ArticleJournal of substance use and addiction treatment2026
Treatment of opioid use disorder in pregnancy among individuals with and without co-occurring stimulant use disorder: A retrospective cohort study.
Article in Journal of substance use and addiction treatment, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionOpioid use disorder (OUD) exists in approximately 1% of US pregnancies and is associated with increased risk of severe maternal morbidity and mortality. Many pregnant individuals with OUD also have a stimulant use disorder (StUD), but it is unclear whether this co-occurring condition changes the types of treatment services they receive. We compared treatment services received during pregnancy between individuals with both OUD and StUD and those only with OUD.
methodsA retrospective cohort study used 2014-2017 data from the Utah All-Payer Claims Database. The sample included pregnancies ≥20 weeks' gestation among individuals aged 15-49 years with ≥4 weeks of insurance enrollment and excluded pregnancies with outcome events occurring <28 weeks after the estimated conception date. Identification of OUD and StUD relied on ICD-9/10 diagnosis codes. Outcomes were receipt of (1) medication for OUD (MOUD; formulations of buprenorphine or methadone administration), (2) outpatient psychosocial services (evaluation and management/assessment services and psychotherapy/counseling or other psychosocial visits), and (3) higher-intensity treatment (intensive outpatient, partial hospitalization, or residential treatment). Logistic generalized estimating equation models, adjusted for demographic and clinical covariates, estimated odds of receiving each service and any service overall.
resultsAmong 146,239 insurance beneficiaries, we identified 1206 pregnancies with OUD, including 305 (25.3%) with co-occurring StUD and 901 (74.7%) only with OUD. Pregnant individuals with StUD and OUD compared to those only with OUD had lower odds of receiving MOUD (adjusted odds ratio [aOR], 0.68; 95% CI, 0.48-0.96) and higher odds of receiving psychotherapy/counseling or other psychosocial visits (aOR, 2.73; 95% CI, 2.01-3.71) and higher-intensity treatment (aOR, 3.47; 95% CI, 1.58-7.59). There were no differences between groups in receipt of evaluation and management/assessment services (aOR, 0.97; 95% CI, 0.83-1.14) or of any treatment service overall (aOR, 1.07; 95% CI, 0.94-1.21).
conclusionsIn this sample of Utah insurance beneficiaries, pregnant individuals with co-occurring StUD and OUD were less likely to receive MOUD and more likely to receive psychosocial and higher-intensity services than those only with OUD.
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