Trends in prenatal prescription opioid use among Medicaid beneficiaries in Wisconsin, 2010-2019

Deborah B Ehrenthal; Yi Wang; Jessica Pac; Christine Piette Durrance; Russell S Kirby; Lawrence M Berger

doi:10.1038/s41372-024-01954-y

Trends in prenatal prescription opioid use among Medicaid beneficiaries in Wisconsin, 2010-2019

J Perinatol. 2024 Apr 1. doi: 10.1038/s41372-024-01954-y. Online ahead of print.

Authors

Deborah B Ehrenthal^{1

2}, Yi Wang^{3

4}, Jessica Pac^{5

6}, Christine Piette Durrance^{6

7}, Russell S Kirby⁸, Lawrence M Berger^{5

6}

Affiliations

¹ Department of Biobehavioral Health, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA. DebEhrenthal@psu.edu.
² Social Science Research Institute, The Pennsylvania State University, University Park, PA, USA. DebEhrenthal@psu.edu.
³ Social Science Research Institute, The Pennsylvania State University, University Park, PA, USA.
⁴ Silberman School of Social Work, Hunter College, City University of New York, New York, NY, USA.
⁵ Sandra Rosenbaum School of Social Work, College of Letters and Sciences, University of Wisconsin-Madison, Madison, WI, USA.
⁶ Institute for Research on Poverty, College of Letters and Sciences, University of Wisconsin-Madison, Madison, WI, USA.
⁷ La Follette School of Public Affairs, University of Wisconsin-Madison, Madison, WI, USA.
⁸ Chiles Center, College of Public Health, University of South Florida, Tampa, FL, USA.

PMID: 38561393
DOI: 10.1038/s41372-024-01954-y

Abstract

Objective: To examine changes in prenatal opioid prescription exposure following new guidelines and policies.

Study design: Cohort study of all (262,284) Wisconsin Medicaid-insured live births 2010-2019. Prenatal exposures were classified as analgesic, short term, and chronic (90+ days), and medications used to treat opioid use disorder (MOUD). We describe overall and stratified temporal trends and used linear probability models with interaction terms to test their significance.

Result: We found 42,437 (16.2%) infants with prenatal exposure; most (90.5%) reflected analgesic opioids. From 2010 to 2019, overall exposure declined 12.8 percentage points (95% CI = 12.1-13.1). Reductions were observed across maternal demographic groups and in both rural and urban settings, though the extent varied. There was a small reduction in chronic analgesic exposure and a concurrent increase in MOUD.

Conclusion: Broad and sustained declines in prenatal prescription opioid exposure occurred over the decade, with little change in the percentage of infants chronically exposed.

Grants and funding

R01 HD102125/HD/NICHD NIH HHS/United States