Duration of medication for opioid use disorder during pregnancy and postpartum by race/ethnicity: Results from 6 state Medicaid programs

Anna E. Austin; Christine Piette Durrance; Katherine A. Ahrens; Qingwen Chen; Lindsey Hammerslag; Mary Joan McDuffie; Jeffery Talbert; Paul Lanier; Julie M. Donohue; Marian Jarlenski

doi:10.1016/j.drugalcdep.2023.109868

Duration of medication for opioid use disorder during pregnancy and postpartum by race/ethnicity: Results from 6 state Medicaid programs

Anna E. Austin, Christine Piette Durrance, Katherine A. Ahrens, Qingwen Chen, Lindsey Hammerslag, Mary Joan McDuffie, Jeffery Talbert, Paul Lanier, Julie M. Donohue, Marian Jarlenski

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Medication for opioid use disorder (MOUD) is evidence-based treatment during pregnancy and postpartum. Prior studies show racial/ethnic differences in receipt of MOUD during pregnancy. Fewer studies have examined racial/ethnic differences in MOUD receipt and duration during the first year postpartum and in the type of MOUD received during pregnancy and postpartum. Methods: We used Medicaid administrative data from 6 states to compare the percentage of women with any MOUD and the average proportion of days covered (PDC) with MOUD, overall and by type of MOUD, during pregnancy and four postpartum periods (1–90 days, 91–180 days, 181–270 days, and 271–360 days postpartum) among White non-Hispanic, Black non-Hispanic, and Hispanic women diagnosed with OUD. Results: White non-Hispanic women were more likely to receive any MOUD during pregnancy and all postpartum periods compared to Hispanic and Black non-Hispanic women. For all MOUD types combined and for buprenorphine, White non-Hispanic women had the highest average PDC during pregnancy and each postpartum period, followed by Hispanic women and Black non-Hispanic women (e.g., for all MOUD types, 0.49 vs. 0.41 vs. 0.23 PDC, respectively, during days 1–90 postpartum). For methadone, White non-Hispanic and Hispanic women had similar average PDC during pregnancy and postpartum, and Black non-Hispanic women had substantially lower PDC. Conclusions: There are stark racial/ethnic differences in MOUD during pregnancy and the first year postpartum. Reducing these inequities is critical to improving health outcomes among pregnant and postpartum women with OUD.

Original language	English
Article number	109868
Journal	Drug and Alcohol Dependence
Volume	247
DOIs	https://doi.org/10.1016/j.drugalcdep.2023.109868
State	Published - Jun 1 2023

Bibliographical note

Funding Information:
This work was made possible by the establishment of the Medicaid Outcomes Distributed Research Network (MODRN; see Appendix Table 4 for a list of MODRN collaborators). The authors appreciate the contributions of the MODRN Founding Members, the Academy Health State University Partnership Learning Network, the Medicaid Medical Directors Network, and NIDA 1 R01 DA048029-01. Qingwen Chen was supported by NIDA R01 DA045675. Katherine Ahrens was supported by a cooperative agreement between the University of Southern Maine and the Maine Department of Health and Human Services. Julie Donohue acknowledges funding for unrelated work from the Pennsylvania Department of Human Services. Mary Joan McDuffie was funded via a cooperative agreement between the University of Delaware and the Delaware Division of Medicaid and Medical Assistance.

Funding Information:
This research was supported by the National Institute on Drug Abuse [ R01 DA048029-01 , R01 DA045675 ].

Publisher Copyright:
© 2023 Elsevier B.V.

Keywords

Inequity disparity
Medicaid
Medication for opioid use disorder
Postpartum
Pregnancy

ASJC Scopus subject areas

Toxicology
Pharmacology
Psychiatry and Mental health
Pharmacology (medical)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.drugalcdep.2023.109868

Cite this

Austin, A. E., Durrance, C. P., Ahrens, K. A., Chen, Q., Hammerslag, L., McDuffie, M. J., Talbert, J., Lanier, P., Donohue, J. M., & Jarlenski, M. (2023). Duration of medication for opioid use disorder during pregnancy and postpartum by race/ethnicity: Results from 6 state Medicaid programs. Drug and Alcohol Dependence, 247, [109868]. https://doi.org/10.1016/j.drugalcdep.2023.109868

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title = "Duration of medication for opioid use disorder during pregnancy and postpartum by race/ethnicity: Results from 6 state Medicaid programs",

abstract = "Background: Medication for opioid use disorder (MOUD) is evidence-based treatment during pregnancy and postpartum. Prior studies show racial/ethnic differences in receipt of MOUD during pregnancy. Fewer studies have examined racial/ethnic differences in MOUD receipt and duration during the first year postpartum and in the type of MOUD received during pregnancy and postpartum. Methods: We used Medicaid administrative data from 6 states to compare the percentage of women with any MOUD and the average proportion of days covered (PDC) with MOUD, overall and by type of MOUD, during pregnancy and four postpartum periods (1–90 days, 91–180 days, 181–270 days, and 271–360 days postpartum) among White non-Hispanic, Black non-Hispanic, and Hispanic women diagnosed with OUD. Results: White non-Hispanic women were more likely to receive any MOUD during pregnancy and all postpartum periods compared to Hispanic and Black non-Hispanic women. For all MOUD types combined and for buprenorphine, White non-Hispanic women had the highest average PDC during pregnancy and each postpartum period, followed by Hispanic women and Black non-Hispanic women (e.g., for all MOUD types, 0.49 vs. 0.41 vs. 0.23 PDC, respectively, during days 1–90 postpartum). For methadone, White non-Hispanic and Hispanic women had similar average PDC during pregnancy and postpartum, and Black non-Hispanic women had substantially lower PDC. Conclusions: There are stark racial/ethnic differences in MOUD during pregnancy and the first year postpartum. Reducing these inequities is critical to improving health outcomes among pregnant and postpartum women with OUD.",

keywords = "Inequity disparity, Medicaid, Medication for opioid use disorder, Postpartum, Pregnancy",

author = "Austin, {Anna E.} and Durrance, {Christine Piette} and Ahrens, {Katherine A.} and Qingwen Chen and Lindsey Hammerslag and McDuffie, {Mary Joan} and Jeffery Talbert and Paul Lanier and Donohue, {Julie M.} and Marian Jarlenski",

note = "Funding Information: This work was made possible by the establishment of the Medicaid Outcomes Distributed Research Network (MODRN; see Appendix Table 4 for a list of MODRN collaborators). The authors appreciate the contributions of the MODRN Founding Members, the Academy Health State University Partnership Learning Network, the Medicaid Medical Directors Network, and NIDA 1 R01 DA048029-01. Qingwen Chen was supported by NIDA R01 DA045675. Katherine Ahrens was supported by a cooperative agreement between the University of Southern Maine and the Maine Department of Health and Human Services. Julie Donohue acknowledges funding for unrelated work from the Pennsylvania Department of Human Services. Mary Joan McDuffie was funded via a cooperative agreement between the University of Delaware and the Delaware Division of Medicaid and Medical Assistance. Funding Information: This research was supported by the National Institute on Drug Abuse [ R01 DA048029-01 , R01 DA045675 ]. Publisher Copyright: {\textcopyright} 2023 Elsevier B.V.",

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doi = "10.1016/j.drugalcdep.2023.109868",

language = "English",

volume = "247",

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TY - JOUR

T1 - Duration of medication for opioid use disorder during pregnancy and postpartum by race/ethnicity

T2 - Results from 6 state Medicaid programs

AU - Austin, Anna E.

AU - Durrance, Christine Piette

AU - Ahrens, Katherine A.

AU - Chen, Qingwen

AU - Hammerslag, Lindsey

AU - McDuffie, Mary Joan

AU - Talbert, Jeffery

AU - Lanier, Paul

AU - Donohue, Julie M.

AU - Jarlenski, Marian

N1 - Funding Information: This work was made possible by the establishment of the Medicaid Outcomes Distributed Research Network (MODRN; see Appendix Table 4 for a list of MODRN collaborators). The authors appreciate the contributions of the MODRN Founding Members, the Academy Health State University Partnership Learning Network, the Medicaid Medical Directors Network, and NIDA 1 R01 DA048029-01. Qingwen Chen was supported by NIDA R01 DA045675. Katherine Ahrens was supported by a cooperative agreement between the University of Southern Maine and the Maine Department of Health and Human Services. Julie Donohue acknowledges funding for unrelated work from the Pennsylvania Department of Human Services. Mary Joan McDuffie was funded via a cooperative agreement between the University of Delaware and the Delaware Division of Medicaid and Medical Assistance. Funding Information: This research was supported by the National Institute on Drug Abuse [ R01 DA048029-01 , R01 DA045675 ]. Publisher Copyright: © 2023 Elsevier B.V.

PY - 2023/6/1

Y1 - 2023/6/1

N2 - Background: Medication for opioid use disorder (MOUD) is evidence-based treatment during pregnancy and postpartum. Prior studies show racial/ethnic differences in receipt of MOUD during pregnancy. Fewer studies have examined racial/ethnic differences in MOUD receipt and duration during the first year postpartum and in the type of MOUD received during pregnancy and postpartum. Methods: We used Medicaid administrative data from 6 states to compare the percentage of women with any MOUD and the average proportion of days covered (PDC) with MOUD, overall and by type of MOUD, during pregnancy and four postpartum periods (1–90 days, 91–180 days, 181–270 days, and 271–360 days postpartum) among White non-Hispanic, Black non-Hispanic, and Hispanic women diagnosed with OUD. Results: White non-Hispanic women were more likely to receive any MOUD during pregnancy and all postpartum periods compared to Hispanic and Black non-Hispanic women. For all MOUD types combined and for buprenorphine, White non-Hispanic women had the highest average PDC during pregnancy and each postpartum period, followed by Hispanic women and Black non-Hispanic women (e.g., for all MOUD types, 0.49 vs. 0.41 vs. 0.23 PDC, respectively, during days 1–90 postpartum). For methadone, White non-Hispanic and Hispanic women had similar average PDC during pregnancy and postpartum, and Black non-Hispanic women had substantially lower PDC. Conclusions: There are stark racial/ethnic differences in MOUD during pregnancy and the first year postpartum. Reducing these inequities is critical to improving health outcomes among pregnant and postpartum women with OUD.

AB - Background: Medication for opioid use disorder (MOUD) is evidence-based treatment during pregnancy and postpartum. Prior studies show racial/ethnic differences in receipt of MOUD during pregnancy. Fewer studies have examined racial/ethnic differences in MOUD receipt and duration during the first year postpartum and in the type of MOUD received during pregnancy and postpartum. Methods: We used Medicaid administrative data from 6 states to compare the percentage of women with any MOUD and the average proportion of days covered (PDC) with MOUD, overall and by type of MOUD, during pregnancy and four postpartum periods (1–90 days, 91–180 days, 181–270 days, and 271–360 days postpartum) among White non-Hispanic, Black non-Hispanic, and Hispanic women diagnosed with OUD. Results: White non-Hispanic women were more likely to receive any MOUD during pregnancy and all postpartum periods compared to Hispanic and Black non-Hispanic women. For all MOUD types combined and for buprenorphine, White non-Hispanic women had the highest average PDC during pregnancy and each postpartum period, followed by Hispanic women and Black non-Hispanic women (e.g., for all MOUD types, 0.49 vs. 0.41 vs. 0.23 PDC, respectively, during days 1–90 postpartum). For methadone, White non-Hispanic and Hispanic women had similar average PDC during pregnancy and postpartum, and Black non-Hispanic women had substantially lower PDC. Conclusions: There are stark racial/ethnic differences in MOUD during pregnancy and the first year postpartum. Reducing these inequities is critical to improving health outcomes among pregnant and postpartum women with OUD.

KW - Inequity disparity

KW - Medicaid

KW - Medication for opioid use disorder

KW - Postpartum

KW - Pregnancy

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Duration of medication for opioid use disorder during pregnancy and postpartum by race/ethnicity: Results from 6 state Medicaid programs

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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