Pregnancy-specific alcohol policies and admissions to substance use disorder treatment for pregnant people in the USA.
Alcohol Alcohol
; 58(6): 645-652, 2023 Nov 11.
Article
em En
| MEDLINE
| ID: mdl-37623929
ABSTRACT
AIMS:
We examined relationships between pregnancy-specific alcohol policies and admissions to substance use disorder treatment for pregnant people in the USA.METHODS:
We merged state-level policy and treatment admissions data for 1992-2019. We aggregated data by state-year to examine effects of nine pregnancy-specific alcohol policies on the number of admissions of pregnant women where alcohol was reported as the primary, secondary, or tertiary substance related to the treatment episode (N = 1331). We fit Poisson models that included all policy variables, state-level controls, fixed effects for state and year, state-specific time trends, and an offset variable of the number of pregnancies in the state-year to account for differences in population size and fertility.RESULTS:
When alcohol was reported as the primary substance, civil commitment [incidence rate ratio (IRR) 1.45, 95% CI 1.10-1.89] and reporting requirements for assessment and treatment purposes [IRR 1.36, 95% CI 1.04-1.77] were associated with greater treatment admissions. Findings for alcohol as primary, secondary, or tertiary substance were similar for civil commitment [IRR 1.31, 95% CI 1.08-1.59] and reporting requirements for assessment and treatment purposes [IRR 1.21, 95% CI 1.00-1.47], although mandatory warning signs [IRR 0.84, 95% CI 0.72-0.98] and priority treatment for pregnant women [IRR 0.88, 95% CI 0.78-0.99] were associated with fewer treatment admissions. Priority treatment findings were not robust in sensitivity analyses. No other policies were associated with treatment admissions.CONCLUSIONS:
Pregnancy-specific alcohol policies related to greater treatment admissions tend to mandate treatment rather than make voluntary treatment more accessible, raising questions of ethics and effectiveness.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Transtornos Relacionados ao Uso de Substâncias
/
Gestantes
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article