualitative research approach we gathered data from individual interviews/focus group discussions for this pilot study. Pregnant and postpartum parenting women ( = 17) responded to questions related to perceptions of MOUD, access to treatment, and availability of social and psychosocial resources. Data were collected, transcribed, and coded (by consensus) and emerging themes were analyzed using grounded theory methodology.
Emerging themes revealed positive uptake and perceptions of MOUD, continuing gaps in knowledge, negative impact of stigmatization, and limited access to programs and resources. Supportive relationships from family, peers, healthcare providers and child welfare staff, and co-located services were perceived as positive motivators to recovery.
Through the unique lenses of women with lived experience, this study revealed several themes that can be transformative for women. Overall perceptions of MOUD were positive and likely to facilitate uptake and promote positive recovery outcomes. Bridging knowledge gaps will reduce anxieties, fears about neonatal opioid withdrawal syndrome and adverse maternal outcomes. Additionally, a deeper understanding of stigmatization and relationships can inform an integrated patient-centered approach to OUD treatment.
在过去的 20 年中,母亲滥用处方类阿片和非法药物(如海洛因和非药物类芬太尼类似物)的情况有所增加,每 5 名女性中就有 1 名报告阿片类药物滥用。药物治疗阿片类药物使用障碍(MOUD)被推荐用于治疗患有阿片类药物使用障碍(OUD)的孕妇。MOUD 可有效减少成瘾和不良后果,但治疗的利用率较低,并且在整个医疗体系中,资源的整合和强度存在差异。探索孕妇/产妇对 MOUD 治疗的看法有望发现和解决治疗的潜在挑战,这种观点可能与提供者和利益相关者不同。因此,我们的主要目的是了解患者对 MOUD 的治疗经验和看法,以及在怀孕期间/产后获得治疗和获得支持性资源的途径,为 OUD 治疗提供信息。
通过定性研究方法,我们为这项试点研究从个人访谈/焦点小组讨论中收集了数据。17 名怀孕和产后有子女的女性对 MOUD 的看法、获得治疗的机会以及在怀孕期间/产后获得社会和心理社会资源的机会相关问题做出了回应。数据被收集、转录和(通过共识)编码,并使用扎根理论方法分析了出现的主题。
出现的主题揭示了对 MOUD 的积极接受和看法、知识持续存在的差距、污名化的负面影响以及对项目和资源的有限获取。来自家庭、同龄人、医疗保健提供者和儿童福利工作人员的支持性关系以及共同提供的服务被视为康复的积极动力。
通过有过亲身经历的女性的独特视角,这项研究揭示了一些可以改变女性的主题。对 MOUD 的总体看法是积极的,这可能有助于接受和促进积极的康复结果。弥合知识差距将减少对新生儿阿片类戒断综合征和不良母婴结局的焦虑和恐惧。此外,对污名化和关系的深入了解可以为以患者为中心的 OUD 治疗方法提供信息。