Incarceration exposure and prescription opioid use during pregnancy

• Published in: Drug and alcohol dependence 2022-06, Vol.235, p.109434-109434, Article 109434
• Main Authors: Testa, Alexander, Fahmy, Chantal, Jackson, Dylan B.
• Format: Article
• Language: English
• Subjects: Analgesics; Analgesics, Opioid - adverse effects; Birth; Childbirth & labor; Codeine; Correctional system; Drug use; Evaluation; Exposure; Female; Fentanyl; Health behavior; Health risks; Humans; Hydromorphone; Imprisonment; Incarceration; Infants; Maternal and infant welfare; Maternal behavior; Morphine; Mothers; Narcotics; Opioid-Related Disorders - drug therapy; Opioid-Related Disorders - epidemiology; Opioids; Oxycodone; Oxycodone - therapeutic use; PRAMS; Pregnancy; Prenatal care; Prescriptions; Public health; Risk analysis; Risk assessment; Risk behavior; Risk factors; Risk taking; Substance abuse; Substance use; Tramadol; Tramadol - therapeutic use; Well being; Women; Womens health; Women’s health
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2022.109434

Prior research demonstrates a high prevalence of substance use, including opioid use, among those who have had personal or vicarious contact with the correctional system. Relatedly, alongside patterns of rising opioid use in general, opioid use during pregnancy is becoming a growing public health concern. Still, risk factors for prescription opioid use during pregnancy remain understudied. This study is the first to assess the connection between a women’s personal or vicarious exposure to incarceration in the 12 months prior to birth and patterns of prenatal opioid use. Data are from the Pregnancy Risk Assessment Monitoring System (PRAMS) in 2019 (N = 17,551 mothers). Logistic and multinomial logistic regression are used to assess the association between incarceration exposure and patterns of opioid use during pregnancy. Incarceration-exposed women were more likely to use all eight types of prescription opioids assessed in this study (Hydrocodone, Codeine, Oxycodone, Tramadol, Hydromorphone/Meperidine, Oxymorphone, Morphine, and Fentanyl). After adjustment for control variables, incarceration-exposed women were significantly more likely to report any prescription opioid use during pregnancy (OR = 1.745, 95% CI = 1.194, 2.554). Furthermore, relative to no opioid use, incarceration exposure was also associated with illicit prescription opioid use (RRR = 2.979, 1.533, 5.791). Incarceration exposure in the year prior to birth is associated with higher odds of prescription opioid use. These findings add to the burgeoning literature that details a women’s exposure to incarceration is a risk marker for substance use and engagement in health risk behaviors that can jeopardize maternal and infant wellbeing. •Incarceration is a risk factor for substance use.•Opioid use during pregnancy is harmful for maternal and infant health.•No prior research has assessed incarceration exposure during pregnancy and opioid use.•Incarceration exposed women are more likely to report opioid use during pregnancy.•Incarceration exposed women are more likely to report opioid misuse during pregnancy.