Factors Affecting Contraception Access and Use in Patients With Opioid Use Disorder

Maternal opioid use disorder increased > 4‐fold from 1999 to 2014 and is associated with poor maternal and fetal outcomes. Women with opioid use disorder are at 2 to 3 times greater risk for unintended pregnancy than the general population and may face additional barriers to accessing and effecti...

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Bibliographic Details
Published in:Journal of clinical pharmacology 2020-12, Vol.60 (S2), p.S63-S73
Main Authors: Stone, Rebecca H., Griffin, Brooke, Fusco, Rachel A., Vest, Kathy, Tran, Tran, Gross, Savannah
Format: Article
Language:English
Subjects:
Aggression
Birth control
condom
Condoms
Contraception
Drug addiction
Drug withdrawal
Family planning
Fetuses
Narcotics
neonatal abstinence syndrome
Newborn babies
opioid use disorder
Opioids
Patients
Pregnancy
Reproductive health
Substance use disorder
Womens health
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Summary:Maternal opioid use disorder increased > 4‐fold from 1999 to 2014 and is associated with poor maternal and fetal outcomes. Women with opioid use disorder are at 2 to 3 times greater risk for unintended pregnancy than the general population and may face additional barriers to accessing and effectively using contraception compared to women without opioid use disorder, particularly highly effective long‐acting reversible contraception. Additionally, women with opioid use disorder tend to use less effective forms of contraception such as condoms alone. Barriers to contraceptive access include patient misconceptions or knowledge gaps regarding reproductive health and family planning, cost, intimate partner violence, fear of criminalization, difficulty accessing care, comorbid health conditions, and health care provider misconceptions or practice limitations. Strategies that may assist women with opioid use disorder in achieving their family planning goals include colocation of family planning services within opioid treatment facilities, optimization of patient care services to minimize the need for costly and/or time consuming follow‐up, increasing provider education and awareness of best practices in family planning and opioid use disorder treatment, and providing patient‐centered family planning education and counseling. Additional research is needed to identify and develop strategies that empower women who use opioids to effectively access and use their preferred contraceptive method.
ISSN:0091-2700
1552-4604
DOI:10.1002/jcph.1772