Perceptions of Women in Opioid Recovery Regarding Policies and Laws on Sexual and Reproductive Health.

Objective: To explore perceptions of policies and laws on sexual and reproductive health among women in recovery from opioid use disorder (OUD).

Design: Qualitative descriptive.

Setting: Telephone interviews conducted in a midsized urban area in the midwestern region of the United States.

Participants: Twenty-two women ages 18 to 49 years who self-identified as being in recovery from OUD.

Methods: We conducted individual, semistructured telephone interviews and analyzed the data using reflexive thematic analysis.

Results: We identified three themes: Barriers to OUD Treatment and Recovery, Pregnancy as a Gateway to Treatment and Recovery, and The Dobbs Effect. Participants described OUD treatment barriers such as inadequate recovery resources for women and the criminalization of drug use. Many participants described pregnancy as a gateway to recovery because of improved access to treatment services and enhanced motivation for engaging in recovery. Participants described unintended pregnancy as a threat to recovery that made them seek woman-controlled contraceptive methods they could use without negotiating with a partner (e.g., intrauterine devices) after the Supreme Court overturned constitutionally protected access to abortion.

Conclusion: Opioid use disorder is a public and mental health crisis in the United States that affects reproductive-age women. Participants in our study closely connected recovery from OUD with sexual and reproductive health policy and laws. There is a need for regulation to support the unique needs of women in OUD treatment. The recent Supreme Court decision that overturned constitutionally protected abortion creates challenges for women in recovery from OUD. Nurses are ideally positioned to advocate for recovery and sexual and reproductive health policies and laws that improve the physical and mental health of women in recovery.