Racial and Ethnic Disparities in Receipt of Medications for Opioid Use Disorder During Pregnancy

Medications for opioid use disorder (MOUD) are the standard of care for treatment of opioid use disorder, including during pregnancy. Previous research has described racial and ethnic disparities in receipt of MOUD. In this retrospective cohort study of pregnant women with OUD (N=5247), researchers examined the association between maternal race and ethnicity and the following outcomes: receipt of MOUD during pregnancy, consistency of receipt, and medication type (methadone or buprenorphine).

  • Overall, 87% of the cohort were white non-Hispanic, 5% were black non-Hispanic, and 9% were Hispanic. About one-third (34%) of the cohort did not receive any MOUD.
  • Compared with white non-Hispanic women, black non-Hispanic and Hispanic women were significantly less likely to receive MOUD during pregnancy (adjusted odds ratios [aORs], 0.37 and 0.42, respectively) and less likely to have consistently received it (i.e., for at least 6 continuous months).
  • Compared with white non-Hispanic women, black non-Hispanic and Hispanic women had a lower likelihood of receiving buprenorphine compared with methadone (aORs, 0.60 and 0.77, respectively).

Comments: This retrospective cohort study demonstrates a treatment gap during pregnancy with racial and ethnic disparities similar to those described in the general population of patients with OUD. Inequitable treatment may stem from differential perinatal and substance use treatment access, retention, and quality. Further research should examine and address the individual, institution, and system-level factors that drive these disparities.

Jordana Laks, MD, MPH† and Melissa Weimer, DO

† Editorial Intern and Addiction Medicine Fellow, Boston Medical Center

Reference: Schiff DM, Nielsen T, Hoeppner BB, et al. Assessment of racial and ethnic disparities in the use of medication to treat opioid use disorder among pregnant women in Massachusetts. JAMA Netw Open. 2020;3(5):e205734.

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