Nonmedical Use of Prescription Opioids among Pregnant U.S. Women

Abstract

Objectives: Nonmedical use of opioids during pregnancy is associated with adverse outcomes for women and infants, making it a prominent target for prevention and identification. Using a nationally representative sample, we determined characteristics of U.S. pregnant women who reported prescription opioid misuse in the past year or during the past month.

Methods: We used data from the National Survey on Drug Use and Health (2005-2014) in a retrospective analysis. The sample included 8,721 (weighted n = 23,855,041) noninstitutionalized women, ages 12 to 44, who reported being pregnant when surveyed. Outcomes were nonmedical use of prescription opioid medications during the past 12 months and during the past 30 days. Multivariable logistic regression models were created to determine correlates of nonmedical opioid use after accounting for potential confounding variables.

Results: Among pregnant women in the United States, 5.1% reported nonmedical opioid use in the past year. In adjusted models, depression or anxiety in the past year was strongly associated with past year nonmedical use (adjusted odd ratio [AOR], 2.15; 95% CI, 1.52-3.04), as were past year use of alcohol (AOR, 1.56; 95% CI, 1.11-2.17), tobacco (AOR, 1.72; 95% CI, 1.17-2.53), and marijuana (AOR, 3.44; 95% CI, 2.47-4.81). Additionally, 0.9% of U.S. pregnant women reported nonmedical opioid use in the past month. Past year depression or anxiety and past month use of alcohol, tobacco, and marijuana each independently predicted past month nonmedical use.

Conclusions: Characteristics associated with nonmedical opioid use by pregnant women reveal populations with mental illness and co-occurring substance use. Policy and prevention efforts to improve screening and treatment could focus on the at-risk populations identified in this study.

Figure 1

Predicted marginal probabilities of past year nonmedical opioid use by pregnant women across multiple characteristics – anxiety or depression, alcohol use, tobacco use, marijuana use, and multiple substance use (alcohol, tobacco, and marijuana) in the past year. ***p<0.001 **p<0.01 *p<0.05

Figure 2

Predicted marginal probabilities of past month nonmedical opioid use by pregnant women across multiple characteristics – anxiety or depression, alcohol use, tobacco use, marijuana use, and multiple substance use (alcohol, tobacco, and marijuana) in the past month. ***p<0.001 **p<0.01 *p<0.05