Dataset Information

Non-medical opioid use and sources of opioids among pregnant and non-pregnant reproductive-aged women.

ABSTRACT: The morbidity and mortality burden of the US opioid epidemic falls heavily on reproductive-age women. Information on the patterns of and sources for non-medical use of prescription opioids among reproductive age women, including pregnant women, will inform public health and prevention efforts to mitigate the effects of the opioid epidemic. This study characterized non-medical use of prescription opioids among reproductive-age U.S. women, with a focus on pregnancy status.We used nationally-representative data from the National Survey of Drug Use and Health (2005-2014) to examine non-medical use (NMU) of prescription opioids in the past 30days among females ages 18-44 (N=154,179), distinguishing pregnant women (N=8069). We used multivariable logistic regression to describe reported sources of opioids, including opioids obtained from a doctor, friend or relative, dealer, or other source.Nearly 1% of pregnant women and 2.3% of non-pregnant reproductive-age women reported opioid NMU in the past 30days. Forty-six percent of pregnant women identified a doctor as their source compared with 27.6% of non-pregnant women reporting NMU. Pregnant women reported a friend or relative as their source of opioids less frequently than non-pregnant women (53.8% versus 75.0%), and some pregnant and non-pregnant women acquired opioids from a dealer (14.6% and 10.6%).Opioid NMU among reproductive-age women is a complex public health challenge affecting a vulnerable population. Pregnant women were more likely than non-pregnant women to list a doctor as their source of opioids for NMU, suggesting the need for targeted policies to address physician prescribing during pregnancy.

SUBMITTER: Kozhimannil KB

PROVIDER: S-EPMC5486870 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

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Non-medical opioid use and sources of opioids among pregnant and non-pregnant reproductive-aged women.

Kozhimannil Katy B KB Graves Amy J AJ Jarlenski Marian M Kennedy-Hendricks Alene A Gollust Sarah S Barry Colleen L CL

Drug and alcohol dependence 20170310

<h4>Background</h4>The morbidity and mortality burden of the US opioid epidemic falls heavily on reproductive-age women. Information on the patterns of and sources for non-medical use of prescription opioids among reproductive age women, including pregnant women, will inform public health and prevention efforts to mitigate the effects of the opioid epidemic. This study characterized non-medical use of prescription opioids among reproductive-age U.S. women, with a focus on pregnancy status.<h4>Me ...[more]

PMID: 28285727

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Project description:BackgroundAlthough mass vaccination against COVID-19 may prove to be the most efficacious end to this deadly pandemic, there remain concern and indecision among the public toward vaccination. Because pregnant and reproductive-aged women account for a large proportion of the population with particular concerns regarding vaccination against COVID-19, this survey aimed at investigating their current attitudes and beliefs within our own institution.ObjectiveThis study aimed to understand vaccine acceptability among pregnant, nonpregnant, and breastfeeding respondents and elucidate factors associated with COVID-19 vaccine acceptance.Study designWe administered an anonymous online survey to all women (including patients, providers, and staff) at our institution assessing rates of acceptance of COVID-19 vaccination. Respondents were contacted in 1 of 3 ways: by email, advertisement flyers, and distribution of quick response codes at virtual town halls regarding the COVID-19 vaccine. Based on their responses, respondents were divided into 3 mutually exclusive groups: (1) nonpregnant respondents, (2) pregnant respondents, and (3) breastfeeding respondents. The primary outcome was acceptance of vaccination. Prevalence ratios were calculated to ascertain the independent effects of multiple patient-level factors on vaccine acceptability.ResultsThe survey was administered from January 7, 2021, to January 29, 2021, with 1012 respondents of whom 466 (46.9%) identified as non-Hispanic White, 108 (10.9%) as non-Hispanic Black, 286 (28.8%) as Hispanic, and 82 (8.2%) as non-Hispanic Asian. The median age was 36 years (interquartile range, 25-47 years). Of all the respondents, 656 respondents (64.8%) were nonpregnant, 216 (21.3%) were pregnant, and 122 (12.1%) were breastfeeding. There was no difference in chronic comorbidities when evaluated as a composite variable (Table 1). A total of 390 respondents (39.2%) reported working in healthcare. Nonpregnant respondents were most likely to accept vaccination (457 respondents, 76.2%; P<.001) with breastfeeding respondents the second most likely (55.2%). Pregnant respondents had the lowest rate of vaccine acceptance (44.3%; P<.001). Prevalence ratios revealed all non-White races except for non-Hispanic Asian respondents, and Spanish-speaking respondents were less likely to accept vaccination (Table 3). Working in healthcare was not found to be associated with vaccine acceptance among our cohort.ConclusionIn this survey study of only women at a single institution, pregnant respondents of non-White or non-Asian races were more likely to decline vaccination than nonpregnant and breastfeeding respondents. Working in healthcare was not associated with vaccine acceptance.

Project description:BACKGROUND:After decades of increased opioid pain reliever prescribing, providers are rapidly reducing prescribing. We hypothesized that reduced access to prescribed opioid pain relievers among patients previously reliant upon opioid pain relievers would result in increased illicit opioid use. METHODS AND FINDINGS:We conducted a retrospective cohort study among 602 publicly insured primary care patients who had been prescribed opioids for chronic non-cancer pain for at least three consecutive months in San Francisco, recruited through convenience sampling. We conducted a historical reconstruction interview and medical chart abstraction focused on illicit substance use and opioid pain reliever prescriptions, respectively, from 2012 through the interview date in 2017-2018. We used a nested-cohort design, in which patients were classified, based on opioid pain reliever dose change, into a series of nested cohorts starting with each follow-up quarter. Using continuation-ratio models, we estimated associations between opioid prescription discontinuation or 30% increase or decrease in dose, relative to no change, and subsequent frequency of heroin and non-prescribed opioid pain reliever use, separately. Models controlled for demographics, clinical and behavioral characteristics, and past use of heroin or non-prescribed opioid pain relievers. A total of 56,372 and 56,484 participant-quarter observations were included from the 597 and 598 participants available for analyses of heroin and non-prescribed opioid pain reliever outcomes, respectively. Participants discontinued from prescribed opioids were more likely to use heroin (Adjusted Odds Ratio (AOR) = 1.57, 95% CI: 1.25-1.97) and non-prescribed opioid pain relievers (AOR = 1.75, 1.45-2.11) more frequently in subsequent quarters compared to participants with unchanged opioid prescriptions. Participants whose opioid pain reliever dose increased were more likely to use heroin more frequently (AOR = 1.67, 1.32-2.12). Results held throughout sensitivity analyses. The main limitations were the observational nature of results and limited generalizability beyond safety-net settings. CONCLUSIONS:Discontinuation of prescribed opioid pain relievers was associated with more frequent non-prescribed opioid pain reliever and heroin use; increased dose was also associated with more frequent heroin use. Clinicians should be aware of these risks in determining pain management approaches.

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Dataset Information

Non-medical opioid use and sources of opioids among pregnant and non-pregnant reproductive-aged women.

Publications

Non-medical opioid use and sources of opioids among pregnant and non-pregnant reproductive-aged women.

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