The Association Between Health Insurance and Opioid Misuse in Pregnancy

We sought to evaluate the association between insurance type and non-medical opioid use in pregnant women in the United States. We conducted a study in women aged 12 to 49 years using the 2005–2014 National Survey on Drug Use and Health (NSDUH). Though multivariable regression, we specifically analyzed the difference in non-medical opioid use during pregnancy between women covered by Medicaid versus private insurance. A total of 244,353 reproductive-aged women were included. Of those women, 8,862 (3.6%) were pregnant at the time of survey and 79 (0.03%) reported non-medical opioid use in the past month. After controlling for socioeconomic factors, we found nonmedical opioid use was greater for pregnant women on Medicaid compared to private insurance in the second trimester (adjusted odds ratio, 6.5; p = .015), despite no significant difference in the first trimester (0.84; p = .656). This difference may suggest a discrepancy in access to care.