Year of Publication

2024

College

Public Health

Date Available

3-27-2024

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Rachel Hogg-Graham

Committee Member

Dr. Rachel Vickers-Smith

Committee Member

Dr. Julia Costich

Abstract

Background

Overdose mortality rates increased significantly between 2018 and 2021 in the United States (NIH, 2023). Moreover, pregnant and postpartum women (PPW), who were aged 35 to 44 were observed to have the highest overdose mortality rates (NIH, 2023). Although there is existing research that examines the increase of co-occurring opioid and methamphetamine use, it still remains understudied when specifically focusing on PPW. This analysis intends to explore this gap in research by 1) exploring the history of co-occurring methamphetamine and opioid use among PPW who were seeking residential treatment, 2) highlighting the adverse health outcomes that follow co-use among PPW, 3) making future recommendations for potential reduction of those adverse health outcomes and harms for PPW.

Methods

Participants (N=211) were PPW with a history of substance use and entering treatment at Chrysalis House, a residential treatment facility in Lexington, Kentucky. The outcome evaluation included a baseline interview (two weeks after admission) and a follow-up interview (six months after the baseline interview). Baseline interviews were conducted in-person or over the phone with participants 2 weeks post-admission. Eligibility consisted of participants who were either currently pregnant or postpartum (had a child that was age 2 or younger) and at Chrysalis House receiving services at the time of baseline. Participants were examined using three groups: women who reported use of opioids only (n=50), methamphetamines only (n=74), or both opioids and methamphetamines (n=87) 30 days prior to their current treatment episode. For continuous dependent variables, analysis of variance (ANOVA) was used to examine differences by groups. Significant ANOVA findings were further explored using post-hoc analyses (Tukey's, Scheffe). Categorical dependent variables were analyzed using a series of chi-square tests.

Results

Participants were predominately White (97.1%) with an average age of 29 years old. Between the three different groups (opioid use only, methamphetamine use only, and co-use of opioids and methamphetamine use), there were many areas of significance with housing conditions, criminal justice involvement, overdose and injection drug use history, mental health concerns, and trauma. Moreover, individuals who reported methamphetamine and opioid co-use were significantly more likely to report IDU in the 30 days prior to treatment (p>.001), and were significantly more likely to have overdosed (p=.024) and witnessed an overdose (p>.001) in the six months prior to treatment.

Conclusion

Implications highlight the need for further education and research regarding potential adverse health outcomes that are present for PPW who report co-occurring opioid and methamphetamine use. Moreover, it points to a critical need for additional research on the long-term implications of co-occurring opioid and methamphetamine use for PPW. A focus on harm reduction efforts, education on polysubstance use, and resources are recommended.

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