Pregnant women in Appalachia face barriers to opioid treatment

A NIDA-funded study has discovered that pregnant women in Appalachia face barriers to receiving medication-assisted treatment for opioid use disorders, from both insurers and providers. Investigators looked at the availability of methadone, an opioid agonist treatment, as well as buprenorphine, which is a partial agonist. Appalachian states have disproportionately higher rates of opioid use. The investigators provided an infographic to explain highlights of their findings, including data from a survey of opioid agonist therapy (OAT) providers.

Infographic Courtesy: Patrick, et al.

Study:

Text Description: Pregnancy, Insurance: Barriers to Accessing Opioid Treatment Infographic

Opioid agonist therapies (OAT) is evidence-based treatment for opioid use disorder, often using medications like buprenorphine or methadone. OAT decreases the risk of overdose death and improves pregnancy outcomes.

Surveying OAT providers in 4 Appalachian states in 2017 revealed that 91 percent of opioid treatment programs accepted pregnant patients and 53 percent of buprenorphine providers accepted pregnant patients.

OAT providers were less likely to treat pregnant women.

Only half of providers accepted any insurance and wait times were nearly two times longer for pregnant women with insurance than for those paying with cash.

Percentage of OAT providers accepting Medicaid, private insurance, and cash in in Kentucky, North Carolina, Tennessee and West Virginia. See article for data.

Recommendations are to train OBs and other providers to prescribe buprenorphine and enhance reimbursement rates to improve insurance acceptance.

Vanderbilt Center for Child Health Policy.

Stephen W. Patrick, Melinda B. Buntin, Peter R. Martin, Theresa A. Scott, William Dupont, Michael Richards & William O. Cooper (2018) Barriers to Accessing Treatment for Pregnant Women with Opioid Use Disorder in Appalachian States, Substance Abuse, DOI: 10.1080/08897077.2018.1488336. Funded by NIDA K23DA038720