Opioid Use Disorder Treatment Discontinuation Among Postpartum Women in Western North Carolina

Opioid use disorder (OUD) is a widespread issue that has developed into an epidemic over the last several decades. It significantly affects thousands of pregnant women in the United States, leading to detrimental health outcomes for both mother and offspring. Medication treatment for opioid use disorder (MOUD) with buprenorphine or buprenorphine HCl-naloxone HCl (Suboxone) aids in reduced opioid use, improved relapse rates, and overall better health outcomes for mothers and offspring. Understanding factors that affect postpartum MOUD continuation is imperative in assisting with future policy changes and necessitating improved perinatal health programs for postpartum women with OUD. The aim of this study is to examine postpartum MOUD discontinuation in perinatal women diagnosed with OUD and assess factors associated with MOUD discontinuation during the postpartum stage. This study evaluated MOUD discontinuation among postpartum women diagnosed with opioid use disorder living in Western North Carolina (n=131). Adjusted multivariable logistic regression using SAS 9.4 statistical software was conducted using Mountain Area Health Education Center electronic health record data collected from 2017-2019. OUD was reported by all 131 patients enrolled. Of those patients with a formal OUD diagnosis, 77.1% of the patients used Buprenorphine HCl-Naloxone HCl for MOUD while 22.9% used Buprenorphine HCl only at approximately 60 days postpartum, 88% of the patient population had evidence of MOUD continuation. Furthermore, 85%, 75%, and 70 % of women have evidence of MOUD continuation at 90, 180, and 270 days, respectively. Women who were more likely to be older had less risk of MOUD discontinuation. This study demonstrates that despite Medicaid coverage ending 60 days postpartum, MOUD continuation remains high among this cohort of women. These findings are most likely attributed to the continuous care provided by comprehensive perinatal treatment programs.Doctor of Pharmac