Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, 606 24th Ave S, Suite 401, Minneapolis, MN 55455, USA.
Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, 701 Park Ave, Minneapolis, MN 55415, USA.
J Subst Use Addict Treat. 2024 Nov;166:209492. doi: 10.1016/j.josat.2024.209492. Epub 2024 Aug 14.
To guide improvements in treatment for pregnant persons with substance use disorders within the criminal legal system, treatment programs must first determine the primary substances of concern for this population. The objective of this study is to compare trends in specific substance use upon admission to treatment in pregnancy, based upon whether referrals originated from the criminal legal system or from another referral source.
This research accessed data on perinatal substance use (1995-2021) and referral sources from the Treatment Episode Data Set-Admissions (TEDS-A). Analyses use multiple logistic regressions to evaluate trends in primary substance use leading to treatment admission during pregnancy.
Approximately 1 % (N = 536,948) of all substance use treatment admissions in TEDS-A were for pregnant people. Between 1995 and 2021, the percentage of treatment admissions increased for primary methamphetamine use (10 % to 27 %), primary opioid use (21 % to 38 %), and primary cannabis use (9 % to 18 %), and decreased for primary cocaine use (32 % to 6 %) and primary alcohol use (26 % to 11 %). By 2021, treatment admissions referred from criminal legal agencies were more likely to primarily be for primary methamphetamine use (33 % vs 25 %) and less likely to be for primary opioid use (22 % vs 42 %) compared to other referral sources.
Trends in substance use treatment during pregnancy have changed substantially over the past few decades and emphasize the unique needs of patients referred to treatment by the criminal legal system. Treatment programs must therefore adapt to fluctuating trends in perinatal substance use. In particular, it is important to expand programs that prioritize treatment of methamphetamine use disorder for pregnant people referred through criminal legal agencies.
为了指导刑事法律体系内治疗药物使用障碍孕妇的治疗改进，治疗计划必须首先确定该人群关注的主要物质。本研究的目的是比较基于刑事法律系统或其他转介来源的妊娠期间治疗入院时特定物质使用的趋势。
本研究从治疗阶段数据采集（TEDS-A）中获取围产期物质使用（1995-2021 年）和转介来源的数据。分析采用多逻辑回归来评估怀孕期间导致治疗入院的主要物质使用趋势。
TEDS-A 中约有 1%（N=536948）的物质使用治疗入院是孕妇。1995 年至 2021 年间，主要使用甲基苯丙胺（10%到 27%）、主要使用阿片类药物（21%到 38%）和主要使用大麻（9%到 18%）的治疗入院比例增加，而主要使用可卡因（32%到 6%）和主要使用酒精（26%到 11%）的治疗入院比例下降。到 2021 年，与其他转介来源相比，刑事法律机构转介的治疗入院更可能主要是为了治疗原发性甲基苯丙胺使用（33%比 25%），而不太可能是为了治疗原发性阿片类药物使用（22%比 42%）。
过去几十年中，妊娠期间物质使用治疗的趋势发生了重大变化，强调了通过刑事法律系统转介的患者的独特需求。因此，治疗计划必须适应围产期物质使用的波动趋势。特别是，为通过刑事法律机构转介的孕妇扩大优先治疗甲基苯丙胺使用障碍的项目非常重要。
