Opioid dependence among pregnant and post-partum incarcerated individuals: A review of the literature

Serra Sozen; David Krag; Carly Milliren

doi:10.5055/jom.2023.0806

Authors

Serra Sozen https://orcid.org/0000-0001-6775-0541
David Krag, MD
Carly Milliren

DOI:

https://doi.org/10.5055/jom.2023.0806

Keywords:

opioid, incarceration, pregnant, post-partum, medications for opioid use disorder, medication-assisted treatment

Abstract

Background: Pregnant and post-partum women with opioid dependence are an extremely vulnerable population within correctional facilities. A significant number of maternal inmates, however, still lack adequate provision of medications for opioid use disorder (OUD) and are subsequently forced into withdrawal. Currently, there exist no comprehensive reviews on the scope of literature regarding the management of this population. We aimed to provide a review on the research surrounding these women.

Design: A systematic search of PubMed Central was conducted to identify studies evaluating OUD among pregnant and post-partum incarcerated women. Citations from only the last 20 years were included to ensure both relevance and scope of information.

Results: The topics that emerged from this review included medications for OUD (MOUD) administration vs detoxification practices, treatment upon incarceration and upon release, and maternal and fetal outcomes. Across all articles, current care management of this population appeared inadequate. We further compiled all author recommendations and perspectives into a framework that can inform potential improvements in care coordination.

Conclusions: This review identifies significant gaps in current management—particularly regarding administration of MOUDs—and emphasizes the need for standardization of addiction-related and perinatal healthcare. We also highlight gaps in the literature and potential areas for future research.

Author Biographies

Serra Sozen

Department of Medicine, The Robert Larner, MD College of Medicine, University of Vermont, Burlington, Vermont

David Krag, MD

Department of Surgery, University of Vermont Cancer Center, University of Vermont Larner College of Medicine, Burlington, Vermont

Carly Milliren

Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, Massachusetts

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