Pregnant Women Shown to Face Additional Barriers to OUD Treatment in Study

A study using trained actors attempting to get addiction treatment in 10 states found that pregnant women were about 20% less likely to be accepted for treatment vs. women who are not pregnant, with the largest discrepancy involving buprenorphine prescribers.

The study, published in JAMA Open by researchers at Vanderbilt University Medical Center, used “secret shoppers,” also showed issues scheduling a first-time appointment to receive medications to treat opioid use disorder and finding providers who take insurance instead of cash.

Researchers randomly selected 6,324 clinicians/clinics from government lists of providers that offer either buprenorphine or methadone; 10,871 patients, a mix of pregnant and non-pregnant women and those with private or public insurance, sought treatment between March and September 2019. About 25% of the participants seeking treatment said they were unable to reach a provider after calling at least five times.

Of the pregnant women seeking treatment, just 61.4% were able to schedule an appointment with an outpatient buprenorphine provider vs. 73.9% of non-pregnant women. Meanwhile, 90% of callers were able to schedule an appointment with opioid treatment programs, which also had no difference in acceptance rates for pregnant vs. non-pregnant patients.

About a quarter of buprenorphine prescribers and one-third of providers overall said they do not accept insurance.

“It wasn’t just that pregnant women had a hard time getting into treatment; everyone did. It was pretty extraordinary,” Stephen Patrick, MD, director of the Center for Child Health Policy at Vanderbilt University School of Medicine, said in a news release. “We have been in the middle of an epidemic of opioid overdose for years now. There are just too many barriers into getting treatment. We are still setting records levels of overdose deaths in the U.S., likely made worse by the COVID-19 pandemic. We know these medicines save lives; it shouldn’t be this hard to get them,” he said.