TY - JOUR AU - Cassandra R. Duffy AU - Jason D. Wright AU - Ruth Landau AU - Mirella J. Mourad AU - Zainab Siddiq AU - Adina R. Kern-Goldberger AU - Mary E. D'Alton AU - Alexander M. Friedman A1 - AB - OBJECTIVE: To assess trends in use of long-acting opioids during delivery hospitalizations. METHODS: The Perspective database, an administrative inpatient database that includes medication receipt, was analyzed to evaluate patterns of long-acting opioid use during delivery hospitalizations from January 2006 through March 2015. Medications evaluated included methadone, formulations including buprenorphine and extended-release formulations of oxycodone, morphine, fentanyl, and other opioids. Temporal trends in use of these medications were determined. Unadjusted and adjusted models evaluating the role of demographic and hospital factors were created evaluating both use of these medications and risk for severe morbidity. Risk for severe morbidity was determined based on Centers for Disease Control and Prevention criteria. RESULTS: Our analysis included 2,994,630 delivery hospitalizations meeting study criteria. Over the entire study period, use of long-acting opioids increased significantly from 457 to 844 per 100,000 deliveries. Although buprenorphine and methadone use increased, use of other long-acting opioids decreased. In 2006, methadone and buprenorphine accounted for less than one third of all long-acting opioids used during delivery hospitalizations. By 2015, buprenorphine and methadone represented 73.5% of long-acting opioids used. In adjusted and unadjusted models, risk for severe morbidity was significantly lower with buprenorphine or methadone compared with other long-acting opioids. Restricting the cohort to only women with drug abuse or dependence, risk for severe morbidity was lower with methadone and buprenorphine than without any long-acting opioids. CONCLUSION: Increased use of methadone and buprenorphine in this study supports the feasibility of use of these medications during pregnancy and uptake of clinical recommendations for women with opioid use disorder. Use of methadone and buprenorphine is associated with decreased maternal morbidity, although causation cannot be presumed from this study model. AD - Departments of Obstetrics and Gynecology and Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, New York. BT - Obstetrics and gynecology C5 - Healthcare Disparities; Opioids & Substance Use CP - 4 CY - United States DO - 10.1097/AOG.0000000000002861 IS - 4 JF - Obstetrics and gynecology LA - eng M1 - Journal Article N2 - OBJECTIVE: To assess trends in use of long-acting opioids during delivery hospitalizations. METHODS: The Perspective database, an administrative inpatient database that includes medication receipt, was analyzed to evaluate patterns of long-acting opioid use during delivery hospitalizations from January 2006 through March 2015. Medications evaluated included methadone, formulations including buprenorphine and extended-release formulations of oxycodone, morphine, fentanyl, and other opioids. Temporal trends in use of these medications were determined. Unadjusted and adjusted models evaluating the role of demographic and hospital factors were created evaluating both use of these medications and risk for severe morbidity. Risk for severe morbidity was determined based on Centers for Disease Control and Prevention criteria. RESULTS: Our analysis included 2,994,630 delivery hospitalizations meeting study criteria. Over the entire study period, use of long-acting opioids increased significantly from 457 to 844 per 100,000 deliveries. Although buprenorphine and methadone use increased, use of other long-acting opioids decreased. In 2006, methadone and buprenorphine accounted for less than one third of all long-acting opioids used during delivery hospitalizations. By 2015, buprenorphine and methadone represented 73.5% of long-acting opioids used. In adjusted and unadjusted models, risk for severe morbidity was significantly lower with buprenorphine or methadone compared with other long-acting opioids. Restricting the cohort to only women with drug abuse or dependence, risk for severe morbidity was lower with methadone and buprenorphine than without any long-acting opioids. CONCLUSION: Increased use of methadone and buprenorphine in this study supports the feasibility of use of these medications during pregnancy and uptake of clinical recommendations for women with opioid use disorder. Use of methadone and buprenorphine is associated with decreased maternal morbidity, although causation cannot be presumed from this study model. PP - United States PY - 2018 SN - 1873-233X; 0029-7844 SP - 937 EP - 947 EP - T1 - Trends and Outcomes Associated With Using Long-Acting Opioids During Delivery Hospitalizations T2 - Obstetrics and gynecology TI - Trends and Outcomes Associated With Using Long-Acting Opioids During Delivery Hospitalizations U1 - Healthcare Disparities; Opioids & Substance Use U2 - 30204694 U3 - 10.1097/AOG.0000000000002861 VL - 132 VO - 1873-233X; 0029-7844 Y1 - 2018 Y2 - Oct ER -