Community buprenorphine continuation post-release following extended release vs. sublingual buprenorphine during incarceration: a pilot project in Maine.

Background: The aim of our study was to evaluate the post-release outcomes of incarcerated individuals with opioid use disorder (OUD) treated with extended-release buprenorphine (XRB) in a rural county jail. Administrative data were collected from a pilot program within a jail in Maine that introduced XRB treatment in 2022 and a comparable jail utilizing sublingual buprenorphine (SLB) during the same period to compare post-release outcomes. Log-binomial regression models were used to estimate the risk ratio (RR) and 95% confidence interval (CI) for jail use of XRB vs.

Trends in maternal opioid use disorder and neonatal abstinence syndrome in Maine, 2016-2022.

Objective: To estimate trends in maternal opioid use disorder (OUD) and neonatal abstinence syndrome (NAS) in Maine using the most recent data available.

Study Design: We used hospital discharge data to estimate the annual prevalence of maternal OUD and NAS between 2016 and 2022. In addition, we used birth certificate-linked Medicaid data to estimate related trends among Medicaid enrollees.

Hepatitis C Virus Cascade of Care Among Perinatal Patients in Maine Diagnosed With Opioid Use Disorder, 2015-2020.

Objective: This is a quality improvement project to determine the best process to identify and address gaps in care for perinatal patients in receiving appropriate hepatitis C virus (HCV) testing and treatment across the largest health system in Maine.

Study Design: We reviewed electronic medical record data between October 1, 2015, and February 1, 2020, to investigate rates of HCV testing and treatment among 916 perinatal patients with opioid use disorder across 8 hospitals using a "cascade of care" framework, a model used previously to identify gaps in care and treatment of chronic diseases.

Main Outcome Measure: We examined HCV testing and treatment rates along the cascade of care and patient characteristics associated with HCV antibody testing and treatment, separately, using log binomial regression models.

Peripartum and Postpartum Analgesia and Pain in Women Prescribed Buprenorphine for Opioid Use Disorder Who Deliver by Cesarean Section.

Aim: Little is known about whether pain can be effectively managed in pregnant women with opioid use disorder (OUD) during delivery hospitalization, particularly those undergoing surgery and taking buprenorphine as medication for OUD (MOUD). To address this question, we compared pain scores and opioid analgesic utilization during delivery hospitalization in women taking their pre-hospital dose of buprenorphine who delivered by cesarean section to matched controls. To inform future research efforts, we also began to explore opioid analgesic utilization and pain scores by type of anesthesia as this variable is often not included in related literature.

Experiences of stigma among individuals in recovery from opioid use disorder in a rural setting: A qualitative analysis.

Introduction: Stigma is a barrier to accessing treatment and support services for individuals with substance use disorder. Stigma is negatively associated with completion of treatment for substance use disorder and management of recovery.

Objective: To learn from individuals in recovery from opioid use disorder in a largely rural area about how their personal experiences of stigma affected their ability to enter into treatment and stay in recovery.

Medication for Addiction Treatment and Postpartum Health Care Utilization Among Pregnant Persons With Opioid Use Disorder.

Objective: To estimate treatment and postpartum health care utilization among pregnant persons with opioid use disorder (OUD) in Vermont and Maine.

Methods: Vermont's and Maine's All Payer Claims Databases were used to identify deliveries 2010 to 2018 that were paid for, in part, by Medicaid. OUD was identified among pregnant persons if they had any claim with an OUD-diagnosis code (ICD-9/10) or medication for addiction treatment (MAT) code during the 5 months before delivery event.

Initial Management of Incarcerated Pregnant Women With Opioid Use Disorder.

The epidemic of opioid and other drug use and related arrests are a growing public health crisis in the United States. The national prevalence of pregnant women with opioid use disorder (OUD) has increased dramatically from 1.5 per 1,000 delivery hospitalizations in 1999 to 6.

Implications of perinatal buprenorphine exposure on infant head circumference at birth.

To determine the potential impact of prenatal buprenorphine exposure on head circumference at birth and analyze whether head circumference may be related to maternal buprenorphine dose at delivery, delayed maternal entry into buprenorphine treatment or exposure to a variety of other medications and substances. A retrospective cohort study was performed of 137 full-term infants exposed to buprenorphine during pregnancy from January 2013 to December 2017. Pearson's correlation was calculated to investigate the potential relationship between head circumference and maternal dose of buprenorphine at delivery.

Predictors of treatment retention in postpartum women prescribed buprenorphine during pregnancy.

Aim: To determine variables related to treatment retention in women six and twelve months postpartum that were in medication treatment using buprenorphine during pregnancy.

Methods: This retrospective cohort study of 190 maternal-infant dyads exposed to buprenorphine during pregnancy examines rates of treatment retention at six and twelve months postpartum and also analyzes a variety of potential predictors of treatment retention including illicit drug use in the third trimester, delayed entry into medication treatment and co-occurring mental health diagnoses requiring prescription medication.

Results: At 12months postpartum, women appeared more likely to remain in medication treatment if they entered treatment early in pregnancy (defined as either being in treatment at the time of conception, p=0.

Maternal and infant outcomes following third trimester exposure to marijuana in opioid dependent pregnant women maintained on buprenorphine.

Background: To determine whether maternal and infant outcomes are associated with exposure to marijuana during the third trimester in a population of opioid dependent pregnant women maintained on buprenorphine.

Methods: This retrospective cohort study of 191 maternal-infant dyads exposed to buprenorphine during pregnancy examines a variety of variables including gestational age, birthweight, method of delivery, Apgar scores at one and five minutes, duration of infant hospital stay, peak neonatal abstinence syndrome (NAS) score, duration of NAS and incidence of pharmacologic treatment of NAS in infants exposed to marijuana during the third trimester as compared to infants not exposed to marijuana during the third trimester.

Results: Analyses failed to support any significant relationship between marijuana use in the third trimester and a variety of maternal and infant outcomes.

Maternal Buprenorphine Dose at Delivery and Its Relationship to Neonatal Outcomes.

Background/aims: To determine whether there is a dose-response relationship between maternal dose of buprenorphine at delivery and neonatal outcomes.

Methods: This retrospective cohort study of 155 maternal-infant dyads exposed to buprenorphine during pregnancy examines the relationship between maternal dose of buprenorphine at delivery and gestational age, birthweight, method of delivery, Apgar scores at 1 and 5 min, duration of infant hospital stay, peak neonatal abstinence syndrome (NAS) score, duration of NAS and incidence of pharmacologic treatment of NAS.

Results: Analyses failed to support any relationship between maternal dose of buprenorphine at delivery and any of the 9 clinical outcomes (all p values >0.

Does concurrent in utero exposure to buprenorphine and antidepressant medications influence the course of neonatal abstinence syndrome?

Objective: To determine whether concurrent in utero exposure to buprenorphine and antidepressants impacts the course of neonatal abstinence syndrome (NAS) in infants.

Methods: A retrospective cohort study of 148 infants who were exposed to buprenorphine during pregnancy. Univariate and bivariate analyses were used to examine associations between concurrent maternal use of buprenorphine and antidepressants as compared to maternal use of buprenorphine alone.

Breastfeeding rates and the relationship between breastfeeding and neonatal abstinence syndrome in women maintained on buprenorphine during pregnancy.

Introduction: Although a growing body of evidence suggests that buprenorphine is a safe alternative to methadone in the treatment of opioid-dependent pregnant women, little is known about breastfeeding in this population. The first objective of this study was to describe breastfeeding rates among opioid-dependent pregnant women maintained on buprenorphine in an integrated medical and behavioral health program. The second objective was to determine whether breastfeeding is related to the duration, severity, and frequency of pharmacologic treatment for neonatal abstinence syndrome (NAS).

Are there gender related differences in neonatal abstinence syndrome following exposure to buprenorphine during pregnancy?

Aim: To determine whether infant gender influences the course of neonatal abstinence syndrome (NAS) following exposure to buprenorphine during pregnancy.

Methods: A retrospective cohort study was performed in which maternal and infant data were collected for 46 male and 44 female infants. All infants were born to women enrolled in a buprenorphine treatment program from December 2007 until October 2012.

Management of women treated with buprenorphine during pregnancy.

The management of pregnancy and delivery of a woman on opiate-substitution therapy with buprenorphine requires a coordinated team approach by social services, addiction medicine, obstetrics, and pediatrics. Her obstetrical care is further complicated by the unique pharmacology of buprenorphine and the issues of pain management. Obstetrical providers should be familiar with the complex issues surrounding the optimal care of these women.

Observational study of buprenorphine treatment of opioid-dependent pregnant women in a family medicine residency: reports on maternal and infant outcomes.

Purpose: Within a family medicine residency, an outpatient buprenorphine treatment program was provided for pregnant women who were dependent on opioids. The purpose of this study was to investigate the outcomes of infants who were exposed to a range of doses of buprenorphine in utero and to determine how closely observed maternal/fetal outcomes (eg, method of delivery and infants requiring treatment for neonatal abstinence syndrome [NAS]) match those previously reported in the literature.

Methods: This study consists of a retrospective case series of 23 infants born to 22 pregnant women who were dependent on opioids and who were treated with buprenorphine during a 31-month period.

Electric power plant emissions and public health.

The generation of electric power is one important source of pollutants such as mercury, sulfur dioxide, nitrogen oxides, and fine particulate matter that can affect the respiratory, cardiovascular, and central nervous systems and cause pregnancy complications. But protecting people from environmental health hazards has become increasingly complex. Air pollutants are often invisible and travel many miles virtually undetected.

Modifiable risk factors for impaired fertility in women: what nurse practitioners need to know.

Purpose: To provide an overview of impaired fertility in childbearing-aged women, to review the current research on modifiable lifestyle risk factors implicated in its development, and to suggest strategies for nurse practitioners (NPs) to assist women in behavioral changes that will allow them to protect their fertility.

Data Sources: Original research articles and comprehensive review articles identified through Medline, CINAHL, and OVID databases.

Conclusions: Research has shown that advancing age, a history of a sexually transmitted infection and/or pelvic inflammatory disease, extremes of body weight, and tobacco and caffeine use are potentially modifiable risk factors in the development of impaired fertility.