Opioid Use Disorder in Pregnancy: Health Policy and Practice in the Midst of an Epidemic.
Opioid abuse among pregnant women has reached epidemic proportions and has influenced maternal and child health policy at the federal, state, and local levels. As a result, we review the current state of opioid use in pregnancy and evaluate recent legislative and health policy initiatives designed to combat opioid addiction in pregnancy. We emphasize the importance of safe and responsible opioid-prescribing practices, expanding the availability and accessibility of medication-assisted treatment and standardizing care for neonates at risk of neonatal abstinence syndrome. Efforts to penalize pregnant women and negative consequences for disclosing substance use to health care providers are harmful and may prevent women from seeking prenatal care and other beneficial health care services during pregnancy. Instead, health care providers should advocate for health policy informed by scientific research and evidence-based practice to reduce the burden of prenatal opioid abuse and optimize outcomes for mothers and their neonates.
Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania; and the Departments of Pediatrics and Health Policy, Vanderbilt University, Nashville, Tennessee.
Elizabeth E
EE
Krans
Stephen W
SW
Patrick
D005260:Female; D006291:Health Policy / Q000331:legislation & jurisprudence / Q000639:trends; D006801:Humans; D007231:Infant, Newborn; D009357:Neonatal Abstinence Syndrome / Q000209:etiology / Q000517:prevention & control; D009293:Opioid-Related Disorders / Q000150:complications / Q000517:prevention & control; D018743:Perinatal Care / Q000379:methods / Q000458:organization & administration / Q000592:standards; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D058996:Quality Improvement