Harm Reduction Approaches to Opioid Use During Pregnancy in the United States: A Critical Literature Synthesis

Background: The use of opioids during pregnancy in the United States has become an issue of particular concern for medical professionals and researchers alike. The impacts of opioid use during pregnancy are vast, as it presents major health risks to both the pregnant individual and the fetus. Utilizing harm reduction in response to opioid use during pregnancy could significantly improve the health of this population. Purpose: The purpose of this literature synthesis is to review the existing literature on harm reduction approaches to opioid use during pregnancy in the United States. This review will aim to clarify key concepts in the literature, identify existing harm reduction approaches, explore current evidence to support these approaches, discuss how these approaches fit within the social ecological framework, and identify and analyze knowledge gaps in this area of research. Methods: A literature search was conducted using Medline and PsycInfo to identify relevant research articles. Results: Fifteen articles meeting the inclusion criteria were identified and synthesized. The literature revealed gaps in the types of studies utilized for this research and a dearth in the types of harm reduction strategies utilized for opioid use during pregnancy. Conclusion: Given the increasing number of cases of opioid use during pregnancy, these results have great public health significance. More research is needed to explore how the many types of harm reduction strategies that are used for the general population can be adapted for pregnant people who use opioids. The studies in this review also failed to address racial disparities in the treatment of OUD during pregnancy. Further analysis of these disparities, as well as exploration of community level interventions would contribute to better treatment strategies for pregnant people who use opioids