Nonfatal Overdoses Among Pregnant Individuals With Opioid Use Disorder.
Journal
Obstetrics and gynecology
ISSN: 1873-233X
Titre abrégé: Obstet Gynecol
Pays: United States
ID NLM: 0401101
Informations de publication
Date de publication:
01 05 2023
01 05 2023
Historique:
received:
07
10
2022
accepted:
22
01
2023
medline:
1
5
2023
pubmed:
27
4
2023
entrez:
27
4
2023
Statut:
ppublish
Résumé
Little is understood about overdose history among pregnant individuals with opioid use disorder (OUD). We performed a cross-sectional secondary analysis of data from the OPTI-Mom 2.0 (Optimizing Pregnancy and Treatment Interventions for Moms 2.0) study (NCT03833245), a multi-site randomized controlled trial of patient navigation and usual care. We summarized participant demographics, overdose history, and substances involved in most recent overdose. Of the 102 participants with severe OUD included, 64.7% (95% CI 54.8-73.4%) had a reported a history of an overdose event and 41.2% (95% CI 31-52%) reported at least one overdose within the past year. In the most recent overdose, 81.8% (95% CI 70.4-89.5%) reported using opioids and 30.3% (95% CI 20.3-42.6%) reported using sedatives. These findings suggest need for heightened awareness of overdose-reduction and harm-reduction strategies in this population.
Identifiants
pubmed: 37103536
doi: 10.1097/AOG.0000000000005129
pii: 00006250-202305000-00014
doi:
Substances chimiques
Analgesics, Opioid
0
Banques de données
ClinicalTrials.gov
['NCT03833245']
Types de publication
Randomized Controlled Trial
Letter
Langues
eng
Sous-ensembles de citation
IM
Pagination
961-963Subventions
Organisme : NCIPC CDC HHS
ID : R01 CE002996
Pays : United States
Informations de copyright
Copyright © 2023 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Financial Disclosure Funds were paid to University of Utah for Marcela C. Smid from Alydia Inc for being site PI for a study of the JADA device. Funds were paid to the University of Utah for Marcela C. Smid and Jasmin E. Charles from Gilead Science Inc for study of hepatitis C treatment in pregnancy. Dr. Smid also reports money was paid to her institution from NIDA and CDC and serving as a consultant for Rhia Ventures. The other authors did not report any conflicts of interest.
Références
VanHouten JP, Rudd RA, Ballesteros MF, Mack KA. Drug overdose deaths among women aged 30-64 years - United States, 1999–2017. MMWR Morb Mortal Wkly Rep 2019;68:1–5. doi: 10.15585/mmwr.mm6801a1
doi: 10.15585/mmwr.mm6801a1
Smid MC, Stone NM, Baksh L, Debbink MP, Einerson BD, Varner MW, et al. Pregnancy-associated death in UT: contribution of drug-induced deaths. Obstet Gynecol 2019;133:1131–40. doi: 10.1097/aog.0000000000003279
doi: 10.1097/aog.0000000000003279
Schiff DM, Nielsen T, Terplan M, Hood M, Bernson D, Diop H, et al. Fatal and nonfatal overdose among pregnant and postpartum women in Massachusetts. Obstet Gynecol 2018;132:466–74. doi: 10.1097/AOG.0000000000002734
doi: 10.1097/AOG.0000000000002734
Callahan T, Zaharatos J, St Pierre A, Merkt PT, Goodman D. Enhancing reviews and surveillance to eliminate maternal mortality. J Women's Health 2021;30:1068–73. doi: 10.1089/jwh.2021.0357
doi: 10.1089/jwh.2021.0357
Cochran G, Smid MC, Krans EE, Bryan MA, Gordon AJ, Lundahl B, et al. A pilot multisite study of patient navigation for pregnant women with opioid use disorder. Contemp Clin Trials 2019;87:105888. doi: 10.1016/j.cct.2019.105888
doi: 10.1016/j.cct.2019.105888
Friedman JR, Hansen H. Evaluation of increases in drug overdose mortality rates in the US by race and ethnicity before and during the COVID-19 pandemic. JAMA Psychiatry 2022;79:379–81. doi: 10.1001/jamapsychiatry.2022.0004
doi: 10.1001/jamapsychiatry.2022.0004
Cochran GT, Hruschak V, Abdullah W, Krans E, Douaihy AB, Bobby S, et al. Optimizing pregnancy treatment interventions for Moms (OPTI-Mom): a pilot study. J Addict Med 2018;12:72–9. doi: 10.1097/adm.0000000000000370
doi: 10.1097/adm.0000000000000370
Tracy M, Piper TM, Ompad D, Bucciarelli A, Coffin PO, Vlahov D, et al. Circumstances of witnessed drug overdose in New York City: implications for intervention. Drug and Alcohol Dependence 2005;79:181–90. doi: 10.1016/j.drugalcdep.2005.01.010
doi: 10.1016/j.drugalcdep.2005.01.010
Fernandez AC, Bush C, Bonar EE, Blow FC, Walton MA, Bohnert ASB. Alcohol and drug overdose and the influence of pain conditions in an addiction treatment sample. J Addict Med 2019;13:61–8. doi: 10.1097/adm.0000000000000451
doi: 10.1097/adm.0000000000000451
Brown JL, Cochran G, Bryan MA, Charron E, Winhusen TJ. Associations between elevated depressive symptoms and substance use, prescription opioid misuse, overdose history, pain, and general health among community pharmacy patients prescribed opioids. Substance Abuse 2022;43:1110–5. doi: 10.1080/08897077.2022.2060450
doi: 10.1080/08897077.2022.2060450
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). APA; 2013.
Caudarella A, Dong H, Milloy MJ, Kerr T, Wood E, Hayashi K. Non-fatal overdose as a risk factor for subsequent fatal overdose among people who inject drugs. Drug Alcohol Dependence 2016;162:51–5. doi: 10.1016/j.drugalcdep.2016.02.024
doi: 10.1016/j.drugalcdep.2016.02.024
Kuehn BM. Accelerated overdose deaths linked with COVID-19. JAMA 2021;325:523. doi: 10.1001/jama.2021.0074
doi: 10.1001/jama.2021.0074
National Harm Reduction Coalition. Pregnancy and substance use: a harm reduction toolkit. Accessed June 6, 2020. https://harmreduction.org/issues/pregnancy-and-substance-use-a-harm-reduction-toolkit/