Pregnancy and Opioid Use Disorder
Primary care providers, clinical behavior health specialists and behavior health directors.
Opioid use in pregnancy has escalated dramatically in recent years, paralleling the epidemic observed in the general population. In 2012, U.S. health care providers wrote more than 259 million prescriptions for opioids, twice as many as in 1998. Rates of admission to substance use disorder treatment programs for misuse of prescription opioids more than quadrupled between 2002 and 2012, and rates of death associated with opioid analgesics rose nearly 400% between 2000 and 2014. Along with the increase in misuse of prescription opioids, there has been a sharp rise in rates of heroin use. Overdose deaths that involve heroin increased more than 300% in less than 5 years, from just above 3,000 in 2010 to more than 10,500 in 2014.
Opioid use in pregnancy has escalated dramatically in recent years, paralleling the epidemic observed in the general population. To combat the opioid epidemic, all health care providers need to take an active role. Pregnancy provides an important opportunity to identify and treat women with substance use disorders. Substance use disorders affect women across all racial and ethnic groups and all socioeconomic groups, and affect women in rural, urban, and suburban populations. Therefore, it is essential that screening be universal. Screening for substance use should be a part of comprehensive obstetric care and should be done at the first prenatal visit in partnership with the pregnant woman. Infants born to women who used opioids during pregnancy should be monitored for neonatal abstinence syndrome by a pediatric care provider. Early universal screening, brief intervention (such as engaging a patient in a short conversation, providing feedback and advice), and referral for treatment of pregnant women with opioid use and opioid use disorder improve maternal and infant outcomes. In general, a coordinated multidisciplinary approach without criminal sanctions has the best chance of helping infants and families.
The purpose is to inform clinic members (admin, providers, nursing, etc.) on how to successfully integrate a MAT program into an outpatient primary care setting. The mission is to help centers and clinics set up primary care based MAT to improve access for patients suffering from opioid use disorder across the state of Iowa.
- List of the risks of opioid use dependency in pregnancy.
- Differentiate between opioid agonist and withdrawal medication.
- Effectively utilize drug testing in clinical settings to help identify, treat, and support the recovery of pregnant women with addictions.
- Discuss methodological limitations, interpretation, and application of drug test results.
- Recognize how drug testing can be a powerful technology for supporting recovery.
Nicole Gastala, MD
Physician, Primary Health Care, Inc.
- Residency: University of Iowa
- Medical School: Loyola University Stritch School of Medicine
- Board Certification: American Board of Family Medicine
Bery Englebretson, MD
Medical Director, Primary Health Care, Inc.
Relevant to the content of this continuing education activity, the speaker and moderator indicated they have no financial relationships with commercial interest companies to disclose.
- DO: Des Moines University (DMU) is accredited by the American Osteopathic Association (AOA) to provide osteopathic continuing medical education for physicians. DMU designates this program for a maximum of 1.0 AOA Category 2-A credits and will report CME and specialty credits commensurate with the extent of the physician’s participation in this activity.
- MD: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Iowa Medical Society (IMS) through the joint providership of Des Moines University (DMU) and Primary Health Care, Inc. DMU is accredited by IMS to provide continuing medical education for physicians. DMU designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
- Nurse: Des Moines University is Iowa Board of Nursing approved provider #112. This live activity has been reviewed and approved for 1.0 continuing education contact hour(s). No partial credit awarded.
- Other healthcare professionals: This live activity is designated for 1.0 AMA PRA Category 1 Credit(s)TM.
No commercial interest provided financial support for this continuing education activity.
Everyone in a position to control the content of this educational activity will disclose to the CME provider and to attendees all relevant financial relationships with any commercial interest. The speaker(s) will disclose if any pharmaceuticals or medical procedures and devices discussed are investigational or unapproved for use by the U.S. Food and Drug Administration (FDA). Determination of educational content and the selection of speakers is the responsibility of the activity director. Firms providing financial support did not have input in these areas.
The information provided at this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition. The content of each presentation does not necessarily reflect the views of Des Moines University.
- 1.00 AMA PRA Category 1 Credits™
- 1.00 AOA Category 2A
- 1.00 CE Contact Hour(s)
- 1.00 IBON