Examining state policies governing opioid use and pregnancy

Opioid use disorders during pregnancy have risen at alarming rates in the U.S. in recent years, increasing the risks of preterm labor and delivery, poor fetal growth, prolonged hospital stays, maternal death and stillborn infants. Maternal opioid use can also result in neonatal abstinence syndrome, an opioid withdrawal condition in infants.

Despite all the risks, opioid-prescribing practices and rates of opioid use in pregnancy vary substantially between states, suggesting state policies may be affecting these outcomes.

A Penn State researcher and his team will receive almost $1.2 million over three years from the Agency for Healthcare Research and Quality in the U.S. Department of Health and Human Services to examine the effects of these policies on pregnant women with opioid use disorder (OUD) and their infants.

According to project principal investigator Doug Leslie, director of the Center for Applied Studies in Health Economics and professor of public health sciences and psychiatry at Penn State College of Medicine, state responses regarding treatment of OUD in pregnancy vary widely, yet evidenced-based data about what specific public health strategies result in the best outcomes for these mothers and their infants are limited.

Leslie, also an affiliate faculty member of Penn State's Consortium to Combat Substance Abuse and the Clinical and Translational Research Institute, will examine the effects and costs of state policies governing the treatment of pregnant women with OUD.

“It is our goal to understand how states react to pregnant women who were using opioids,” said Leslie. “Some states treat these women as in acute need, while other states treat them like criminals. We want to inform state policies to improve maternal and infant outcomes.”

Leslie and his research team will study two insurance claims databases that include both publicly and privately insured individuals. By using data from the MarketScan Commercial Claims and Encounters and the Medicaid Analytic eXtract (MAX) files, the study will provide a comprehensive assessment of the effects of these policies on maternal and neonatal outcomes in pregnant women with OUD.

“The information we generate from the study will be crucial to providers, insurers, and policymakers as they design treatment processes and policies to provide adequate care to these women and their infants,” Leslie said.

Other co-investigators on the project are Charleen Hsuan, assistant professor of health policy and administration at Penn State; Andrew Dick, senior economist at RAND Cooperation; Guodong Liu, assistant professor of public health science at Penn State; and Tammy Corr, assistant professor of pediatrics at Penn State College of Medicine.

The Penn State Consortium to Combat Substance Abuse (CCSA), located within the Social Science Research Institute at Penn State, leverages the vast scope of researcher-practitioner experience to support, inform and improve programs that address prevention, addiction, and treatment and recovery, while supporting affected families and communities. The CCSA will be hiring 12 faculty members to bolster scientific leadership for research, teaching, and outreach, and has awarded seed grants for 13 projects to help fuel innovative solutions to solve problems at the local level.