Tailored strategies to reduce opioid overdose deaths for pregnant and postpartum women: Examples and lessons learned from the HEALing Communities Study

IF 1.9 0 PSYCHOLOGY, CLINICAL

Journal of substance use and addiction treatment Pub Date : 2025-07-31 DOI:10.1016/j.josat.2025.209766

Miriam T.H. Harris , Megan Hall , Sylvia Ellison , JaNae Holloway , Carly Bridden , Sarah M. Bagley , Mackenzie Bullard , Deborah Chassler , Avik Chatterjee , Anindita Dasgupta , Mari-Lynn Drainoni , Dawn E. Gruss , Elizabeth Jadovich , Rachel Katz , Christine Mayotte , Jessica L. Neufeld , Emmanuel Oga , LaShawn Glasgow

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引用次数: 0

Abstract

Introduction

Pregnant and postpartum women (PPW) face substantial barriers to opioid use disorder (OUD) care despite overdose being a leading cause of maternal mortality in the United States. In this study, we leveraged data from the Helping End Addictions Long Term (HEALing) Communities Study (HCS), a community-engaged implementation trial aimed at reducing opioid overdose deaths, to 1) describe evidence-based practice (EBP) strategies designed to reach PPW and 2) review implementation determinants.

Methods

We analyzed data from 50 communities across Massachusetts, New York, and Ohio that implemented the Communities That HEAL intervention from January 2020 through December 2023. HCS community coalitions used the HCS Opioid-overdose Reduction Continuum of Care Approach (ORCCA) menu to inform the selection of overdose education naloxone distribution (OEND) and medication for OUD (MOUD) EBP strategies. We used the ORCCA tracker, an HCS tool documenting strategy selection and implementation details, to identify and summarize strategies designed for PPW. We reviewed written community action and implementation plans to analyze and summarize implementation determinants.

Results

The 50 communities included in this analysis selected 29 EBP strategies designed to reach PPW, and 21 (72.4 %) of the selected strategies were implemented, accounting for 3.5 % of all implemented strategies. Most (85.7 %) focused on MOUD, 31.0 % were based in rural communities, and 66.7 %, 23.8 %, and 9.5 % were delivered in healthcare sectors, behavioral health sectors, and criminal legal sectors, respectively. Barriers to implementing OUD strategies intended for PPW included a lack of staff or services with adequate experience, and stigma preventing delivery and engagement. Facilitators included leveraging existing services and community expertise to expand OUD care.

Conclusion

Our findings indicate a need for greater awareness of OUD among PPW and research on implementation approaches for EBPs that effectively reach this group. Leveraging existing community programs that serve PPW with substance use disorders could help expand tailored services.

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减少孕妇和产后妇女阿片类药物过量死亡的量身定制战略：从康复社区研究中获得的例子和经验教训

尽管过量使用阿片类药物是美国孕产妇死亡的主要原因，但孕妇和产后妇女（PPW）在阿片类药物使用障碍（OUD）护理方面面临巨大障碍。在这项研究中，我们利用了来自帮助结束成瘾长期（治疗）社区研究（HCS）的数据，这是一项旨在减少阿片类药物过量死亡的社区参与实施试验，以1)描述旨在达到PPW的循证实践（EBP）策略，2)审查实施决定因素。方法：我们分析了马萨诸塞州、纽约州和俄亥俄州50个社区的数据，这些社区从2020年1月到2023年12月实施了“治愈社区”干预。HCS社区联盟使用HCS减少阿片类药物过量连续护理方法（ORCCA）菜单来选择过量教育纳洛酮分布（OEND）和OUD (mod) EBP策略的药物。我们使用ORCCA跟踪器，一个记录策略选择和实施细节的HCS工具，来识别和总结为PPW设计的策略。我们审查了书面的社区行动和实施计划，以分析和总结实施决定因素。结果纳入的50个社区共选择了29种EBP策略，其中21种（72.4%）得到了实施，占全部实施策略的3.5%。大多数（85.7%）以妇女为重点，31.0%以农村社区为基础，66.7%、23.8%和9.5%分别在卫生保健部门、行为卫生部门和刑事法律部门提供。实施针对PPW的OUD战略的障碍包括缺乏具有足够经验的工作人员或服务，以及阻碍实施和参与的耻辱感。促进因素包括利用现有服务和社区专业知识来扩大OUD护理。结论：我们的研究结果表明，需要提高PPW对OUD的认识，并研究有效覆盖这一群体的ebp实施方法。利用现有的社区项目，为患有药物使用障碍的PPW提供服务，可以帮助扩大量身定制的服务。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of substance use and addiction treatment Biological Psychiatry, Neuroscience (General), Psychiatry and Mental Health, Psychology (General)

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