(950) Perinatal opioid use prevention and treatment at a public, inner-city hospital system

Opioid use disorder (OUD) is a leading cause of maternal mortality in the postpartum period. We evaluated implementation of a multidisciplinary prevention and treatment program in an inner-city public hospital system designed to engage patients in recovery services, provide overdose prevention education, and increase access to buprenorphine medication assisted therapy (MAT).

Study Design:

A one-year descriptive analysis of a state grant-funded program. Care involved a multidisciplinary team of nurse-midwives, peer navigators, licensed chemical dependency counselors, and physicians with expertise in addiction and maternal-fetal medicine. Postpartum, individuals with OUD were approached with an option to consent for additional recovery services with or without buprenorphine MAT. All received opioid overdose prevention education and a prescription for intranasal naloxone kit independent of consent. Implications for care and policy are included.

Results:

From March 2021 through March 2022, 80 postpartum patients with OUD were approached. A history of trauma was verified in 50(62%), with 25 (31%) indicating sexual trauma(Table 1). Fifty-three(66%) had a mental health diagnosis, and 32(40%) had a family history of substance use. All received opioid overdose prevention education and a prescription for intranasal naloxone. Pharmacy dispensation was verified for 49(61%). Thirty-six(45%) declined participation; of these 15(42%) were not previously engaged in care in our system and 8(22%) were discharged to residential programs. Of the 44 who engaged in our program, 17(39%) received MAT initiation; 13(30%) were not previously engaged in care(Table 2). Of those engaged, 12(27%) completed the MAT or recovery program at 30 days and care transitioned to another established MAT program.

Conclusion:

A multidisciplinary team for OUD with awareness of trauma-informed care can reach a population otherwise not engaged in health care services at the time of delivery admission. Future efforts to overcome system-level barriers are needed to provide increased access to continued MAT and overdose prevention after discharge.