Accessing quality substance use treatment for pregnant women with opioid use disorder in Florida

The standard of care for opioid use disorder (OUD) among pregnant women includes pharmacotherapy treatment such as Buprenorphine or Methadone. However, less than 25% of women with OUD will receive any form of substance use treatment, and an even smaller proportion will receive pharmacotherapy. Pregnant women with OUD experience numerous barriers and are likely to face challenges associated with accessing substance use treatment. We aimed to identify barriers in accessing treatment by pregnant women with OUD and recommendations for improvement from the perspectives of parenting women in recovery.

Participants from multiple substance use, home visiting, and treatment programs across Florida were recruited to form a Parent Advisory Committee of women who received buprenorphine or methadone during pregnancy. Eight group discussions were held from May to September 2021 to identify and summarize barriers to accessing substance use treatment and recommendations for improvement. Interviews were recorded and transcribed, and applied thematic analysis was conducted.

Several challenges identified for pregnant women with OUD included limited insurance coverage for treatment, nonacceptance into treatment by providers, ethical concerns related to treatment disbursement, difficulty navigating the health system to access OUD treatment, patient-physician communication, and continuation of OUD treatment once pregnant. Additional challenges included balancing recovery care schedules with parenting, work demands, and limited transportation.

Pregnant women with opioid use disorder experience numerous barriers when seeking substance use treatment. Advisory members who have experienced these challenges offer insight and recommendations. In addition to bridging the gap between prenatal care and OUD treatment, improvement strategies should also address barriers at the personal, community, healthcare system, and policy levels.