Policy perceptions of US state public health and child and family services regarding maternal opioid use and neonatal exposure

Abstract Objective To explore how state legislatures and departments of health are responding to the public health and economic issues of increases in opioid use disorder and the impact on pregnant women and infants. Design The design was a non-experimental descriptive study using a mixed methods survey research approach. Setting Electronic and telephone survey of individuals from state departments of health associated with departments of behavioral health and substance use, or child and family services. Participants Fifty-two respondents employed by individual state departments of health and child and family services. Methods Univariate analysis and frequency distribution of ordinal variables was completed. Thematic analysis was used to analyze free text questions and identify themes. Results All states reported recent changes or plans to address the problem of opioid misuse in their state. Many respondents feel their state continues to lack adequate services for treatment. Some states are exploring unique methods for addressing this in a safe and timely fashion, such as moving medication-assisted treatment to primary care and expanding licensure to Primary Care Physicians (PCPs) and nurse practitioners. Conclusions Our findings demonstrate an increased commitment throughout the United States to enhance access to clinically appropriate treatment of substance use disorder particularly during pregnancy, consider unique methods for addressing the problem of opioid dependency, and increase education and primary prevention programs.