Opioid, methamphetamine co-use in pregnancy up since 2000

SAN DIEGO — Admissions for opioid and methamphetamine co-use in pregnancy increased between 2000 and 2017, according to data presented here.

“Overall, these results parallel what many clinicians have reported anecdotally, and are consistent with broader trends across the country,” Christina N. Schmidt, BS, a fourth-year medical student at the University of California, San Francisco, told Healio.

Schmidt and colleagues analyzed data on substance use in 98,444 pregnant patients who presented for opioid use treatment at federally funded substance use centers across the United States between 2000 and 2017. They examined rates of methamphetamine, benzodiazepine, cocaine, marijuana and alcohol co-use within the study population; 61% of patients reported some type of co-use.

On average, admissions involving the co-use of methamphetamines and benzodiazepines increased by 13.7% (95% CI, 8.6%-19%) and 6.7% (95% CI, 4.5%-9%), respectively, each year during the study period. However, the average annual percent change (AAPC) in admissions with co-use of cocaine decreased by 5.7% (95% CI, –7.8% to –3.5%).

Co-use of alcohol and marijuana remained relatively stable, with AAPCs of –3.5% (95% CI, –5.5% to 1.4%) and 2.9% (95% CI, –0.4% to 6.4%), respectively.

When stratifying by region, the researchers noted that increased methamphetamine co-use was largely due to trends in the Western U.S., “where admissions for methamphetamine co-use surpassed those for opioid use alone and co-use with other substances,” they wrote.

“These results reinforce that most pregnant patients presenting to substance use treatment centers do not have an isolated opioid use disorder,” Schmidt told Healio. “Methamphetamine co-use in particular is on the rise, and our treatment systems require shifts to better serve the increasingly complex treatment needs of our pregnant population.”

Future research should investigate treatment options for stimulant use disorders, Schmidt said.

“Currently, we rely on contingency management as our evidence-based strategy, but ongoing efforts to identify strategies for management — especially for our pregnant populations — is crucial and will become increasing so in the coming years,” she said. “We also need additional research to better understand the clinical implications of various co-use disorders in pregnancy.”

The abstract was awarded first place at the ACOG Annual Clinical & Scientific Meeting, according to organizers.