The Impact of X-Waiver Training Within Obstetrics and Gynecology Residency Programs on Improving Access to Medication-Assisted Treatment in Pregnancy [A51

Abstract

INTRODUCTION: The opioid epidemic is a crisis within the country, with 136 Americans dying daily from opioid overdose. One of the hardest hit areas is the Appalachian region. Despite medication-assisted treatment (MAT) with methadone or buprenorphine being considered standard of care, studies find that pregnant women in this region face significant barriers to receiving this lifesaving treatment from both insurers and providers. While the number of providers in the country with X-waivers has increased dramatically, the availability of providers willing to prescribe in pregnancy is disproportionate to the severity of the epidemic. METHODS: We surveyed 91 obstetrics and gynecology residency programs within Appalachian states to assess if X-waiver training was a part of their residency training. We then collected the geographic locations of program graduates from 2016 to 2021 to assess the impact that this training could have provided to the region. RESULTS: Despite working in regions disproportionately impacted by the opioid epidemic, the majority of obstetrics and gynecology residency programs do not provide X-waiver training to their residents. Many residents who train in residency programs located in the Appalachian regions work/have worked in the region after graduation. Our results will be displayed graphically along with mapping illustrations. CONCLUSION: Residents of the Appalachian region face barriers accessing adequate health care. This disparity is more prevalent among pregnant women. Coordinated efforts by obstetrics and gynecology residency programs to allow access to X-waiver licensure among residents in training could make a significant impact by improving access to MAT among pregnant women and lead to improved maternal and fetal outcomes.