928 Treatment admission trends for substance use disorders in pregnancy (1994-2017)

Abstract

Treatment admissions for opioid use among pregnant women in the United States (US) have increased substantially, but less is known about trends in treatment admissions for other substances or how treatment admissions vary by referral source (criminal justice agency referral vs. other). We sought to examine changes in primary substance leading to admission and differences by treatment referral source. We used 1994-2017 Treatment Episode Data Set-Admissions (TEDS-A) data to examine treatment admissions among pregnant women. We first described sociodemographic characteristics by primary substance and then estimated trends in primary substance, stratified by referral source, using logistic regression models that adjusted for age, race, employment status, education, treatment setting, and region. We used predictive margins to estimate adjusted probabilities from our regression models. Between 1994 and 2017, 1.2 % of treatment admissions (n=499,857) involved pregnant women, and this remained stable over time (1.1-1.3%). Pregnant women in treatment for amphetamines were predominantly from the West region of the US (69.2%). Overall treatment admissions for cocaine (35.1% to 5.3%) and alcohol use (29.3% to 10.7%) decreased over time, while admissions for marijuana (8.5% to 19.5%), amphetamine (8.9% to 20.1%), and opioid use (18.1% to 44.3%) increased (Figure 1). By 2017, pregnant individuals referred from criminal justice agencies were significantly more likely to be admitted for treatment of amphetamines, and less likely to be admitted for opioids (p<0.001) compared with women referred from other sources (Figure 2). Trends in admission for substance use disorders during pregnancy have changed substantially in the US over the past decades. While opioids are the predominant substance among women referred to treatment from the community, referrals for amphetamines are equally as common in women referred by criminal justice agencies. Substance use treatment in pregnancy must be individualized and address methamphetamine and polysubstance use disorders.View Large Image Figure ViewerDownload Hi-res image Download (PPT)