Women-centered drug treatment models for pregnant women with opioid use disorder: A scoping review

• Published in: Drug and alcohol dependence 2021-09, Vol.226, p.108855-108855, Article 108855
• Main Authors: Joshi, Chandni, Skeer, Margie R., Chui, Kenneth, Neupane, Gagan, Koirala, Reecha, Stopka, Thomas J.
• Format: Article
• Language: English
• Subjects: Access; Coordination; Criminalization; Drug abuse; Drug addiction; Drugs; Health care access; Health research; Health services; Literature reviews; Narcotics; Opioid use disorder; Opioids; Patients; Perinatal; Pregnancy; Pregnant; Quality of care; Regulation; Research projects; Scoping review; Services; Sociology; Stigma; Substance abuse; Substance abuse treatment; Substance use; Substance use disorder; Systematic review; Treatment; Treatment methods; Treatment needs; Treatment programs; Websites; Women; Womens health
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2021.108855

•There is a high unmet need for comprehensive women-centered drug treatment.•Treating pregnant women in groups improved quality of care.•Co-locating various services for drug treatment and care improved access.•Stigmatization and criminalization of substance use was a significant barrier to care. While there is a high unmet need for drug treatment services tailored to the needs of pregnant women, fewer than half of the opioid use disorder (OUD) treatment programs in the U.S. offer such services. We conducted a scoping review of the literature to identify women-centered drug treatment models that address access, coordination, and quality of care, and their facilitators and barriers. We searched PubMed, EMBASE, PsycInfo, Sociology Database, Web of Science, CINAHL, EBSCO Open Dissertations, Health Services Research Projects in Progress, and relevant agency websites from 1990 to 2020. We included studies that evaluated multicomponent models of care that provided medication for OUD (MOUD) to pregnant women in the U.S. Of the 1,578 unduplicated articles screened, 26 articles met the inclusion criteria, which reported on 19 different studies and included 3,193 women. We identified seven different models of care and found that: (1) access was improved by co-locating various services for drug treatment and care, (2) coordination was enhanced by inter-professional collaboration, (3) quality was improved by treating pregnant patients in groups, and (4) stigmatization and criminalization of substance use during pregnancy was a significant barrier to care. There is an urgent need to bolster patient-provider relationships that are built on trust, are free of stigma, and that empower patients to make their own decisions. Improved policies and regulations to reduce stigma around the use of opioids and MOUD are needed, so that pregnant women with OUD can access high quality care.