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In Pregnancy, Buprenorphine Use Up, Methadone Use Down

And the 4Ps Plus and SURP-P scale are sensitive for identifying illicit drug use in pregnancy

Please note: This article was published more than one year ago. The facts and conclusions presented may have since changed and may no longer be accurate. And "More information" links may no longer work. Questions about personal health should always be referred to a physician or other health care professional.

FRIDAY, April 12, 2019 (HealthDay News) -- From 2009 to 2015, the prevalence of methadone use decreased and buprenorphine use increased among Medicaid-enrolled pregnant women with opioid use disorder, and the 4Ps Plus and Substance Use Risk Profile-Pregnancy (SURP-P) scale are sensitive for identifying illicit drug use, according to two studies published online April 5 in Obstetrics & Gynecology.

Elizabeth E. Krans, M.D., from the Magee-Womens Research Institute in Pittsburgh, and colleagues evaluated 12,587 pregnancies among 10,741 women with opioid use disorder who had a live birth between 2009 and 2015 to examine trends in medication-assisted treatment, opioid pharmacotherapy, and behavioral health counseling. The researchers observed a decrease in the adjusted prevalence of methadone use from 31.6 to 25.2 percent; the adjusted prevalence of buprenorphine use increased from 15.8 to 30.9 percent.

Victoria H. Coleman-Cowger, Ph.D., from the Batelle Memorial Institute in Baltimore, and colleagues compared and assessed the accuracy of three screening tools to identify illicit drug use and prescription drug misuse in pregnant women. A sample of 500 pregnant women were enrolled and administered three index tests -- 4Ps Plus, NIDA Quick Screen-ASSIST (Modified Alcohol, Smoking and Substance Involvement Screening Test), and the SURP-P scale -- and reference tests. The researchers found that the sensitivity and specificity were 90.2 and 29.6 percent, respectively, for the 4Ps Plus; 79.7 and 82.8 percent, respectively, for the NIDA Quick Screen-ASSIST; and 92.4 and 21.8 percent, respectively, for the SURP-P.

"The dissemination of a strong and clear recommendation for a clinically useful prescription and illicit drug screening tool for pregnant women is highly significant, relevant for public health, and will likely increase screening," Coleman-Cowger and colleagues write.

One author from the Krans study disclosed financial ties to the pharmaceutical industry.

Abstract/Full Text (subscription or payment may be required) - Krans
Abstract/Full Text (subscription or payment may be required) - Coleman-Cowger

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