The Obstetric Response to the Opioid Epidemic [A218

Abstract

INTRODUCTION: Daily, 136 Americans die from an opioid overdose. One of the areas hardest hit by this epidemic is the Appalachian region. To combat this crisis, Congress and the American College of Obstetricians and Gynecologists recommend a multifaceted approach in identifying, monitoring, and managing patients. Medication-assisted treatment (MAT) with methadone or buprenorphine is a cornerstone of therapy. Despite the acceptance of MAT as standard of care, opioid related maternal and neonatal morbidity rates continue to rise. METHODS: A telephone survey of obstetric care professionals in highly affected counties (as determined by Centers for Disease Control and Prevention analysis) in West Virginia, Kentucky, Ohio, Tennessee, Indiana, and South Carolina was performed. Providers were asked if they: 1. Prescribe methadone or buprenorphine; 2. Manage patients who obtain the medications from other prescribers; 3. Had a preferred provider where they referred these patients. Additional variables included average distance to the referral center and average wait time on phone. RESULTS: Our data show that pregnant women experience limited access as well as significant barriers in obtaining MAT compared to nonpregnant patients. Data analysis will be displayed graphically as well as illustratively using state mapping data highlighting the limited options that pregnant women face when seeking MAT. CONCLUSION: Our data show a wide gap in both the quantity and the accessibility of obstetric providers willing to prescribe MAT to pregnant patients. The burden of management has fallen disproportionately on academic centers and non-obstetric providers which makes accessing this potentially life-saving treatment in a timely manner out of reach in this high-risk population.