Opioid treatment for pregnant women twice as high in white women as in black women, study finds

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A new study from Virginia Commonwealth University School of Medicine has found that while opioid treatment for pregnant women is available, white mothers are more than twice as likely to receive treatment than black mothers.

Looking at the state’s Addiction and Recovery Treatment Services program, a team of faculty members from the university analyzed the diagnosis and treatment of substance use disorder in pregnant women enrolled in Medicaid. The program, implemented in 2017, was designed to increase access to treatment for those on Medicaid with opioid or other substance use disorders and resulted in about 60,000 Virginians receiving treatment.

What researchers found was that nearly 1 in 10 pregnant women who are enrolled in Medicaid are diagnosed with substance use disorder in the 12 months before their delivery. Between January 2017 and December 2018, treatment rates for pregnant women on Medicaid rose from 58 percent to 76 percent.

However, the study also found that while the treatment rate for white women was 44 percent, the treatment rate for black women was only 20 percent. Researchers said the disparity was found across the state and were not explained by factors such as age or length of time in Medicaid.

“There’s a lot more to learn and understand about the racial disparity because it appears that substance use disorders are also underdiagnosed among black women compared to white women,” Peter Cunningham, Ph.D., a professor with the school’s Department of Health Behavior and Policy who led the evaluation team said. “This conflicts with national data showing that prevalence among women of childbearing age is roughly the same between both groups. There are concerns that stigma and child welfare actions triggered by the mother’s addiction problems could be discouraging many from getting treatment.”

Cunningham said the positive aspects highlighted in the study, however, show that more pregnant women in Virginia are getting access to treatment when they have a substance use disorder treatment. As substance use disorder in pregnant women can cause preterm labor stillbirths and higher maternal mortality, increased access to treatment can lead to a reduction in adverse outcomes, he said.

In the future, the team hopes to expand their analysis to the postpartum period to understand how addiction and treatment continue after delivery.

“Now that we’re seeing higher rates of treatment, we also want to understand whether that treatment is resulting in better outcomes for women, as well as for their newborn babies,” Cunningham said. “Rates of neonatal abstinence syndrome have been increasing in recent years as the opioid crisis has worsened, so ultimately, we would like to see that increased access to treatment results in better delivery and birth outcomes.”

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