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“Toward an Evaluation of Medication Assisted Therapy for Pregnant Women with Opioid Use Disorder: Facilitating Effective Treatment with Primary and Secondary Interventions”

Author: Citlali Rodriguez

Department: UIC Institute for Policy & Civic Engagement

Advisor: Dr. Joseph K. Hoereth, UIC IPCE
Dr. Amanda Knepper, UIC IPROMOTE-IL
Dr. Elizabeth Glassgow, UIC IPROMOTE-IL

Abstract: From 2008 to 2016, Opioid Use Disorder (OUD) within the U.S. resulted in a four-fold increase in deaths among pregnant women and a 52% increase in infants affected by neonatal abstinence syndrome (NAS) or neonatal withdrawal (IDPH 2018). OUD during pregnancy not only leads to a range of negative social and medical complications for the woman - including malnourishment, trauma, sexually transmitted infections, and death - but also leads to an increased risk of the infant suffering from developmental complications (Clemens-Cope et al., 2019). The expansion of Medicaid has led to increased coverage for substance use disorder (SUD) treatment services, particularly endorsing the use of Medication Assisted Treatment (MAT) for pregnant women with OUD. This study conducts a literature review in an effort to investigate the impact of Medicaid’s federal policy endorsement of MAT for the treatment of OUD within pregnant populations. In the literature, scholars voice the necessity of political measures in providing effective interventions for maternal OUD prevention, recovery, and relapse. However, the literature also suggests that, despite the expansion of Medicaid coverage, barriers limiting the use of MAT range from medical professionals’ recognition of OUD to the stigma and persecution of patients with OUD experience. Without addressing these barriers, an effective provision and utilization of healthcare will not occur and, consequently, the reduction in quality of life and elevated mortality rates for pregnant women with OUD will continue. This study recommends a number of supplementary primary and secondary interventions, consisting of prevention strategies for OUD-affected women of reproductive age and mitigation strategies for pregnant and postpartum women, respectively. Here, primary interventions include in-reach programs focused on educating and guiding incoming patients, preconceptional counseling, and early universal screening. Secondary interventions emphasize the use of peer support specialists alongside OUD treatment and the inclusion of healthcare providers as a means of continued guidance, support, and primary connection to resources. Furthermore, to ensure long-lasting change, healthcare providers must also receive a comprehensive education on best practices for patient-centered care and knowledge of treatment options, guidelines, and reimbursement.

Keywords: Opioid Use Disorder (OUD), OUD among pregnant women, Medication Assisted Therapy (MAT), Medicaid, Primary & Secondary Interventions