Substance use, treatment, and demographic characteristics of pregnant women entering treatment for opioid use disorder differ by United States census region
Open accessAbstract
Opioid use disorder (OUD) among pregnant women increased substantially between 1992 and 2012 across the United States, with the greatest increases occurring in the southern states. We analyzed the 2013 Treatment Episodes Database-Admissions to determine how substances used, characteristics of treatment, and demographics of pregnant women entering treatment for opioid use disorder vary between geographical regions. Analyses were restricted to cases where women reported being pregnant at the time of admission and reported opioids as the primary substance problem leading to the treatment admission. Characteristics were compared between U.S. census regions using Chi-square tests and logistic regression with the South census region as the reference group. Compared to the South, pregnant women admitted for OUD treatment in other regions were 33-79% less likely to use benzodiazepines, twice as likely to be admitted to medication assisted treatment (MAT), 2-3 times more likely to use heroin, and up to 1.5 times more likely to inject drugs. Fewer women in the South reported having medical insurance, education beyond high school, and being married. There is a need in the southern U.S. for policies and treatment programs to target reducing concomitant opioid and benzodiazepine use, increasing access to, and utilization of, MAT, and increasing access to medical insurance.
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Welborn, A. C., Gringle, M. R., & Nichols, T. R. (2024) · Nursing Inquiry · doi:10.1111/nin.12691 · Cited by 1 · see citing works
“…nurses and mothers with an SEP within the context of the southeast region of the United States, where disparities in healthcare and legal consequences for mothers who use substances in pregnancy are magnified (Angelotta and Appelbaum 2017; Hand, Short, and Abatemarco 2017; Patrick et al. 2015).”
Burduli, E., Landis, T. T., Brumley, C., Kenefick, L. A., Paulsgrove, K., Jones, H. E., Barbosa‐Leiker, C., Brooks, O., Gartstein, M. A., & Saldana, L. (2025) · Journal of Substance Use and Addiction Treatment · doi:10.1016/j.josat.2025.209644 · Cited by 1 · see citing works
Malone, C. A., Rogers, J., Guastaferro, W. P., & Whitaker, D. J. (2019) · Journal of the Georgia Public Health Association · doi:10.20429/jgpha.2019.070219
“And the greatest increase in this disorder among pregnant women between 1992 and 2012 occurred in southern states (Hand, Short, & Abatemarco, 2017).”
BackgroundRamakrishnan, A., Fujita, A. W., Mehta, C. C., Wilson, T. E., SHOPTAW, S. J., Carrico, A. W., Adimora, A. A., Eaton, E., Jones, D. L., Chandran, A., et al. (2023) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000003373 · Cited by 1 · see citing works
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Salameh, T. N. (2017) · doi:10.18297/etd/2775
“This may be due to a lack of health insurance coverage and available treatment services (Hand et al., 2017).”
BackgroundMethodSubstance Use Disorders in Pregnancy and Lactation
Johnson, E., & Myers, S. (2021) · Springer eBooks · doi:10.1007/978-3-030-71497-0_14
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“These figures represent a significant increase since 2015, with a 4.7% rise in illicit drug use, a 3.4% increase in marijuana use, and a 9.3% surge in alcohol use [3].”
InfluentialStokes, L. (2024) · doi:10.1093/med/9780190063559.003.0010
Qato, D. M., & Gandhi, A. B. (2021) · Figshare · doi:10.6084/m9.figshare.14532807
Qato, D. M., & Gandhi, A. B. (2021) · Figshare · doi:10.6084/m9.figshare.14532822
Qato, D. M., & Gandhi, A. B. (2021) · Figshare · doi:10.6084/m9.figshare.14532816
Qato, D. M., & Gandhi, A. B. (2021) · Figshare · doi:10.6084/m9.figshare.14532819
Leiner, C., Cody, T., Mullins, N., Ramage, M., & Ostrach, B. M. M. (2021) · Figshare · doi:10.6084/m9.figshare.14053558
Qato, D. M., & Gandhi, A. B. (2021) · Figshare · doi:10.6084/m9.figshare.14532810
Qato, D. M., & Gandhi, A. B. (2021) · Figshare · doi:10.6084/m9.figshare.14532813
Reyes, J., Ager, E. E., Ahmed, Z., Follman, S., Gonzalez, A., Quinley, K., & Agarwal, A. (2026) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2026.02.019
- Authors
- Hand, D. J., Short, V. L., & Abatemarco, D. J.
- Affiliations
- Thomas Jefferson University (US)
- Corresponding author
- Hand, Dennis J.
- Short, Vanessa L.
- Abatemarco, Diane J.
- Venue
- Journal of Substance Abuse Treatment
- Publisher
- Elsevier BV
- Published
- 2017-05
- Volume
- 76
- Pages
- 58-63
- ISSN
- 0740-5472 (ISSN-L)
- OpenAlex
- W2583175204
- Cited by
- 71
- References
- 42
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 7 · 2023: 7 · 2022: 6 · 2021: 18 · 2020: 8 · 2019: 14 · 2018: 5 · 2017: 3
- FWCI
- 7.73
- Type
- journal article
- Language
- en
- Open access
- green
- jdc.jefferson.edu
- Licence
- Locations
- Journal of Substance Abuse Treatment (publishedVersion)
- PubMed (publishedVersion)
- The Medicine Forum (submittedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Keywords
- opioid use disorder, pregnant women, maternal substance use, medication-assisted treatment, benzodiazepine use, heroin use, intravenous drug use, regional disparities, Southern United States, health insurance, demographic factors, treatment admissions
- MeSH terms
- Adult, Benzodiazepines, Female, Geography, Humans, Opioid-Related Disorders, Pregnancy, Pregnancy Complications, Socioeconomic Factors, United States, Southeastern United States, Substance Abuse, Intravenous, Prevalence, Insurance Coverage, Substance-Related Disorders, Young Adult, Opiate Substitution Treatment
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