Substance use among pregnant and postpartum people is a public health concern and a leading cause of death during or shortly after pregnancy. According to a 2022 national survey, nearly 10% of pregnant women used illicit substances in the past 30 days. In 2020, more than 1,200 pregnant and postpartum women died of a drug overdose in the US, representing an 81% increase since 2017. Yet, stigma presents a significant barrier to care, preventing access to vital services and putting them and their babiea at risk.
In this blog, we briefly explore substance use during pregnancy, how stigma is a significant barrier to treatment, and tips to get the support you or your loved one needs.
Substance use during pregnancy
Opioid use disorder affects people in all walks and stages of life, including pregnancy. According to a 2023 study, 40% of people with a lifetime substance use disorder and 26% of people with a combined alcohol and drug use disorder are women. Researchers stated that women are at the highest risk of substance use disorder during reproductive years, and use is prevalent.
According to a 2018 study, pregnant people with opioid use disorder rose 333% between 1999 and 2014. In a recent blog, the Director of the National Institute on Drug Abuse, Dr. Nora Volkow, highlighted a study from Columbia University showing deaths of pregnant and postpartum people rose 81 percent between 2017 and 2020 and that deaths related to mental health conditions, including substance use disorder, accounted for 23 percent of deaths during pregnancy or in the year following it.
Despite the American College of Obstetricians and Gynaecologists recommending early screening for substance use disorders, many pregnant people are left unscreened due to inadequate training, geographical location, transportation, stigma, and access to health insurance.
How does stigma affect pregnant people with substance use disorder?
Stigma negatively impacts societal, medical, and moral attitudes towards people with substance use disorder. These negative perceptions prevent access to care and affect the quality of care and treatment outcomes in pregnant and postpartum people. Research also shows that the stigma and discrimination people face also influence their likelihood to internalize self-stigmatizing, which also delays care.
Pregnant and postpartum people, especially people of color and those living in rural areas face medical and social stigma and disparities in access to treatment. These barriers cause social isolation, limit access to vital pregnancy care, and deter pregnant people from seeking help for fear of punitive state laws.
Volkow highlighted a survey that showed that addiction treatment providers in 10 states were 17 percent less likely to provide an appointment if the caller said they were pregnant.
Despite research strongly supporting the use of medication-assisted treatment for the treatment of opioid use disorder in pregnancy, Black and Hispanic people are less likely to receive treatment, and states that criminalize people with opioid use disorder receive less treatment, and the infants have increased rates of being born with neonatal abstinence syndrome.
Left untreated, opioid use disorder is a leading cause of death in pregnancy and postpartum, highlighting the need to normalize treatment versus punishment and encourage pregnant people to seek the help and support they deserve.
How to get help for substance use disorder
Comprehensive, compassionate, and non-judgmental care during and after pregnancy is critical for people with opioid use disorder to improve health outcomes for both the parent and the infant. That may include medication-assisted treatment (MAT), which is considered the gold standard of care for opioid use disorder.
Medication-assisted treatment has many benefits, including:
- Suppressing cravings and withdrawal symptoms.
- Reducing the risk of relapse.
- When enrolled in a treatment program, pregnant people are more likely to engage in prenatal care and experience fewer complications.
- Reduces the likelihood of neonatal abstinence syndrome.
- Lowered risk of overdose.
Having a substance use disorder is nothing to be ashamed of. It is a mental health condition and requires treatment. MAT is a life-saving treatment that remains the recommended therapy for pregnant people.